Slide 1 - Herts Valleys CCG
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Transcript Slide 1 - Herts Valleys CCG
Cancer indicator trend analysis
NHS Luton CCG
Summary of practice level cancer indicators 2010 to 2013
March 2014
Version 1.0
cunliffeanalytics
2
Contents
Page
Introduction – purpose of the report
4
Screening indicators
5
•
•
•
•
Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation
Percentage of females aged 25–64 attending cervical screening within target period
Percentage of persons aged 60–69 screened for bowel cancer within 6 months of invitation
Screening indicator performance vs demographics
Two week wait indicators
•
•
•
•
Two Week Wait referral ratio
Percentage of Two Week Wait referrals with cancer
Percentage of new cancer cases treated which are Two Week Wait referrals
Two week wait indicator performance vs demographics
Emergency admission indicator
•
•
•
21
31
Rate of emergency admissions with cancer per 100,000 population
Rate of persons diagnosed with cancer via an emergency admission per 100,000 population
Emergency admission indicator performance vs demographics
Appendices
• Definitions for indicators and demographics.
43
3
Introduction
Purpose of the report
The purpose of this report is to provide a three year summary of the key diagnosis and referral indicators for practices across Luton
CCG. If you have any questions relating to the pack please contact [email protected]
Eight key indicators are reviewed at CCG and practice level, highlighting how the activity rates have changed over the last four
years, in relation to the current national targets and recommended ranges. The key indicators are:
•
•
•
•
•
•
•
•
Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation
Percentage of females aged 25–64 attending cervical screening within target period
Percentage of persons aged 60–69 screened for bowel cancer within 6 months of invitation
Two Week Wait referral ratio
Percentage of Two Week Wait referrals with cancer
Percentage of new cancer cases treated which are Two Week Wait referrals
Rate of emergency admissions with cancer per 100,000 population
Rate of persons diagnosed with cancer via an emergency admission per 100,000 population
Please note that this report is based on a small number of practices and therefore the CCG level percentages shown are sensitive to
volatile changes.
There is no data available for:
Whipperley MC (Y02477) for 2010 for any indicator.
GP led WIC (Y02463) for 2010 for any indicator.
All practices for the ‘rate of persons diagnosed with cancer via an emergency admission per 100,000 population’, 2012.
Acknowledgement
CCG analysis of GP Cancer Profiles by East of England Strategic Clinical Network based on methodology and best practice
recommendations first developed by Mount Vernon Cancer Network.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit 2010 to 2013
Maps contain: Ordnance Survey data © Crown copyright and database right 2012 Royal Mail data © Royal Mail copyright and database right 2012, National Statistics data ©
Crown copyright and database right 2012.
4
Percentage of females aged 50–70 screened for breast
cancer within 6 months of invitation
Aim to be above the national target (70%). Consider actively encouraging patients to participate in
screening programmes with letters or opportunistic prompts. GPs can be influential here.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
Definition: The number of females aged 50-70 registered to the practice screened adequately within 6 months of invitation, divided by the total
number of females aged 50-70 invited for screening in the previous 12 months. (See appendix for full definition)
Indicator source(s): Data was extracted from the NHAIS via the Open Exeter system. Data was collected by the NHS Cancer Screening
Programme.
5
Luton CCG’s average has remained below the national average for the last four years with just
over a third of practices achieving the national target of 70%.
CCG range and mean average
2010
2011
2012
2013
England mean average
74.4%
74.7%
74.3%
73.3%
CCG/PCT1 mean average
69.3%
72.5%
71.8%
69.3%
CCG practice min
CCG practice max
Practices above national
target2
Practices above national target (%)
1 Mean
0.0%
0.0%
25.0%
0.0%
100.0%
80.0%
87.5%
85.2%
10(28)
11(31)
11(31)
11(31)
35.7%
35.5%
35.5%
35.5%
% Screened for breast
cancer ( F50-70)
Summary statistics
100%
—
60%
40%
4 Range
2010
Distribution of practice screening rates within the CCG
CCG range4
National target >70%
average for PCT in 2010 and 2011,
CCG for 2012 and 2013.
0%
target > 70%
CCG/PCT3 mean average
3 Mean
20%
average for PCT in 2010 and 2011, CCG for 2012 and 2013. ,
2National
Key
80%
2011
2012
for practices within the current CCG
2013
Targets achieved for 4 years
Key
Targets
achieved
2013
Indicator value
0%-30%
2012
30%-50%
2011
50%-70%
70%-90%
2010
4
3
2
1
0
90%-100%
0%
20%
40%
60%
80%
100%
Proportion of practices
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
53 Leagrave Rd
2013
2A Malzeard Rd
Kingsway HC
Hockwell Ring
2012
Gardenia Surgery
GP led WIC
Leagrave Surgery
2011
Neville Rd
Moakes MC
Medina MC
90%
Whipperley MC
Bute House
Wenlock St
Blenheim MC
49 Ashcroft Rd
Lea Vale MC
Conway MC
Medici Practice
Stopsley Village
Bell House
Petros MC
Sundon Park HC
39 Castle St
Lister House
Larkside Practice
Pastures Way
Oakley Surgery
Sundon MC
Barton Hills
Kingfisher Practice
Woodland Ave
% Screened for breast cancer (F50-70)
6
11 out of 31 practices within Luton CCG achieved the 70% target in 2013. 11 practices within the
CCG failed to meet the target for the last three years.
