Reducing variation in clinical practice for prostate cancer diagnosis across South West England
Challenge
There was considerable variation in the prostate cancer diagnostic and patient experience across South West England.
Working together with Peninsula Cancer Alliance and Somerset, Wiltshire, Avon and Gloucestershire Cancer Alliance, we aimed to improve equitable access to high-quality diagnostics, reduce variation and improve time to diagnosis to comply with the 28-day standard.
What we did
The project was led and funded by the SW Cancer Alliances. They worked with the urology Clinical Advisory Groups including patient representatives in both Alliances to form the Prostate Working Group.
We were the partner identified to provide the data analysis, subsequent dashboard development and IG expertise.
Initial stakeholder engagement involved questionnaires and follow-up provider site visits by the project team. This was to understand the variation that exists across the pathway and how these impact on patient experience. These visits resulted in meaningful discussions with clinicians, managers and patients about the pathway and helped to identify the improvement required. Following the visits, a SW prostate pathway transformation event was held to share findings and gain commitment to implement change. This was attended by representatives from acute providers (clinical, nursing and management), Prostate Cancer UK, patient representatives, and GP cancer clinical leads.
We continue to be a key part of the working group and have linked closely with the group to define and agree the dashboard metrics. This has resulted in the dashboard having relevant clinical and operational metrics.
Activity
Analytics and business intelligence
Provided data analysis and insight on patients with suspected prostate cancer
Information governance
Provided IG expertise to support how the dashboard could inform service redesign
Cancer and long-term conditions
Working with Cancer Alliances to deliver sustainable and equitable services
Data-driven decision-making
Developed a prostate cancer dashboard to be used by key stakeholders to enable engagement and decision-making
Outcome
Data from the dashboard has raised the standard of care across all 13 providers ensuring equity of access to high-quality and timely services for patients. This includes the introduction of straight-to-MRI testing in 5 of 13 providers with others actively considering how to implement it.
Detailed pathway analysis has identified areas of success and challenge across providers and has enabled targeted service improvement activity to support the achievement of performance standards. This results in earlier and faster diagnosis for patients and improved survival outcomes.
There is an ambition to develop the dashboard into a national tool. This has received support from Prostate Cancer UK and would result in a rich repository of data to improve patient outcomes on a wider scale.
Outputs and learning from the project have been shared with other Cancer Alliances in England, the National Cancer Programme and with Health Boards and Trusts in Wales and Scotland at virtual and face-to-face meetings and events.
