S69 Rising Standards Of Care Continue In Year 9 Of The National Lung Cancer Audit

Abstract

Introduction The National Lung Cancer Audit, now in its 9th year, is run jointly by the Royal College of Physicians and The Information Centre for Health and Social Care (HSCIC), and commissioned by the Healthcare Quality Improvement Partnership (HQIP). Over this period, the rich data of increasing quality has charted improving standards of care for patients, as well as persistent variation across organisations which in most cases is independent of case-mix. Methods Although several other countries also submit data to the audit, this abstract presents provisional results for England only for patients first seen in 2013. Results 30,508 patient records were submitted with more than 93% having performance status and the same number having disease stage recorded (see Table 1 ). Spirometry is available for 65% of Stage I-II/PS 0–1 NSCLC patients, allowing more detailed risk-adjustment to be carried out in future. The histological confirmation rate remains steady at 75%, and the proportion with non-subtyped NSCLC continues to fall. There has been a small but incremental rise in the resection rate in histologically-confirmed NSCLC which now stands at 23%, and in the proportions of patients with SCLC receiving chemotherapy (70%). Patient access to specialist nurses appears to have improved but demonstrates a continuing unmet need. The proportion having CT scan before bronchoscopy continues to rise (91%) as does the proportion having chemotherapy for locally advanced NSCLC with good PS (60%). Variation in practice still exists – for example, the resection rate in Stage I-II NSCLC varies from 46% to 66% across the cancer networks, although the range is narrower than the previous year (35% to 62%). Our final presentation will contain further analyses of survival across the audit lifespan. Conclusions In contrast to the early years of the audit where standards of care appeared to improve rapidly and were partly related to improvements in data quality, recent years have shown only small incremental improvements. A reconfiguration of the audit as part of a new commissioning process, and the linkage with other developing datasets will allow the project to continue to realise the goal of improved and less variable outcomes and for patients with lung cancer.