Percentage uptake of breast screening Five year relative survival rate for breast cancer
Breast cancer surgical activity Percentage uptake of cervical screening Five year relative survival rate for
cervical cancer
Colon cancer surgical activity Five year relative survival rate for
colorectal cancer
Rectal cancer surgical activity
33 Helping people to stay healthy and well; supporting people with long term conditions; helping people when they are being treated and cared for in our health services; supporting people to have positive experiences of health care; treating and caring for people in a safe environment.
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The Department of Health will develop further indicators as appropriate under the NHQRS to assess progress in achieving the objectives of this Strategy.
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Recommendation
The NCCP will develop, publish and monitor a programme of national quality healthcare indicators for cancer care, involving both process and outcome measures, in line with international standards.
Lead: NCCP
11.8. Adverse Events, the National Incident Management System and Open Disclosure
The further development and rationalisation of cancer care, as proposed in this Strategy is intended to enhance the quality of care to patients. However, the delivery of healthcare is inherently risky, and its scale and complexity is without parallel in other sectors and businesses. It is essential that we are always vigilant with regard to quality and that we have a strong patient safety culture.
The reporting of adverse events is one indicator of a strong patient safety culture. Healthcare services covered by the Clinical Indemnity Scheme are legally obliged to report all adverse events, including Serious Reportable Events (SREs), on the National Incident Management System (NIMS) to the State Claims Agency. Legislation is being progressed which will require providers to report SREs to the State Claims Agency, HIQA and the Mental Health Commission. Cancer services will report adverse events and will support open disclosure with patients and their families in parallel with other services in the health system.
11.9. Clinical Effectiveness
The National Clinical Effectiveness Committee (NCEC) is charged with prioritising and quality assuring, to the level of international methodological standards, a suite of National Clinical Guidelines and National Clinical Audit for the Irish health system. Clinical guidelines are internationally recognised methods for defining healthcare interventions, improving the effectiveness of care and treatment and reducing variation in care delivery. Policies, procedures, protocols and guidelines are also a source of robust, quality information for patients. Development of these Guidelines is informed by the NCEC Standards for
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clinical practice guidance should be prioritised in a systematic manner, in line with the service need and the methodological rigour required.
NCEC National Clinical Guidelines and National Clinical Audit endorsed by the Minister for Health are mandated for implementation in the Irish health system and their implementation will be monitored through HSE Performance Assurance Reports, compliance with the National Standards for Safer Better Healthcare and increased alignment with the Clinical Indemnity Scheme. There should be a focus on guideline implementation and audit performance, and on ensuring that the resources and clinical leadership to support the development and implementation of prioritised guidelines and audit are available. Where appropriate, high quality international guidelines should be formally adapted for the Irish healthcare setting.
Fourteen NCEC National Clinical Guidelines have been published to date. A number of these relate directly to cancer services as outlined below. Further guidelines in relation to lung, colon, rectal, pancreatic and oesophageal cancer are being developed by the NCCP.
National Clinical Guidelines Relating to Cancer and Palliative Care
NCG No. 7 Diagnosis, Staging and Treatment of Patients with Breast Cancer, June 2015 NCG No. 8 Diagnosis, Staging and Treatment of Patients with Prostate Cancer, June 2015 NCG No. 9 Pharmacological Management of Cancer Pain in Adults, Nov 2015
NCG No. 10 Management of Constipation in Adult Patients receiving Palliative Care, Nov 2015
NCG No. 13 Diagnosis, Staging and Treatment of Patients with Gestational Trophoblastic Disease, Nov 2015
Future National Clinical Guidelines relating to cancer should include where appropriate recommendations on MDT location and composition, and on centralisation of services, as well as descriptions of how care should be structured at a community, regional and national level. Where necessary, these guidelines should also include recommendations relating to the
establishment of Rapid Access Clinics.
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Recommendation
The NCCP will develop further guidelines for cancer care in line with National Clinical
Effectiveness Committee (NCEC) Standards. Audits will also be developed in accordance with the NCEC Framework for National Clinical Audit.
Lead: NCCP/NCEC
11.10. Leadership in Safe, High Quality Cancer Care
Leadership, governance, clinical commitment and clinical effectiveness approaches are required to deliver safe, high quality cancer care at national, regional and local level. There is a need for investment in capacity development for quality and patient safety in our cancer services. This requires that each service/hospital has a dedicated patient safety and quality leadership and oversight function, which encompasses both cancer patient safety elements (e.g. complaints procedures, advocacy, and management of risk and adverse events) and cancer quality elements such as standards, clinical effectiveness guidelines, audit and key performance indicators.
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