Brain and central nervous system cancer: clinical quality performance indicators - engagement document

3. QPI Formal Review Process

As part of the National Cancer Quality Programme, a systematic rolling programme of national review process has been developed. This ensures all tumour specific QPIs are subject to formal review following every 3rd year of comparative QPI data analysis.

The formal review process is clinically driven with proposals for change sought from specialty specific representatives in each of the Regional Cancer Networks. It is designed to be flexible in terms of the extent of review required with tumour specific Regional Clinical Leads undertaking a key role in this decision making. Formal review meetings to further discuss proposals are arranged where deemed necessary. The review builds on existing evidence using expert clinical opinion to identify where new evidence is available, and a full public engagement exercise will take place where significant revisions have been made or new QPIs developed.

During formal review QPIs may be archived and replaced with new QPIs. Triggers for doing so include significant change to clinical practice, targets being consistently met by all Boards, and publication of new evidence. Where QPIs have been archived, associated data items will continue to be collected where these are utilised for other indicators, or measures such as survival analysis.

Any new QPIs are developed in line with the following criteria:

• Overall importance – does the indicator address an area of clinical importance that would significantly impact on the quality and outcome of care delivered?
• Evidence based – is the indicator based on high quality clinical evidence?
• Measurability – is the indicator measurable i.e. are there explicit requirements for data measurement and are the required data items accessible and available for collection?

Three formal reviews of the Brain/CNS Cancer QPIs have been undertaken to date. Further information can be found in appendix 2.