Cancer Data Dashboard: How to guide for MPs in England

This guide is designed to help you review cancer data in your local area so you can assess the quality of services.

A new online dashboard of cancer-related information was launched by Public Health England and NHS England in May 2016.

Monitoring key metrics in the cancer dashboard will allow you to effectively scrutinise your Clinical Commissioning Group’s (CCG) and local providers’ performance. This will enable you to work with them and others, to identify ways to improve local cancer services.

What can you do locally?

Use your local data to make change happen.

Compare

Compare your local statistics against the national average.

Meet

Meet with local patient groups and constituents to find out about their experiences of local cancer services.

A hand, notepad and keyboard.

Write

Write to the Chief Executive of your local Clinical Commissioning Group and hospital Trust to ask what is being done to improve cancer outcomes.

Houses of parliament

Ask

Ask Parliamentary Questions on the issues covered by the metrics to ensure the implementation of the England Cancer Strategy remains a Government priority.

The key metrics to monitor now and what to look out for:

The cancer dashboard covers data for survival, treatment, patient experience, quality of life, operational performance and incidence and mortality.

Within these areas, there are three key metrics we recommend you monitor:

  • Incidence – how many people have cancer in your area?
  • One-year survival – how many people are living 1 year after a cancer diagnosis?
  • Overall experience of care – how do individuals rate their care?

When assessing the performance of your local services, you may wish to explore how the data compares to the national average and any trends from previous years.

How many people have cancer in your area?

Incidence data records the number of new cases of cancer diagnosed in your area, within a specific timeframe.

Why look at incidence rate?

This data is important to monitor as higher than average incidence rates could:

  • indicate potential risk factors in your area
  • allow local health leaders to assess whether targeted prevention and public health programmes are needed.

Using the data

These data are age-standardised, which means that the statistics are adjusted to take into account the age range of the population in question, making it fairer to compare one area to another.

It is also useful to look at this data alongside prevalence data which counts the number of people still alive who have been diagnosed with cancer in the past. Cancer prevalence reflects trends in cancer incidence, mortality and survival, as well as advances in cancer treatment and detection, and the ageing of the population.

You can find cancer prevalence data, including projected 20-year cancer prevalence for your CCG by using the Local Cancer Intelligence Tool.

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How many people are living for 1 year after a cancer diagnosis?

The proportion of adults living one year after survival is a key metric for which CCGs are now accountable for.

Although cancer survival is improving, the UK is significantly weaker than comparable European countries on ensuring that patients reach the one-year mark.i

Why monitor one-year survival rates?

One year survival rates are widely considered to be an important measure of early diagnosis. In order to support progress in one year survival rates, delivering year on year improvement in the proportion of cancers diagnosed at stage one and stage two, and reducing the proportion of cancers diagnosed following an emergency admission, are seen as key.

Therefore, when analysing this data it is important to examine what steps are being taken by your local CCG to promote early diagnosis. It is also useful to look at this data alongside five-year survival rates to assess how successful local services are at helping people survive cancer in the longer term.

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How do individuals rate their care?

Using data from the National Cancer Patient Experience Survey (CPES), this indicator measures the total number of positive responses to the question 'Overall, how would you rate your care?'.

Why look at overall experience of care?

Improving cancer patient experience is one of three key ambitions outlined in the new Cancer Strategy for England, with the Taskforce setting an ambition for the measurement to be given equal priority to clinical outcomes. While it is essential that patients receive the most appropriate treatment, their experience of care is vital and evidence shows that it also has an impact on the patient’s outcomes.

Monitoring patient experience data helps to measure and assess the quality of patient care at your local provider on a wide range of issues, and can ultimately drive meaningful improvement on the ground.

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Quality of life

Quality of life data will be available in the near future.

One of the recommendations set out in the new Cancer Strategy is that a metric or set of metrics are developed to encourage providers and commissioners to focus more consistently on improving people’s quality of life during their treatment.

Why we need quality of life data

Macmillan lobbied for this recommendation on the basis that embedding a quality of life metric in accountability mechanisms clearly sets out that patient experience is a priority at a national level. With an estimated 3.4 million people expected to be living with cancer in England by 2030, it is crucial that quality of life is monitored in your local area to encourage NHS England, hospitals and other providers to do more to improve how people living with cancer experience their care.

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Further information about the cancer dashboard

Why is this data important?

By the end of this Parliament, about one in every two people will be diagnosed with cancer in their lifetime.ii However, improvements in diagnosing and treating the disease mean that:

  • More people are surviving, or living longer with cancer. 
  • 2.5 million people are living with or beyond cancer in the UK today; a figure which is expected to rise to an estimated 4 million by 2030.

