NCQSG 13/38
SCOTTISH GOVERNMENT HEALTH AND SOCIAL CARE DIRECTORATES
The Quality Unit / Clinical Priorities
The National Cancer Quality Steering Group (NCQSG)
ACTION NOTES: 11th December 2013
Present
Hilary Dobson (Chair) (HD)
Roger Black (RB)
James Docherty (JD)
Rob Jones (RJ)
Iona Scott (IS)
David Brewster (DB)
Evelyn Thomson (ET)
Karen Ritchie (KR)
Brian Murray (BM)
Ken O’Neill (KO)
Kate MacDonald (KM)
Matthew Barber (MB)
Belinda Henshaw (BH)
Andrew Anderson (AA)
Debbie Schofield (DS)
In attendance
Helen Stevens (HS)
Niall Taylor (NT)
Andrew McLeish (AM)
By Teleconference
Neil McLachlan (NM)
(Via mobile phone due to VC equipment error)
Apologies
Alan Finlayson (AF)
Maggie Grundy (MG)
1
1
Item/Topic
Welcome and apologies
2
Action notes from previous
meeting (NCQSG 13/25)
3.
Matters arising
3.1 Recurrence data
3.2 National Meetings
Upper GI Cancer – 15th
November 2013 (Paper
13/27)
Discussion
Members were welcomed and introduced
themselves. Apologies were noted as above and no
declarations of interest were recorded.
The action notes of the previous meeting (NCQSG
13/25) were agreed as an accurate record.
Action Agreed
Lead
Date
Post on SG
website
AM
ASAP
HD reported that she had spoken to VD and PK and
that it was proposed that a paper should be drafted
setting out an approach to get consistent data for
the whole of Scotland.
It was agreed that key clinical questions would have
to be considered and discussed further before this
could be drafted.
NM reported that an Upper GI Cancer event took
place on the 15 November 2013. Professor Derek
Alderson was at the event to present an unbiased
assessment between regions in Scotland.
Feedback from the event was positive and it was
noted that it included a comprehensive review of
Upper GI Cancer in Scotland.
NM reported that survival data had been received
but that this would need to be looked at further.
NM noted that data had been received from all
areas, but that there were concerns over the quality
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of the data. HD clarified that there is an agreed
process to collect and publish data.
HD noted that paper 13/27 was a debriefing of a
successful day, and as such suggested there was
no value in placing this in the public domain as it
doesn’t contain details as to how services will
improve.
HD noted that it is not clear from the paper what
action is being taken to improve services. JD sought
clarification on whether the paper was ever intended
for the public domain, and noted that the data is not
QPI data.
HD noted that it is essential to have a clear, agreed
reporting format before the public have access to
the data. HD reported that it was suggested that a
meeting be arranged with Dr Aileen Keel and other
key people to discuss this further.
HD to discuss the
reporting format
and scrutiny with
Dr Keel and other
key stakeholders.
HD,
ET,
BH
Update by
next
meeting
KM noted that information is being pulled from
Breast meeting which may help these discussions
and that this will be shared when available.
HD noted that it was important that the report noting
‘here’s where we are, here’s where we need to be,
and here’s what we’re going to do about it.’
BH raised concerns about yearly national reporting
of data and noted that it has the ability to cause
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confusion rather than provide clarity due to the
timescale. HD noted that this was why the narrative
was so important.
BH noted that media may still pick up on the raw
data and suggested that the 3 year cycle is arbitrary,
and should be intelligence-led, not time-led. This
was echoed by KR noting that an intelligence-driven
cycle is better. BH agreed to work with the group to
develop a flexible work plan going forward. HD
emphasised the importance of a robust scrutiny
model being developed.
HD noted that yearly reporting should be done by
Regions anyway, to drive improvement. BH noted
that this was fine as a national report for boards, but
would be difficult, and caution should be given to
publishing this without advice. JD noted that NoScan
data is in the public domain already.
HD asked NM to consider further how we report on
national meetings, pointing out that there is a
template for the National Breast Cancer meeting. It
was agreed that slides from the November National
meeting would be sent to attendees.
HD reported that a Scottish-wide paper (which will
be going to the NPF) on what upper GI surgery is
like in Scotland will have to be produced and that
there are 3 options which could be included in the
report:
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1. have presentations on the web so that
attendees only can see them.
2. networks have regional reports on the web for
public consumption.
3. further discussion with regional leads on
reports.
JD suggested slides with narrative should be sent to
clinical leads in boards and asked to disseminate.
Concluding the discussion HD proposed that
documents of national meetings be sent to cancer
leads/clinical leads in each network, rather than
circulate widely in the public domain, and clinical
leads to confirm whether these can be made public.
HD confirmed that further discussion was needed on
this with NM.
QPI Development
Programme
4.1 QPI Development
 Tumour specific QPI
Update (13/28)
HD to take
forward further
discussions with
NM about the OG
paper
HD
Update
next
meeting
4
IS stated that QPIs for all cancer types included on
the QPI Development Programme will be in place by
October 2014.
RB left the meeting at 11:50. RB was thanked for his
work on the Dashboard.
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
Clinical Trial QPI
IS spoke to this item, and noted concerns around
definitions and target levels. IS stated that the
revised draft is to go to SLWG in near future, with
engagement envisioned for next year.