Three year profile (2011 to 2013)
85%
Target
80%
75%
70%
65%
60%
55%
50%
7
Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation
Practice indicator scores
Year on year rate
2011
2012
2010
E81018
E81075
E81632
E81040
E81025
E81076
E81026
E81016
E81013
E81054
E81064
E81005
E81006
E81073
E81063
E81032
E81617
E81028
E81001
E81048
Y02477
E81065
Y02464
E81633
E81010
Y02463
E81041
E81612
Y02332
E81631
E81618
Woodland Ave
Kingfisher Practice
Barton Hills
Sundon MC
Oakley Surgery
Pastures Way
Larkside Practice
Lister House
39 Castle St
Sundon Park HC
Petros MC
Bell House
Stopsley Village
Medici Practice
Conway MC
Lea Vale MC
49 Ashcroft Rd
Blenheim MC
Wenlock St
Bute House
Whipperley MC
Medina MC
Moakes MC
Neville Rd
Leagrave Surgery
GP led WIC
Gardenia Surgery
Hockwell Ring
Kingsway HC
2A Malzeard Rd
53 Leagrave Rd
66.7%
64.3%
89.5%
78.8%
77.8%
71.0%
90.0%
50.0%
74.7%
73.2%
72.9%
60.7%
50.0%
66.6%
58.3%
67.7%
100.0%
57.9%
64.4%
64.4%
55.6%
42.9%
47.1%
29.4%
38.9%
70.0%
0.0%
33.3%
76.5%
69.2%
78.8%
72.7%
33.3%
33.3%
75.3%
68.0%
57.1%
66.7%
61.5%
74.8%
72.5%
37.0%
60.0%
40.5%
70.0%
62.5%
50.0%
70.6%
63.6%
31.3%
80.0%
66.7%
75.2%
20.0%
75.0%
66.7%
56.3%
0.0%
50.0%
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
55.6%
79.5%
83.3%
76.5%
66.7%
66.7%
69.2%
40.0%
36.4%
87.5%
70.0%
61.5%
82.6%
50.0%
25.0%
44.9%
77.3%
40.0%
71.4%
75.0%
66.7%
60.0%
60.2%
75.0%
70.0%
45.0%
69.2%
45.5%
58.1%
52.2%
50.0%
2013
85.2%
81.8%
79.5%
78.4%
75.8%
75.6%
75.1%
75.0%
73.9%
72.6%
71.1%
68.8%
67.8%
67.6%
65.4%
64.3%
63.6%
62.4%
60.2%
58.3%
56.7%
56.6%
56.5%
56.3%
50.0%
46.5%
44.8%
42.9%
39.5%
33.3%
0.0%
At or above target
2010 2011 2012 2013
Difference over
4 years (pp1)
18.5%
17.5%
-10.0%
-0.4%
-2.0%
4.6%
-14.9%
25.0%
-0.8%
-0.6%
-1.8%
8.1%
17.8%
1.0%
7.1%
-3.4%
-36.4%
4.5%
-4.2%
-6.1%
1.0%
13.4%
2.9%
15.4%
4.0%
-30.5%
33.3%
-33.3%
Key
Year on year increase
Year on year decrease
Above national target
Below national target
National target > 70%
1
Percentage points
Percentage of females aged 25–64 attending cervical
screening within target period
Aim to be above the national target (80%). Consider actively encouraging patients to
participate in screening programmes with letters or opportunistic prompts. GPs can be influential here.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
Definition: The overall cervical screening coverage: the number of women registered at the practice screened adequately in the previous 42 months (if
aged 24-49) or 66 months (if aged 50-64) divided by the number of eligible women on last day of review period. (See appendix for full definition)
Indicator source(s): Data was extracted from the NHAIS via the Open Exeter system. Data was collected by the NHS Cancer Screening Programme.
Luton CCG’s average has decreased over the last four years, remaining below the national
average and national target of 80%. The number of practices within the CCG achieving the
80% target has decreased over the last four years.
CCG range and mean average
England mean average
1
CCG/PCT mean average
CCG practice min
CCG practice max
Practices above national target
2
Practices above national target (%)
1 Mean
2010
2011
2012
2013
75.4%
75.6%
75.3%
74.0%
73.5%
73.3%
72.5%
70.6%
60.8%
55.4%
54.3%
53.9%
87.8%
88.0%
86.1%
84.5%
6(28)
4(31)
4(31)
3(31)
21.4%
12.9%
12.9%
9.7%
% Screened for cervical
cancer ( F25-64)
Summary statistics
85%
Key
80%
—
75%
70%
65%
60%
3 Mean
55%
4 Range
CCG/PCT3 mean average
CCG range4
National target >80%
average for PCT in 2010 and 2011,
CCG for 2012 and 2013.
for practices within the current CCG
50%
average for PCT in 2010 and 2011, CCG for 2012 and 2013. ,
2National
90%
2010
target > 80%
2011
2012
Distribution of practice screening rates within the CCG
Targets achieved for 4 years
2013
Key
Targets
achieved
2012
Indicator value
50%-60%
2011
60%-70%
70%-80%
2010
2013
4
3
2
1
0
80%-90%
0%
20%
40%
60%
80%
100%
Proportion of practices
Note: Published year shown, 2010 refers to 3.5 or 5.5 year coverage for 2004/05Q3 to 2009/10, 2011: 2005/06Q3
to 2010/11, 2012: 2006/07Q3 to 2011/12, 2013: 2010/11 to 2012/13
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
9
Note: Published year shown, 2010 refers to 3.5 or 5.5 year coverage for 2004/05Q3 to 2009/10, 2011: 2005/06Q3 to 2010/11, 2012: 2006/07Q3 to 2011/12 , 2013: 2010/11 to 2012/13
39 Castle St
GP led WIC
2013
Lister House
Kingsway HC
2012
53 Leagrave Rd
Bute House
Leagrave Surgery
2011
Medici Practice
Lea Vale MC
2A Malzeard Rd
85%
Neville Rd
Medina MC
Blenheim MC
Conway MC
Gardenia Surgery
Hockwell Ring
Petros MC
Oakley Surgery
Barton Hills
Woodland Ave
Sundon MC
Larkside Practice
Wenlock St
Pastures Way
Moakes MC
Bell House
49 Ashcroft Rd
Whipperley MC
Kingfisher Practice
Sundon Park HC
Stopsley Village
% Screened for cervical cancer (F25-64)
10
Three out of 31 practices within Luton CCG achieved the 80% target in 2013. 26 practices within
the CCG failed to meet the target for the last three years.
