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. 2000 Jul 24;83(4):421–425. doi: 10.1054/bjoc.2000.1302

Performance and standards for the process of head and neck cancer care: South and West audit of head and neck cancer 1996–1997 (SWAHN I)

M A Birchall 1, D Bailey 2, A Lennon 2; on behalf of the South and West Regional Cancer Organisation Tumour Panel for Head and Neck Cancer2
PMCID: PMC2374665  PMID: 10945484

Abstract

Evidence suggests wide variation in cancer care between different hospitals in the UK. To establish bench-marking data, we designed a prospective, 1 year regional study comparing key performance measures with established standards for the 28 hospital Trusts in the South and West of England involved in head and neck cancer care. 566 sequential patients with a newly-diagnosed head and neck cancer were included. Numbers referred and treated per hospital Trust were 1–58 and 1–65 respectively. 59% of patients received a pretreatment chest X-ray (standard 95%). 45% of patients were seen in a multidisciplinary clinic pretreatment (standard 95%), and this was proportional to the frequency of clinics held (P< 0.0001). Median number of cases treated per surgeon was 4 (1–26), and by radiotherapist was 10 (1–51). Times between parts of the process of oral cancer care were closer to the standards than those for laryngeal cancer. Two patients were entered into a clinical trial. One had a quality-of-life score. Thus, in 1996–1997, in the South and West of England, there were major discrepancies between actual performance and established standards in many fundamental aspects of head and neck cancer care. Re-audit is essential to determine if the implementation of the Calman–Hine report has resulted in improvements. © 2000 Cancer Research Campaign

Keywords: performance indicators, standards, process, audit, head and neck cancer

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Selected References

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  1. Birchall M. A. Consensus standards for the process of cancer care: a modified expert panel method applied to head and neck cancer. South and West Expert Tumour Panel for Head and Neck Cancer. Br J Cancer. 1998 Jun;77(11):1926–1931. doi: 10.1038/bjc.1998.319. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Dickinson A. J., Howe K., Bedford C., Sanders T., Prentice A., Sibley G. N. A retrospective study of the investigation and management of muscle-invasive bladder cancer in the South West Region. Br J Urol. 1996 Jan;77(1):70–75. doi: 10.1046/j.1464-410x.1996.82611.x. [DOI] [PubMed] [Google Scholar]
  3. Dische S., Saunders M., Barrett A., Harvey A., Gibson D., Parmar M. A randomised multicentre trial of CHART versus conventional radiotherapy in head and neck cancer. Radiother Oncol. 1997 Aug;44(2):123–136. doi: 10.1016/s0167-8140(97)00094-7. [DOI] [PubMed] [Google Scholar]
  4. Edwards D. M., Johnson N. W. Treatment of upper aerodigestive tract cancers in England and its effect on survival. Br J Cancer. 1999 Sep;81(2):323–329. doi: 10.1038/sj.bjc.6690695. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Edwards D., Johnson N. W., Cooper D., Warnakulasuriya K. A. Management of cancers of the head and neck in the United Kingdom: questionnaire survey of consultants. BMJ. 1997 Dec 13;315(7122):1589–1589. doi: 10.1136/bmj.315.7122.1589. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Houghton D. J., Hughes M. L., Garvey C., Beasley N. J., Hamilton J. W., Gerlinger I., Jones A. S. Role of chest CT scanning in the management of patients presenting with head and neck cancer. Head Neck. 1998 Oct;20(7):614–618. doi: 10.1002/(sici)1097-0347(199810)20:7<614::aid-hed6>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  7. Jackson S., Murdoch J., Howe K., Bedford C., Sanders T., Prentice A. The management of cervical carcinoma within the south west region of England. Expert Tumour Panel. Br J Obstet Gynaecol. 1997 Feb;104(2):140–144. doi: 10.1111/j.1471-0528.1997.tb11033.x. [DOI] [PubMed] [Google Scholar]
  8. Kee F., Wilson R. H., Harper C., Patterson C. C., McCallion K., Houston R. F., Moorehead R. J., Sloan J. M., Rowlands B. J. Influence of hospital and clinician workload on survival from colorectal cancer: cohort study. BMJ. 1999 May 22;318(7195):1381–1385. doi: 10.1136/bmj.318.7195.1381. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Levendag P. C., Nowak P. J., van der Sangen M. J., Jansen P. P., Eijkenboom W. M., Planting A. S., Meeuwis C. A., van Putten W. L. Local tumor control in radiation therapy of cancers in the head and neck. Am J Clin Oncol. 1996 Oct;19(5):469–477. doi: 10.1097/00000421-199610000-00009. [DOI] [PubMed] [Google Scholar]
  10. Martin I. G., Young S., Sue-Ling H., Johnston D. Delays in the diagnosis of oesophagogastric cancer: a consecutive case series. BMJ. 1997 Feb 15;314(7079):467–470. doi: 10.1136/bmj.314.7079.467. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Rogers S. N., Lowe D., Brown J. S., Vaughan E. D. A comparison between the University of Washington Head and Neck Disease-Specific measure and the Medical Short Form 36, EORTC QOQ-C33 and EORTC Head and Neck 35. Oral Oncol. 1998 Sep;34(5):361–372. doi: 10.1016/s1368-8375(98)00031-1. [DOI] [PubMed] [Google Scholar]
  12. Ryall R. D. Medical manpower and workload in clinical oncology in the United Kingdom. Clin Oncol (R Coll Radiol) 1992 Mar;4(2):69–70. doi: 10.1016/s0936-6555(05)80966-5. [DOI] [PubMed] [Google Scholar]
  13. Shepherd N. A., Quirke P. Colorectal cancer reporting: are we failing the patient? J Clin Pathol. 1997 Apr;50(4):266–267. doi: 10.1136/jcp.50.4.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Stiller C. A. Centralisation of treatment and survival rates for cancer. Arch Dis Child. 1988 Jan;63(1):23–30. doi: 10.1136/adc.63.1.23. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Tobias J. S. Management of head and neck cancer in Britain. BMJ. 1997 Dec 13;315(7122):1556–1556. doi: 10.1136/bmj.315.7122.1556. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Wilson G. D. Tpot and head and neck cancer: where are we now? Anticancer Res. 1998 Nov-Dec;18(6B):4801–4805. [PubMed] [Google Scholar]

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