Evidently the burden of cancer is ever increasing and the cost will continue to rise rapidly during this Parliament. 

The Five Year Forward View projections indicate:

  • Expenditure on cancer services will need to grow by about 9% a year, reaching £13 billion by 2020/21iii;
  • this growth is at between two and three times the rate of other health spend.iv 

The Cancer Strategy sets out clear recommendations for how to make radical improvements in the outcomes the NHS delivers for everyone affected by cancer, from pre-diagnosis to post-treatment, including quality of care. It also includes recommendations on improving access to treatments and end of life care. However, more work needs to be done to ensure that its recommendations are put into practice so that the ambition to save an additional 30,000 lives each year by 2020 through these initiatives is achieved.

Given this, it is increasingly important to scrutinise cancer services locally to drive improvements and ensure people survive cancer and are able to live well after treatment.

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Why has the Cancer Dashboard been created?

In July 2015 the Independent Cancer Taskforce published the new Cancer Strategy for England: Achieving World-Class Cancer Outcomes

One of the key themes to emerge from the report was the need to make better use of data to underpin service improvements. The new Strategy sets out a number of key national ambitions to achieve by 2020, including improving performance across incidence, survival, patient experience and quality of life.

The creation of an integrated cancer data dashboard

However, in order to achieve the ambitions set by the Taskforce, the first recommendation in the report is for the creation of an integrated cancer data dashboard. The purpose of the dashboard is to bring together, and make more readily available, data across the whole cancer pathway at Clinical Commissioning Group (CCG), provider and national levels.

The 16 Alliances

As part of the implementation of the Strategy, NHS England will establish Cancer Alliances from September 2016 consisting of clinical and other local leaders from across different health and care settings. These Alliances will need to be an effective way of creating a joined-up environment and culture of improvement, and should be a vital enabler for delivering better outcomes for people affected by cancer. Having them in place means there will be national leadership to help guide how local services are delivered, to make sure patients do not fall into gaps between different parts of their care.

The 16 Alliances should use the data for their area to support improvements and provide the basis of evidence and intelligence for conversations to integrate care pathways and improve services. The development of Sustainability and Transformation Plans (STPs) by the 44 STP footprints in England provides the context in which this new approach to collaborative, cross-organisation, whole-pathway planning and improvement in cancer services sits.

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How does the Dashboard work alongside the new CCG improvement and assessment framework?

For 2016/17 NHS England has introduced a new CCG Improvement and Assessment Framework. Alongside carrying out its statutory function of conducting an annual assessment of each CCG, this new framework provides a greater focus on assisting improvement and is designed to play an important role in the delivery of the Five Year Forward View (FYFV).

The FYFV sets out national ambitions for improvements in a number of clinical priority areas including:

  • mental health
  • dementia
  • learning disabilities
  • diabetes
  • maternity
  • and cancer. 

As part of this, NHS England will publish online CCG ratings for each of these six clinical areas on a four point ‘Ofsted-style’ scale, which means local health bodies and communities will be able to assess their own progress on cancer.

The cancer dashboard will link closely with the new CCG Improvement and Assessment Framework and all indicators included in the CCG IAF will be included in the dashboard. In addition, the dashboard will help to provide context for these indicators and allow a broader view of cancer services to be developed across a CCG.

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Contact us

If you would like more information on this, a tailored local briefing or a face to face meeting to discuss this with Macmillan we would be very happy to arrange this, please contact: parliament@macmillan.org.uk

References

i 'One Year Cancer Survival Rates: Measuring Progress', The All Party Parliamentary Group on Cancer
ii Macmillan estimate based on; Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202. (Scenario 1 presented here)   Forman D, et al. Cancer prevalence in the UK: results from the EUROPREVAL Study. Annals of Oncology. 2003. 14: 648–654; Office for National Statistics; Information Services Division (ISD) Scotland; General Registrar Office Scotland; Welsh Cancer Intelligence & Surveillance Unit; Northern Ireland Cancer Registry; Northern Ireland Statistics and Research Agency
iii FYFV forecasts were based on a Technical Annex published in December 2013, which included assumptions indicating that budget lines related to cancer are likely to grow by around 9% per annum over the next five years, in the absence of any efficiency savings. Described further in the 2015 Cancer Strategy: Independent Cancer Taskforce (2015), 'Achieving world-class cancer outcomes: A strategy for England, 2015-2020', p. 6.
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