Making clinical audit data transparent
In his transparency and open data letter to Cabinet Ministers on 7 July 2011, the Prime Minister restated the commitment to make clinical audit data available from the national audits within the National Clinical Audit and Patient Outcomes Programme. The National Lung Cancer Audit (NLCA) was identified as the pilot for this data release.
These data will be released in an open and standardised format for the first time in December 2011, and provided annually from then onwards.
Covering all Cancer Networks and NHS Trusts in England, the data from the audit includes information about data completeness, audit process and outcome measures. The data will be available in a pdf format in the National Lung Cancer Audit 2011 annual report.
What information is being made available?
Measures about the process of care given to patients
Information about care outcomes and treatment.
The data also provides Audit participation by Trust and data completeness for the key fields; These data do not list data about individual patients nor does it contain any patient identifiable data.
Using and interpreting the data
Data from the National Lung Cancer Audit requires careful interpretation, and the information should not be looked at in isolation when assessing standards of care.
Data are provided either by cancer network or by place first seen in secondary care for the calendar year 2010. As a result, some trusts that only provide some specialist treatments for patients and do not supply diagnostic data are not properly represented in these data. This is because all the analyses of the NLCA to date have been carried out by 'place first seen' and cancer networks. The ‘place first seen' is the Clinical Multi-Disciplinary Team (MDT) which makes the first treatment decisions (in partnership with representatives from the specialist centres who sit on these peripheral MDTs).
We largely know the population base for these MDTs and that number provides the ‘denominator' for the outcome measures. It is much more difficult to define a population denominator for specialist centres and the treatment they provide is usually only one part of a complex care pathway. So taking the raw data at face value gives a very distorted picture both of their activity and performance. Therefore their performance should not be assessed from the results as published here. These trusts do however fully participate in the audit by providing treatment data for the referring MDTs.
The trusts concerned are:
The Christie NHS Foundation Trust
University Hospitals of South Manchester NHS Foundation Trust
Clatterbridge Centre for Oncology NHS Foundation Trust
Royal Brompton and Harefield NHS Foundation Trust
The Royal Marsden NHS Foundation Trust
Papworth Hospital NHS Foundation Trust
Accessing the data
The data are being made available on the data.gov website. Each year two files of data from the National Lung Cancer Audit will be made available in CSV format. Trusts and Networks are identified by name and their national code.
What does the data cover?
The data measure levels of completeness for data submitted to the NLCA and measures of performance in the audit at trust level for key performance measures for assessing standards of care for lung cancer in secondary care. Details of these standards can be found in appendix 2 of the NLCA report.
Are all Trusts included?
All Trusts in England that manage patients diagnosed with lung cancer or mesothelioma are included.
What period does the data cover?
This data were extracted from the NLCA database in July 2011 and covers patients first seen in the calendar year 2010.