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Scottish model suggested for cancer patient and quality initiative

Recommendation 34 of the National Cancer Strategy 2017-2026 states the NCCP will ensure that each cancer centre has a clearly-defined framework for assessing cancer patient safety and quality.

As background to the implementation process, the NCCP examined a number of international cancer care quality frameworks and has agreement from the Executive Committee that the model used in Scotland should be used as a template for modification and adaption into an Irish context.

The Scottish framework involves local, regional and national processes with responsibilities and activities from different bodies within NHS Scotland. Within the Scottish Cancer Quality Framework, tumour-specific quality performance indicators (QPIs) are developed with clinical leads.

A rolling programme of self-assessment against the indicators is progressed on a three-year cycle within the cancer centres, while local governance structures are used to review performance, develop local action plans and monitor delivery.

The (Scottish) National Cancer Quality Steering Group has responsibility for development of QPIs and overseeing the implementation of the national governance framework.

According to a briefing paper prepared on the subject, seen by MI, advantages of the model for Ireland include: Similar population size and resources; similar demographics and cancer incidence rates; clinical lead groups already established for K/QPI development; capacity for QPI development already in place as KPIS have been developed; and cancer centres have data managers in place and a process for data collection.

Some disadvantages are: The regional component is missing from the structure with the HSE, and specific and wide-spread data-collection and management capability is not currently compatible with the Irish system due to the lack of national data-management infrastructure.

Also, the report states the Scottish QPIs are very specific, with “stringent” definitions and high target thresholds which would be too burdensome for translation to the Irish system.

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