Transparency agenda: first clinical audit work goes live with national lung cancer data

The first clinical audit-based outputs of the government's transparency agenda have gone live today, with data from the National Lung Cancer Audit (NLCA) available on the data.gov.uk website in a new, more flexible format to allow easier access and more dynamic capabilities.

In his transparency and open data letter to cabinet ministers on 7 July 2011, Prime Minister David Cameron restated the commitment to make available clinical audit data from the national audits within the National Clinical Audit and Patient Outcomes Programme (NCAPOP), commissioned and managed by HQIP.  NLCA, carried out by the NHS Information Centre, was identified as the pilot for this data release.

Covering all Cancer Networks and NHS Trusts in England the data includes information about data completeness, audit process and outcome measures.

The information on Data.Gov is taken from the NLCA annual report, published earlier this month and includes information regarding:

• Measures about the process of care given to patients
• Information about care outcomes and treatment
• Audit participation by Trust
• Data completeness for the key fields;

The data is available via this link: http://data.gov.uk/dataset/national-lung-cancer-audit-2011-annual-report

Previously only available as a PDF (therefore not allowing individual results to be highlighted and shared), the data is now released as CSV files, an open and standardised spreadsheet-style format. This will now become standard practice for all NCAPOP audits reporting from April 2012 onwards.

Notes on the data and its interpretation:

Patient identification:

Please note, this data does not list data about individual patients nor does it contain any patient identifiable data.

Full NLCA annual report:

The data is available in a pdf format in the NLCA 2011 annual report, available here.

Using and interpreting the data:

Data from the NLCA requires careful interpretation, and the information should not be looked at in isolation when assessing standards of care.

Data is 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) who 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 is 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 measures 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 available at http://www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncasp/audit-reports/lung-cancer

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 was extracted from the NLCA database in July 2011 and covers patients first seen in the calendar year 2010.