Three year profile (2011 to 2013)
90%
Target
80%
75%
70%
65%
60%
55%
50%
11
Percentage of females aged 25–64 attending cervical screening within target period
Practice indicator scores
Year on year rate
2011
2012
2010
E81006
E81054
E81075
Y02477
E81617
E81005
Y02464
E81076
E81001
E81026
E81040
E81018
E81632
E81025
E81064
E81612
E81041
E81063
E81028
E81065
E81633
E81631
E81032
E81073
E81010
E81048
E81618
Y02332
E81016
Y02463
E81013
Stopsley Village
Sundon Park HC
Kingfisher Practice
Whipperley MC
49 Ashcroft Rd
Bell House
Moakes MC
Pastures Way
Wenlock St
Larkside Practice
Sundon MC
Woodland Ave
Barton Hills
Oakley Surgery
Petros MC
Hockwell Ring
Gardenia Surgery
Conway MC
Blenheim MC
Medina MC
Neville Rd
2A Malzeard Rd
Lea Vale MC
Medici Practice
Leagrave Surgery
Bute House
53 Leagrave Rd
Kingsway HC
Lister House
GP led WIC
39 Castle St
87.8%
84.3%
83.4%
82.7%
80.0%
76.1%
69.4%
77.3%
79.3%
76.4%
74.9%
72.3%
79.5%
74.3%
71.0%
78.8%
67.2%
76.8%
80.3%
74.5%
60.8%
68.8%
73.4%
77.0%
63.3%
64.4%
65.2%
61.0%
88.0%
86.5%
83.6%
74.3%
78.6%
78.9%
77.8%
80.2%
72.9%
76.8%
78.9%
76.7%
74.7%
72.8%
78.2%
76.6%
72.1%
78.5%
67.8%
73.8%
78.0%
76.0%
62.8%
71.2%
72.6%
74.6%
59.4%
68.2%
63.1%
55.4%
58.2%
86.1%
85.9%
81.5%
72.4%
78.9%
80.3%
77.6%
79.4%
72.6%
77.3%
77.0%
76.6%
74.4%
73.5%
76.2%
73.3%
74.6%
76.5%
69.3%
72.8%
75.8%
70.7%
66.3%
71.2%
70.8%
69.7%
60.6%
63.4%
61.6%
58.8%
54.3%
2013
84.5%
84.2%
81.4%
79.3%
78.1%
77.3%
76.8%
76.1%
75.0%
74.9%
74.5%
72.6%
72.5%
71.9%
71.7%
71.5%
71.4%
70.6%
69.9%
69.6%
69.0%
69.0%
67.9%
67.8%
67.8%
67.1%
61.7%
61.2%
57.8%
54.5%
53.9%
At or above target
2010 2011 2012 2013
Note: Published year shown, 2010 refers to 3.5 or 5.5 year coverage for 2004/05Q3 to 2009/10, 2011: 2005/06Q3 to 2010/11, 2012: 2006/07Q3 to 2011/12 , 2013: 2010/11 to 2012/13
Difference over
4 years (pp1)
-3.3% Key
-0.1% Year on year increase
-2.0%
Year on year decrease
Above national target
-4.6%
-2.7%
0.0% National target > 80%
5.6% 1 Percentage points
-2.4%
-4.8%
-3.8%
-2.4%
-0.4%
-7.8%
-2.8%
0.4%
-8.2%
2.7%
-7.2%
-11.3%
-5.5%
7.1%
-1.0%
-5.6%
-9.9%
-1.6%
-3.2%
-7.4%
-7.1%
Below national target
12
Percentage of persons, 60–69, screened for
bowel cancer within 6 months of invitation
Aim to be above the national target (60%). Consider actively encouraging patients to participate in
screening programmes with letters or opportunistic prompts. GPs can be influential here.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
Definition: The number of persons aged 60-69 registered to the practice screened adequately within 6 months of invitation, divided by the total
number of females aged 60-69 invited for screening in the previous 12 months. (See appendix for full definition)
Indicator source(s): Bowel Cancer Screening System (BCCS) via the Open Exeter system. Data was collected by the NHS Cancer Screening
Programme.
13
Over the last four years, Luton CCG’s average has remained below the national target of 60% and
below the national average.
CCG range and mean average
2010
2011
2012
2013
55.1%
57.5%
55.7%
58.7%
CCG/PCT mean average
45.1%
50.1%
46.4%
50.3%
CCG practice min
8.3%
12.0%
12.8%
22.0%
58.8%
61.3%
58.9%
63.6%
0(28)
1(31)
0(31)
3(31)
0.0%
3.2%
0.0%
9.7%
England mean average
1
CCG practice max
Practices above national target
2
Practices above national target (%)
1 Mean
% Screened for bowel cancer
( P60-69)
Summary statistics
average for PCT in 2010 and 2011, CCG for 2012 and 2013. ,
2National
70%
60%
Key
50%
—
40%
30%
20%
National target >60%
average for PCT in 2010 and 2011,
CCG for 2012 and 2013.
4 Range
0%
2010
Distribution of practice screening rates within the CCG
CCG range4
3 Mean
10%
target > 60%
CCG/PCT3 mean average
2011
2012
for practices within the current CCG
2013
Targets achieved for 4 years
Key
Targets
achieved
2013
2012
Indicator value
0%-20%
2011
20%-40%
40%-60%
2010
4
3
2
1
0
60%-80%
0%
20%
40%
60%
80%
Proportion of practices
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
100%
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
53 Leagrave Rd
2013
Medina MC
2A Malzeard Rd
Conway MC
2012
Whipperley MC
Kingsway HC
Wenlock St
2011
GP led WIC
Hockwell Ring
Lister House
65%
Pastures Way
Moakes MC
Medici Practice
Blenheim MC
Bute House
Gardenia Surgery
Lea Vale MC
Oakley Surgery
39 Castle St
Petros MC
Bell House
Sundon Park HC
Larkside Practice
Woodland Ave
Barton Hills
Leagrave Surgery
Sundon MC
Neville Rd
49 Ashcroft Rd
Kingfisher Practice
Stopsley Village
% Screened for bowel cancer (P60-69)
14
Three out of 31 practices within Luton CCG achieved the 60% target in 2013. 28 practices failed
to meet the target for the last three years.
