Review of colorectal cancer quality performance indicators: consultation

Appendix 1: QPI Development Process

Preparatory Work and Scoping

NHS Quality Improvement Scotland ( QIS) Clinical Standards for Colorectal Cancer already existed, and were utilised nationally. It was therefore agreed that rather than undertake a lengthy QPI development process the extensive literature search and clinical discussion undertaken in the recent review of NHS QIS Colorectal Cancer 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 Colorectal 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.

Bowel screening and primary care referral were not included within the scope of the QPI development process as significant work is already being undertaken across NHSScotland to measure and improve the quality of these important areas. Specifically this work includes the Scottish Bowel Screening Programme and the Scottish Governments Detect Cancer Early Initiative.

Indicator Development

The Colorectal 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 clinical recommendations set out in the briefing paper as a base, ensuring all indicators met 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?

Engagement Process

A wide clinical and public engagement exercise was undertaken as part of development in April 2013 where the Colorectal 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 colorectal cancer and the wider public were given the opportunity to influence the development of Colorectal Cancer QPIs.

Draft documentation was circulated widely to professional groups, health service staff, voluntary organisations and individuals for comment and feedback.

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