Patient Experience
QPIs (13/30)
DS spoke to this item, and DS noted minor
amendments after public engagement.
HD, BH, AA, IS all noted approval. DS was thanked
for an excellent document and HD noted the
importance of this work and thanked the Patient
Experience group for their work.
HD noted that it is important to ensure these QPIs
are aligned with other questionnaires and that
although patient experience can be measured by
using existing tools, it is deliberately flexible to allow
boards to do this in whatever way they see fit. IS
offered to include a sentence in the document to
cover this point.
The group agreed that these QPIs are ready for
engagement.
4.2 QPI Engagement
 Melanoma QPI
Engagement
Document (13/31)
BH asked if a SG letter could be sent with QPIs to
clarify purpose.
Discussion on QPI 12 :
JD noted his concern about the 30 day mortality
rate, and asked whether certain patients be put on
PC instead of radiotherapy. JD said that QPI 12 is
not ready for public consultation as yet.
IS to make
changes to QPI
document
IS
ASAP
This request to be
taken back by
secretariat for
discussion.
NT
Update
next
meeting
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JD also noted there were no views from
dermatologists and plastic surgeons and that it was
difficult to get comments on this.
Discussion on QPI 7
KO queried ’90 days’. It was agreed to change it to
84, go out to consultation, and see what comes
back.
Discussion on QPI 8
It was agreed this needs to be amended to fit SMC
guidance.
Discussion on QPI 11
BM noted a difference in lymphoedema services
across areas and tumour types. It was noted that all
patients should be seen by a lymphoedema
specialist and that this may need to be clarified.
HD said we need to be more proactive in assessing
lymphoedema since it can have late effects,
meaning assessment could be in a different
calendar year to the diagnosis. In this QPI, it may be
helpful to clarify the need to be more proactive in
assessing and having patients seen.
Discussion on QPIs 5 and 6
MB noted that the definitions are not as clear as
they could be. IS said that the dataset definitions are
tighter, and can be carried into the QPI.
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Discussion on QPI 9
JD noted that ‘high grade’ and ‘low grade’ is old
nomenclature and not used anymore as cancer is
now referred to by ‘stages’. Also, it needs to be
noted that PET CT isn’t in the guidelines and as
such this will need to be clarified.
HD left the meeting at 12:30 and ET continued to
chair the meeting.
4.3 QPI Publication
 Bladder Cancer QPI
Publication
(NCQSG 13/32)
Discussion on QPI 7
RJ and MB agreed that 3 months was a long
timescale and it sends a negative picture, but
conceded it reflects reality. IS noted that this was
based on the guidelines. ET noted that target needs
to be aligned with that of QPI 3 (target may be
challenging) and QPI 5.
IS to make
relevant changes
to document
.
IS
ASAP
Agree and advise
whether
glossaries are
required.
BH,
KR
ASAP
DB asked if audit data and SMROI data can be
compared.
Discussion on QPI 9
This needs to go back to the Tumour group.
There was also a short discussion on waiting times
and how these related to this QPI.
It was concluded that confirmation from HIS on
whether glossaries are required would be helpful.
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4.4 Dataset Review and Cancer
Audit Helpdesk
5
National Governance
Process
 National Reporting
Schedule(NCQSG
13/33)
BM noted that this is going through a virtual
reference group and questions will go to clinicians.
Queries are primarily from audit staff.
IS spoke to this item, and stated that there is a 3year rolling reporting programme, which follows the
date of implementation and follows a 12-month
pattern.
MB stated that the 3rd year will be 2014, and the
next cycle commencing in 2015, so the QPIs should
be revised by Spring 2014 if we want to collect data
for 2015. IS confirmed that this is on the work plan
as an action; ET noted that it hadn’t been started as
yet.
Discuss and agree
workplan ahead of
meeting with Dr
Aileen Keel
BH,
IS,
ET,
HD
Draft to go to
boards
IS
ASAP
BM highlighted the difficulties that can occur when
bunching reporting together.
It was agreed that when agreed a draft should go to
boards for comment.

Breast Cancer QPI
Data Dashboard and
associated National
Comparative Report
(NCQSG 13/34)
BM gave an overview of the dashboard and noted
that ISD aims to have the comparative report
published in February.
ET confirmed that dashboard data is not ‘real time’
and so is not up to date data but historical. ET noted
it was originally intended that it be updated every
three years, but it’s now thought it should be kept
more current.
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Access to the dashboard and report by the public
was discussed. JD suggested that the public get
access to the 3-yearly updates, whilst interim
updates are accessible for internal staff for service
improvement use. KO concurred with this.
KR raised issue of accessibility on old browsers and
it was confirmed that the dashboard would be
suitable for the variety of software used by NHS
computers.

6
Expert Review Group
Stage
NCQSG Workplan 2013-15
(NCQSG 13/35)
7
Risks and Issues
(NCQSG 13/36 and 13/37)
8
9
AOCB
Future meeting dates/times
It was noted that the meeting on 10 January 2014
will lead to a decision on the report.
Expert Review discussed earlier on agenda.
ET asked for discussion with SG on the
sustainability of the programme.
IS noted slippage of melanoma work and a typo and
agreed to make any relevant changes. All agreed
with the workplan.
ET noted that 3 risks have been closed and 1 risk
has been added, and asked for comments on this to
be sent to her and IS.
None
The next meeting is due to take place on 12th March
2014 in Atlantic Quay, Glasgow.
Discussion with
SG on NCQSG
future
HD,
ET,
IS,
NT
Following
meeting
with AK
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