Three year profile (2011 to 2013)
Target
60%
55%
50%
45%
40%
35%
15
Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation
Practice indicator scores
Year on year rate
2011
2012
2010
E81006
E81075
E81617
E81633
E81040
E81010
E81632
E81018
E81026
E81054
E81005
E81064
E81013
E81025
E81032
E81041
E81048
E81028
E81073
Y02464
E81076
E81016
E81612
Y02463
E81001
Y02332
Y02477
E81063
E81631
E81065
E81618
Stopsley Village
Kingfisher Practice
49 Ashcroft Rd
Neville Rd
Sundon MC
Leagrave Surgery
Barton Hills
Woodland Ave
Larkside Practice
Sundon Park HC
Bell House
Petros MC
39 Castle St
Oakley Surgery
Lea Vale MC
Gardenia Surgery
Bute House
Blenheim MC
Medici Practice
Moakes MC
Pastures Way
Lister House
Hockwell Ring
GP led WIC
Wenlock St
Kingsway HC
Whipperley MC
Conway MC
2A Malzeard Rd
Medina MC
53 Leagrave Rd
58.8%
53.5%
51.0%
37.1%
54.4%
50.0%
51.5%
52.4%
46.0%
38.5%
47.3%
44.4%
45.9%
51.7%
47.0%
47.4%
38.0%
28.3%
34.9%
44.8%
39.9%
36.5%
27.2%
27.2%
21.8%
21.3%
20.4%
8.3%
61.3%
56.5%
51.1%
50.0%
59.3%
58.7%
50.9%
58.3%
56.6%
48.7%
50.5%
51.5%
54.2%
51.6%
50.7%
48.6%
45.9%
39.2%
41.1%
48.5%
38.4%
43.9%
42.3%
40.9%
37.1%
30.9%
28.6%
29.5%
13.0%
25.8%
12.0%
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
58.9%
56.3%
57.2%
46.7%
55.3%
51.7%
49.6%
56.1%
43.2%
43.8%
47.8%
45.6%
46.5%
52.5%
44.5%
49.1%
41.0%
36.9%
40.5%
40.0%
43.4%
45.7%
34.3%
28.6%
33.7%
30.1%
37.5%
26.2%
12.8%
25.0%
16.2%
2013
63.6%
60.3%
60.1%
58.7%
58.3%
57.5%
56.7%
56.6%
56.1%
54.1%
53.5%
53.1%
53.1%
50.4%
48.4%
45.4%
43.1%
42.3%
41.9%
41.5%
41.1%
40.7%
39.8%
37.8%
36.9%
34.7%
34.2%
33.3%
28.6%
28.5%
22.0%
At or above target
2010 2011 2012 2013
Difference over
4 years (pp1)
4.8%
6.8%
9.1%
21.6%
3.9%
7.5%
5.2%
4.2%
10.1%
15.6%
6.2%
8.7%
7.2%
-1.3%
1.4%
-2.0%
5.1%
14.0%
7.0%
-3.7%
0.8%
3.3%
9.7%
7.5%
11.5%
7.3%
8.1%
13.7%
Key
Year on year increase
Year on year decrease
Above national target
Below national target
National target > 60%
1
Percentage points
16
Screening indicator performance vs demographics
•
•
•
Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation
Percentage of females aged 25–64 attending cervical screening within target period
Percentage of persons aged 60–69 screened for bowel cancer within 6 months of invitation
17
No clear relationship between practices within East and North Hertfordshire CCG achieving the
screening targets and local demographics
Population aged 65+
Popn aged 65+ (average)
20
15
10
5
0
0
500
2
25%
Mean
Median
0
1
Mean
Median
20%
15%
10%
5%
0%
2
0
1
2
Number of indicators where target was
achieved for2+ years
Number of indicators where target was
achieved for2+ years
Number of indicators where target was
achieved for2+ years
New cancer cases
Cancer deaths
Cancer prevalence
250
Mean
Cancer deaths (average)
New cancer cases (average)
600
1
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
Median
400
300
200
100
200
2.0%
Mean
Median
150
100
50
0
0
0
1
2
Number of indicators where target was
achieved for2+ years
0
1
2
Number of indicators where target was
achieved for2+ years
Cancer prevalence (average)
Number of practices
25
Deprivation
Deprivation (average)
Number of practices
1.5%
Mean
Median
1.0%
0.5%
0.0%
0
1
2
Number of indicators where target was
achieved for2+ years
Two Week Wait referral ratio
(Indirectly age standardised )
Aim to be referring within 20% of the England average two week wait referral rate.
Rates outside this range may indicate over/under use of the two week wait referral route.
You may wish to audit your referrals against NICE cancer referral guidance.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
Definition: The number of Two Week Wait referrals where cancer is suspected multiplied by 100,000 divided by the list size of the practice in question.
Indicator source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the NHS
England Cancer Waiting Times Database.
19
The number of practices within Luton CCG achieving the best practice range (80% to 120%) has
varied year on year.
CCG range
2010
2011
2012
2013
100.0%
100.0%
100.0%
100.0%
n/a
n/a
n/a
n/a
CCG practice min
2.3%
3.5%
4.9%
4.1%
CCG practice max
148.2%
135.7%
167.6%
141.0%
4(28)
11(31)
8(31)
7(31)
14.3%
35.5%
25.8%
22.6%
England mean average
1
CCG/PCT mean average
Practices within best practice range
2
Practices within best practice range (%)
1 Mean
2Best
175%
TWW Referral ratio (IAS)
Summary statistics
150%
Key
125%
—
100%
Best practice range = 80%
to 120%
75%
3 Range
50%
for practices within the current CCG
25%
0%
average for CCG/PCT not available
2010
practice range = 80% to 120%
Distribution of practice referral ratios within the CCG
CCG range3
2011
2012
2013
Luton CCG practices achieving the best practice range for 4
years
Key
Targets
achieved
2013
2012
Indicator value
0%-40%
2011
40%-80%
80%-120%
2010
4
3
2
1
0
120%-160%
0%
20%
40%
60%
80%
Proportion of practices
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
100%
160%-200%
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12 , 2013: 2012/13
53 Leagrave Rd
Medina MC
Wenlock St
Gardenia Surgery
2013
GP led WIC
Lister House
2012
Lea Vale MC
Conway MC
49 Ashcroft Rd
2011
Pastures Way
160%
Bute House
180%
Hockwell Ring
Neville Rd
2A Malzeard Rd
Stopsley Village
Blenheim MC
Woodland Ave
Sundon Park HC
Bell House
Kingfisher Practice
Leagrave Surgery
39 Castle St
Kingsway HC
Whipperley MC
Barton Hills
Oakley Surgery
Petros MC
Sundon MC
Larkside Practice
Medici Practice
Moakes MC
TWW referral ratio (IAS)
20
Seven out of 31 practices within Luton CCG were within the best practice range of 80% to 120% in
2013. 16 practices failed to achieve the best practice range for the last three years.
