Breast Cancer Clinical Quality Performance Indicators Engagement Document.

Appendix 1: QPI Development Process

Preparatory Work and Scoping

NHS Quality Improvement Scotland (formerly Clinical Standards Board for Scotland) Clinical Standards for Breast Cancer have been utilised nationally since 2001. It was therefore agreed that rather than undertake a lengthy QPI development process the extensive literature search and clinical discussion undertaken in the review of NHS Quality Improvement Scotland ( NHSQIS) breast standards (in 2008) was used as the basis for QPI development.

The preparatory work involved the development group members independently reviewing and assessing the existing NHS QIS Breast Cancer Standards against agreed criteria and identifying any potential gaps where they considered a need to develop new outcome focussed quality indicators. Responses were then collated and the output of this exercise used to inform development group discussions.

Indicator Development

The Breast Cancer QPI Development Group defined evidence based, measurable indicators with a clear focus on improving the quality and outcome of care provided.

The Group developed QPIs using the existing NHS QIS clinical standards as a base. Draft QPIs were then assessed by the Breast Cancer QPI Development Group against three 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?

Engagement Process

A wide clinical and public engagement exercise was undertaken as part of development in 2011 where the Breast Cancer QPIs, along with accompanying draft minimum core dataset and measurability specifications, were made available on the Scottish Government website.

During the engagement period clinical and management colleagues from across NHSScotland, patients affected by breast cancer and the wider public were given the opportunity to influence the development of Breast Cancer QPIs. Several different methods of engagement were utilised:

Professional groups, health service staff, voluntary organisations and individuals:

• Wide circulation of the draft documentation for comment and feedback.

Patient representative groups:

• Organised patient focus group sessions were held in conjunction with Cancer Support Scotland (Tak Tent) and Breakthrough Breast Cancer.

Following the engagement period all comments and responses received were reviewed by the Breast Cancer QPI Development Group and used to produce and refine the final indicators.