Three year profile (2011 to 2013)
Best practice range
140%
120%
100%
80%
60%
40%
20%
0%
21
Two Week Wait referral ratio
Practice indicator scores
Year on year rate
2011
2012
2010
Y02464
E81073
E81026
E81040
E81064
E81025
E81632
Y02477
Y02332
E81013
E81010
E81075
E81005
E81054
E81018
E81028
E81006
E81631
E81633
E81612
E81048
E81076
E81617
E81063
E81032
E81016
Y02463
E81041
E81001
E81065
E81618
Moakes MC
Medici Practice
Larkside Practice
Sundon MC
Petros MC
Oakley Surgery
Barton Hills
Whipperley MC
Kingsway HC
39 Castle St
Leagrave Surgery
Kingfisher Practice
Bell House
Sundon Park HC
Woodland Ave
Blenheim MC
Stopsley Village
2A Malzeard Rd
Neville Rd
Hockwell Ring
Bute House
Pastures Way
49 Ashcroft Rd
Conway MC
Lea Vale MC
Lister House
GP led WIC
Gardenia Surgery
Wenlock St
Medina MC
53 Leagrave Rd
66.2%
148.2%
62.5%
112.2%
83.3%
81.6%
58.9%
64.3%
79.5%
88.8%
70.8%
70.6%
58.9%
41.0%
70.3%
5.2%
70.0%
38.8%
43.1%
66.3%
24.2%
30.8%
73.8%
51.2%
43.6%
2.6%
2.3%
6.4%
70.3%
110.0%
101.1%
64.7%
96.0%
82.9%
81.6%
63.8%
85.2%
87.7%
94.4%
78.6%
57.8%
114.1%
49.4%
54.7%
72.5%
4.2%
135.7%
18.9%
31.9%
90.9%
23.2%
44.4%
61.6%
40.5%
111.8%
41.3%
11.8%
3.5%
28.3%
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12 , 2013: 2012/13
118.8%
94.8%
99.9%
76.9%
100.2%
72.4%
101.2%
167.6%
74.8%
78.0%
97.4%
107.0%
61.4%
68.6%
73.2%
64.2%
53.5%
19.4%
128.1%
29.4%
61.8%
96.8%
23.9%
31.3%
65.5%
42.6%
34.7%
36.8%
8.5%
10.5%
4.9%
2013
141.0%
137.2%
103.1%
101.3%
98.0%
96.4%
95.8%
90.2%
87.9%
77.4%
75.0%
71.2%
68.4%
66.9%
63.3%
62.5%
62.2%
60.6%
59.1%
59.0%
58.8%
52.0%
51.7%
51.0%
50.2%
43.4%
41.7%
36.2%
28.5%
9.9%
4.1%
At or above target
2010 2011 2012 2013
Difference over
4 years (pp1)
Key
71.0%
-45.1%
38.8%
-14.2%
13.1%
14.2%
29.0%
13.1%
Best practice range = 80% to
-4.5% 120%
-17.6% 1 Percentage points
-2.4%
-3.7%
4.4%
21.5%
-8.1%
55.4%
-10.9%
20.2%
15.7%
-14.3%
27.5%
20.2%
-23.6%
-7.8%
Year on year increase
Year on year decrease
Within best practice
range
Outside best practice
range
-7.4%
25.9%
7.6%
-2.3%
Percentage of Two Week Wait referrals with cancer
Aim to have conversion rate between 8-14%. Rates outside this range may indicate over/under use of
the two week wait referral route. You may wish to audit your referrals against NICE cancer referral
guidance. There is no target number for referral as this depends on practice size and demographics.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
Definition: The ‘conversion rate’, i.e., the proportion of Two Week Wait referrals that are subsequently diagnosed with cancer: the number of new
cancer cases treated in 2012/13 who were referred through the two week wait route divided by the total number of Two Week Wait referrals in
2012/13.
Indicator source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the
NHS England Cancer Waiting Times Database.
23
Luton CCG’s average has remained within the best practice range of 8% to 14% for the last four
years. The maximum for the range of values has reduced over the last three years.
CCG range and mean average
2010
2011
2012
2013
11.2%
10.9%
10.6%
10.0%
CCG/PCT mean average
13.3%
10.3%
12.5%
11.6%
CCG practice min
0.0%
0.0%
0.0%
0.0%
CCG practice max
100.0%
100.0%
44.4%
37.5%
13(28)
10(31)
9(31)
14(31)
46.4%
32.3%
29.0%
45.2%
England mean average
1
Practices within best practice range
2
Practices within best practice range (%)
1 Mean
2Best
average for PCT in 2010 and 2011, CCG for 2012 and 2013. ,
100%
% of TWW referrals with cancer
Summary statistics
Key
80%
—
60%
40%
Best practice range = 8%
3 Mean
average for PCT in 2010 and 2011,
CCG for 2012 and 2013.
4 Range
0%
2010
Distribution of practice referrals within the CCG
CCG range4
to 14%
20%
practice range = 8% to 14%
CCG/PCT3 mean average
2011
2012
for practices within the current CCG
2013
Luton CCG practices achieving the best practice range over 4
years
Key
Targets
achieved
2013
2012
Indicator value
0%-8%
2011
8%-14%
4
3
2
1
0
14%-50%
2010
50%-100%
0%
20%
40%
60%
80%
Proportion of practices
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
100%
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13.
53 Leagrave Rd
Whipperley MC
Conway MC
Kingsway HC
2013
Pastures Way
Sundon Park HC
2012
Larkside Practice
Medici Practice
Moakes MC
2011
Blenheim MC
Kingfisher Practice
45%
Oakley Surgery
50%
39 Castle St
Three year profile (2011 to 2013)
2A Malzeard Rd
Leagrave Surgery
Barton Hills
GP led WIC
49 Ashcroft Rd
Petros MC
Neville Rd
Bell House
Bute House
Lea Vale MC
Hockwell Ring
Woodland Ave
Gardenia Surgery
Stopsley Village
Sundon MC
Lister House
Medina MC
Wenlock St
% of TWW referrals with cancer
24
14 of the 31 practices within Luton CCG achieved the best practice range of 8% to 14% in 2013.
10 practices failed to achieve the best practice range for the last three years.
100%
Best practice range
40%
35%
30%
25%
20%
15%
10%
5%
0%
25
Percentage of Two Week Wait referrals with cancer
Practice indicator scores
Year on year rate
2011
2012
2010
E81001
E81065
E81016
E81040
E81006
E81041
E81018
E81612
E81032
E81048
E81005
E81633
E81064
E81617
Y02463
E81632
E81010
E81631
E81013
E81025
E81075
E81028
Y02464
E81073
E81026
E81054
E81076
Y02332
E81063
Y02477
E81618
Wenlock St
Medina MC
Lister House
Sundon MC
Stopsley Village
Gardenia Surgery
Woodland Ave
Hockwell Ring
Lea Vale MC
Bute House
Bell House
Neville Rd
Petros MC
49 Ashcroft Rd
GP led WIC
Barton Hills
Leagrave Surgery
2A Malzeard Rd
39 Castle St
Oakley Surgery
Kingfisher Practice
Blenheim MC
Moakes MC
Medici Practice
Larkside Practice
Sundon Park HC
Pastures Way
Kingsway HC
Conway MC
Whipperley MC
53 Leagrave Rd
200.0%
0.0%
13.6%
11.7%
13.8%
11.4%
16.2%
8.7%
12.7%
18.2%
13.1%
6.3%
12.2%
47.1%
9.5%
14.9%
0.0%
14.9%
14.5%
20.4%
10.9%
5.6%
13.8%
5.4%
8.3%
14.3%
10.0%
100.0%
40.0%
0.0%
15.4%
14.1%
17.1%
19.4%
11.0%
23.1%
10.2%
16.2%
13.4%
5.6%
9.4%
26.3%
10.5%
9.4%
10.3%
100.0%
5.4%
6.6%
11.8%
2.9%
0.0%
7.0%
7.5%
5.5%
5.3%
12.5%
0.0%
9.1%
0.0%
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13.
25.0%
0.0%
17.8%
11.8%
18.9%
14.3%
21.9%
21.7%
13.3%
17.5%
13.5%
5.1%
12.8%
33.3%
44.4%
8.9%
11.9%
0.0%
14.1%
16.7%
7.6%
6.7%
8.0%
9.6%
4.2%
2.8%
10.4%
6.1%
18.5%
7.9%
0.0%
2013
37.5%
37.5%
25.9%
19.5%
18.3%
17.5%
15.3%
14.5%
13.6%
13.2%
13.1%
13.0%
12.2%
11.5%
11.1%
11.0%
10.9%
10.5%
9.9%
8.9%
8.7%
8.6%
7.3%
7.0%
5.5%
4.9%
4.8%
3.1%
1.9%
0.0%
0.0%
At or above target
2010 2011 2012 2013
Difference over
4 years (pp1)
-162.5%
37.5%
12.3%
7.8%
4.5%
6.1%
-0.9%
5.8%
0.9%
-5.0%
0.0%
6.7%
0.0%
-35.6%
1.5%
-4.0%
10.5%
-5.0%
-5.6%
-11.7%
-2.3%
1.4%
-8.3%
-0.5%
-3.5%
-11.2%
-8.1%
-100.0%
Key
Year on year increase
Year on year decrease
Within best practice range
Outside best practice range
Best practice range = 8% to 14%
1
Percentage points
Percentage of new cancer cases treated which are
Two Week Wait referrals
Aim to be above the line and have more of your cancer cases diagnosed through the two week wait
referral route. Consider doing the RCGP cancer diagnosis audit.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
Definition: The proportion of new cancer cases treated who were referred through the Two Week Wait route.
Indicator source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the
NHS England Cancer Waiting Times Database.
27
Luton CCG’s average has remained around the national target of 40%, but below the national
average, for the last four years.
CCG range and mean average
2010
2011
2012
2013
42.9%
45.3%
46.5%
47.7%
CCG/PCT mean average
40.2%
35.3%
41.9%
41.6%
CCG practice min
0.0%
0.0%
0.0%
0.0%
CCG practice max
67.9%
72.7%
80.0%
85.7%
14(28)
11(31)
16(31)
15(31)
Practices above recommended min. (%) 50.0%
35.5%
51.6%
48.4%
England mean average
1
Practices above recommended min.
1 Mean
2
% of new cancer cases are
TWW referrals
Summary statistics
100%
—
60%
40%
Recommended minimum
average for PCT in 2010 and 2011,
CCG for 2012 and 2013.
4 Range
2010
Distribution of new cancer cases (as a proportion of TWW)
within the CCG
CCG range4
3 Mean
0%
minimum = 40%
CCG/PCT3 mean average
= 40%
20%
average for PCT in 2010 and 2011, CCG for 2012 and 2013. ,
2Recommended
Key
80%
2011
2012
for practices within the current CCG
2013
Luton CCG practices achieving the recommended
minimum of 40%
over 4 years
Key
Targets
achieved
2013
Indicator value
2012
0%-20%
20%-40%
2011
40%-60%
60%-80%
2010
4
3
2
1
0
80%-100%
0%
20%
40%
60%
80%
Proportion of practices
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
100%
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
53 Leagrave Rd
Whipperley MC
Conway MC
Sundon Park HC
Pastures Way
2013
Kingsway HC
49 Ashcroft Rd
2012
Gardenia Surgery
Moakes MC
Medina MC
2011
Oakley Surgery
39 Castle St
80%
Medici Practice
Bell House
Leagrave Surgery
Lea Vale MC
GP led WIC
Hockwell Ring
Larkside Practice
Blenheim MC
Petros MC
Stopsley Village
Woodland Ave
Kingfisher Practice
Lister House
Bute House
Neville Rd
Sundon MC
Barton Hills
2A Malzeard Rd
Wenlock St
% of new cancer cases are TWW referrals
28
15 out of 31 practices within Luton CCG achieved the recommended minimum of 40% in 2013.
Five practices failed to achieve 40% for the last three years
Three year profile (2011 to 2013)
90%
Recommended minimum
70%
60%
50%
40%
30%
20%
10%
0%
29
Percentage of new cancer cases treated which are Two Week Wait referrals
Practice indicator scores
Year on year rate
2011
2012
2010
E81001
E81631
E81632
E81040
E81633
E81048
E81016
E81075
E81018
E81006
E81064
E81028
E81026
E81612
Y02463
E81032
E81010
E81005
E81073
E81013
E81025
E81065
Y02464
E81041
E81617
Y02332
E81076
E81054
E81063
Y02477
E81618
Wenlock St
2A Malzeard Rd
Barton Hills
Sundon MC
Neville Rd
Bute House
Lister House
Kingfisher Practice
Woodland Ave
Stopsley Village
Petros MC
Blenheim MC
Larkside Practice
Hockwell Ring
GP led WIC
Lea Vale MC
Leagrave Surgery
Bell House
Medici Practice
39 Castle St
Oakley Surgery
Medina MC
Moakes MC
Gardenia Surgery
49 Ashcroft Rd
Kingsway HC
Pastures Way
Sundon Park HC
Conway MC
Whipperley MC
53 Leagrave Rd
28.6%
0.0%
38.1%
28.1%
50.0%
50.0%
42.9%
67.9%
41.5%
37.5%
50.0%
31.3%
63.3%
15.4%
48.9%
45.2%
34.1%
19.2%
45.5%
45.5%
0.0%
25.8%
36.4%
60.0%
23.1%
25.0%
50.0%
50.0%
50.0%
50.0%
30.0%
40.6%
50.0%
23.1%
35.3%
52.4%
32.4%
44.9%
52.4%
13.3%
32.0%
30.0%
50.0%
35.4%
38.2%
32.5%
40.0%
28.6%
23.8%
0.0%
0.0%
33.3%
62.5%
72.7%
27.3%
23.1%
0.0%
33.3%
0.0%
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
11.1%
0.0%
46.2%
48.3%
40.0%
46.7%
36.4%
40.7%
55.6%
36.8%
58.6%
35.3%
33.3%
35.7%
80.0%
46.4%
43.6%
42.9%
39.0%
43.5%
54.5%
0.0%
50.0%
22.2%
38.1%
30.8%
53.8%
11.1%
38.5%
42.9%
0.0%
2013
85.7%
66.7%
65.4%
60.0%
60.0%
60.0%
53.8%
52.6%
52.1%
51.9%
50.0%
42.9%
42.1%
42.1%
40.0%
39.4%
38.9%
38.8%
36.8%
31.4%
31.3%
30.0%
27.3%
26.9%
24.1%
23.1%
20.0%
14.3%
7.1%
0.0%
0.0%
At or above target
2010 2011 2012 2013
Difference over
4 years (pp1)
57.1%
66.7%
27.3%
31.9%
10.0%
10.0%
10.9%
-15.3%
10.6%
14.4%
0.0%
11.6%
-21.2%
26.7%
-9.5%
-6.3%
4.7%
17.6%
-14.1%
-14.2%
30.0%
1.1%
-12.3%
-36.9%
-3.1%
-10.7%
-42.9%
-50.0%
Key
Year on year increase
Year on year decrease
Above recommended
minimum
Below recommended
minimum
Recommended minimum = 40%
1
Percentage points
30
Two week wait indicator performance vs demographics
•
•
•
Two Week Wait referral ratio (Indirectly age standardised )
Percentage of Two Week Wait referrals with cancer
Percentage of new cancer cases treated which are Two Week Wait referrals
31
Practices within Luton CCG achieving the best practice and recommended ranges for Two Week
Waits, tend to have a higher proportion of new cancer cases
Population aged 65+
Popn aged 65+ (average)
15
10
5
0
1
2
3
Mean
Median
25%
Mean
20%
Median
15%
10%
5%
0%
0
1
2
3
0
1
2
3
Number of indicators where target was
achieved for2+ years
Number of indicators where target was
achieved for2+ years
Number of indicators where target was
achieved for2+ years
New cancer cases
Cancer deaths
Cancer prevalence
700
Mean
600
Median
300
Cancer deaths (average)
New cancer cases (average)
0
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
500
400
300
200
100
0
250
Mean
2.0%
Median
200
150
100
50
0
0
1
2
3
Number of indicators where target was
achieved for2+ years
0
1
2
3
Number of indicators where target was
achieved for2+ years
Cancer prevalence (average)
Number of practices
20
Deprivation
Deprivation (average)
Number of practices
Mean
Median
1.5%
1.0%
0.5%
0.0%
0
1
2
3
Number of indicators where target was
achieved for2+ years
Rate of emergency admissions with
cancer, per 100,000 population
Aim to minimize the number of cancer patients requiring emergency admissions. Try to
proactively manage cases. Consider using the RCGP Significant Event Audit to reflect on cases.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
Definition: The number of persons admitted to hospital as an inpatient or day-case via an emergency admission multiplied by 100,000 divided by
the number of persons in the practice list, expressed as a rate per 100,000 persons.
Indicator source(s): Hospital Episode Statistics (HES) data for 1st March 2012 to 29th February 2013 was taken from the UKACR “Cancer HES”
offload originally sourced from the NHS Information Centre for Health and Social Care HES dataset.
The number of practices within Luton CCG below the recommended maximum of 481 increased
year on year, leading to a decrease in the CCG average to below the recommended maximum in
2013.
CCG range and mean average
2010
2011
2012
2013
691
583
587
481
CCG/PCT mean average
555
464
485
346
CCG practice min
76
77
55
49
CCG practice max
866
977
848
618
Practices below recommended max.
9(28)
17(31)
13(31)
25(31)
Practices below recommended max. (%)
32.1%
54.8%
41.9%
80.6%
England mean average
1
2
1 Mean
Emergency admis. per 100,000
population
Summary statistics
1,000
Key
800
—
600
400
CCG range4
Recommended maximum
3 Mean
average for PCT in 2010 and 2011,
CCG for 2012 and 2013.
4 Range
0
2010
maximum = 481 (National average in 2013)
CCG/PCT3 mean average
= 481
200
average for PCT in 2010 and 2011, CCG for 2012 and 2013. ,
2Recommended
2011
2012
for practices within the current CCG
2013
Distribution of admission rates within the CCG
Luton CCG practices achieving recommended maximum rate
of 481 over 4 years
2013
Key
Targets
achieved
2012
Indicator value
0-250
2011
250-500
500-750
2010
4
3
2
1
0
750-1000
0%
20%
33
40%
60%
80%
Proportion of practices
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
100%
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
Leagrave Surgery
Barton Hills
Petros MC
49 Ashcroft Rd
Sundon Park HC
2013
Sundon MC
Kingsway HC
2012
Woodland Ave
Oakley Surgery
2011
39 Castle St
900
Stopsley Village
1,000
Gardenia Surgery
Bell House
Medici Practice
Blenheim MC
Larkside Practice
Wenlock St
Kingfisher Practice
Bute House
Lea Vale MC
Hockwell Ring
2A Malzeard Rd
Lister House
Pastures Way
Neville Rd
Moakes MC
Conway MC
GP led WIC
Whipperley MC
53 Leagrave Rd
Medina MC
Emergency admis. per 100,000 population
34
25 out of 31 practices in Luton CCG were below the recommended maximum of 481 in 2013.
Four practices failed to achieve the maximum of 481 target for the last three years
Three year profile (2011 to 2013)
Recommended maximum
800
700
600
500
400
300
200
100
0
35
Rate of emergency admissions with cancer per 100,000 population
Practice indicator scores
Year on year rate
2011
2012
2010
E81065
E81618
Y02477
Y02463
E81063
Y02464
E81633
E81076
E81016
E81631
E81612
E81032
E81048
E81075
E81001
E81026
E81028
E81073
E81005
E81041
E81006
E81013
E81025
E81018
Y02332
E81040
E81054
E81617
E81064
E81632
E81010
Medina MC
53 Leagrave Rd
Whipperley MC
GP led WIC
Conway MC
Moakes MC
Neville Rd
Pastures Way
Lister House
2A Malzeard Rd
Hockwell Ring
Lea Vale MC
Bute House
Kingfisher Practice
Wenlock St
Larkside Practice
Blenheim MC
Medici Practice
Bell House
Gardenia Surgery
Stopsley Village
39 Castle St
Oakley Surgery
Woodland Ave
Kingsway HC
Sundon MC
Sundon Park HC
49 Ashcroft Rd
Petros MC
Barton Hills
Leagrave Surgery
334
542
76
302
491
651
376
274
581
434
426
499
521
544
864
643
575
713
491
632
669
407
699
317
652
637
643
866
137
427
977
277
189
139
313
855
295
77
188
403
208
525
343
518
256
467
664
427
772
436
902
537
494
578
391
501
499
739
706
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
104
604
844
236
199
55
592
528
282
150
237
450
278
347
535
734
313
562
626
550
848
604
519
543
374
595
497
555
471
726
632
2013
49
60
153
167
174
195
199
205
221
224
230
235
244
265
266
285
299
303
389
407
417
445
469
470
475
500
503
505
526
575
618
At or above target
2010 2011 2012 2013
Difference over
4 years
-285
Key
-482
Year on year increase
98
Year on year decrease
Below recommended
maximum
Above recommended
-103
maximum
-286
-430
-152 Recommended maximum = 481
(national average in 2013)
-44
-346
-190
-161
-233
-236
-245
-561
-254
-168
-296
-46
-163
-199
68
-199
186
-147
-111
-68
-248
Rate of persons diagnosed with cancer
via an emergency admission, per 100,000 persons
Aim to have as few emergency presentations of cancer and more of the cases detected through
managed referral routes. Consider using the RCGP significant Event Audit to reflect on cases and using
Risk Assessment Tools to help guide investigation and referral.
Data source: GP Practice Profiles for cancer, Cancer Commissioning Toolkit
NOTE: DEFINITION AND DATA SOURCE CHANGED IN 2013
Definition: Proportion of persons diagnosed via an emergency, managed referral or other route (2010 to 2012) recalculated as a rate per 100,000
persons, Number of persons diagnosed via an emergency route multiplied by 100,000 divided by the number of persons in the practice list,
expressed as a rate per 100,000 persons (2013)
Indicator source(s): Routes to Diagnosis project database (2010 to 2012), Hospital Episode Statistics (2013)
37
Luton CCG’s average has decreased over the last three years to a level below the recommended
maximum of 74 in 2013. It has remained below the national average for the last four years.
Note: 2012 data not available for individual practices across all CCGs
2010
2011
2012
2013
89
107
105
74
CCG/PCT mean average
77
81
78
59
CCG practice min
0
0
-
0
CCG practice max
149
167
-
136
13(28)
15(31)
-
24(31)
46.4%
48.4%
-
77.4%
England mean average
1
Practices below recommended max
2
Practices below recommended max (%)
1 Mean
CCG range and mean average
Emergency presentations per
100,000 population
Summary statistics
average for PCT in 2010 and 2011, CCG for 2012 and 2013. ,
2Recommended
maximum = 74 (national average in 2013)
180
160
140
120
100
80
60
40
20
0
Key
—
CCG/PCT3 mean average
CCG range4
Recommended maximum
= 74
3 Mean
average for PCT in 2010 and 2011,
CCG for 2012 and 2013.
4 Range
2010
2011
2012
for practices within the current CCG
2013
Distribution of persons diagnosed with cancer (via an
emergency admission), within the CCG
Luton CCG practices achieving recommended maximum of
74 over three
available years
2013
Key
Targets achieved
2012
Indicator value
0-50
2011
50-100
3
2
1
0
100-150
2010
150-200
0%
20%
40%
60%
80%
Proportion of practices
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
100%
Maps contain: Ordnance Survey data © Crown copyright
and database right 2012, Royal Mail data © Royal Mail copyright
and database right 2012, National Statistics data © Crown copyright and database right 2012
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
49 Ashcroft Rd
Leagrave Surgery
Bell House
Moakes MC
Stopsley Village
Barton Hills
Gardenia Surgery
Lea Vale MC
Sundon Park HC
Oakley Surgery
Wenlock St
Kingsway HC
53 Leagrave Rd
Woodland Ave
GP led WIC
Hockwell Ring
Whipperley MC
Bute House
Petros MC
Medici Practice
Blenheim MC
Larkside Practice
2013
Neville Rd
39 Castle St
2012
Sundon MC
Conway MC
2011
Pastures Way
Medina MC
160
Lister House
Kingfisher Practice
2A Malzeard Rd
Emergency presentations per 100,000 population
38
24 out of 31 practices in Luton CCG were below the recommended maximum of 74 in 2013
Three year profile (2011 to 2013)
180
Recommended maximum
140
120
100
80
60
40
20
0
39
Rate of persons diagnosed with cancer via an emergency admission, per 100,000 persons
Practice indicator scores
Year on year rate
2011
2012
2010
E81631
E81075
E81016
E81065
E81076
E81063
E81040
E81013
E81633
E81026
E81028
E81073
E81064
E81048
Y02477
E81612
Y02463
E81018
E81618
Y02332
E81001
E81025
E81054
E81032
E81041
E81632
E81006
Y02464
E81005
E81010
E81617
2A Malzeard Rd
Kingfisher Practice
Lister House
Medina MC
Pastures Way
Conway MC
Sundon MC
39 Castle St
Neville Rd
Larkside Practice
Blenheim MC
Medici Practice
Petros MC
Bute House
Whipperley MC
Hockwell Ring
GP led WIC
Woodland Ave
53 Leagrave Rd
Kingsway HC
Wenlock St
Oakley Surgery
Sundon Park HC
Lea Vale MC
Gardenia Surgery
Barton Hills
Stopsley Village
Moakes MC
Bell House
Leagrave Surgery
49 Ashcroft Rd
0
77
28
0
47
25
121
95
86
149
65
65
97
40
78
67
120
0
133
22
75
112
96
47
84
96
129
42
0
79
15
39
93
63
55
99
134
76
86
81
115
65
0
76
0
167
61
46
34
68
120
92
102
63
86
69
53
93
83
Note: Published year shown, 2010 refers to 2009/10, 2011: 2010/11, 2012: 2011/12, 2013: 2012/13
2013
0
12
14
16
22
24
27
34
39
45
45
46
47
48
51
53
55
58
60
62
66
67
67
69
75
75
87
97
126
131
136
At or above target
2010 2011 2012 2013
Difference over
4 years
0
-65
-14
16
-25
-1
-94
-61
-47
-104
-20
-19
-50
8
-25
-9
-60
62
-67
45
-8
-43
-21
28
3
30
2
94
Key
Year on year increase
Year on year decrease
Below recommended
maximum
Above recommended
maximum
Recommended maximum = 74
(national average in 2013)
Emergency admission indicator performance vs
demographics
•
•
Rate of emergency admissions with cancer per 100,000 population
Rate of persons diagnosed with cancer via an emergency admission
Practices within Luton CCG achieving the emergency admission recommended rates tend to have
a lower proportion of the population aged 65+, higher levels of deprivation, a lower
proportion of new cancer cases, cancer deaths and cancer prevalence.
Population aged 65+
Popn aged 65+ (average)
12
10
8
6
4
2
0
0
1
Mean
Median
30%
Mean
25%
Median
20%
15%
10%
5%
0%
0
1
2
0
1
2
Number of indicators where target was
achieved for1+ years
Number of indicators where target was
achieved for1+ years
Number of indicators where target was
achieved for1+ years
New cancer cases
Cancer deaths
Cancer prevalence
Median
400
300
200
100
0
300
Mean
250
Median
200
150
100
50
0
0
1
2
Number of indicators where target was
achieved for1+ years
0
1
2
Number of indicators where target was
achieved for1+ years
Mean
2.0%
Cancer prevalence (average)
Mean
500
New cancer cases (average)
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
2
Cancer deaths (average)
Number of practices
14
Deprivation
Deprivation (average)
Number of practices
Median
1.5%
1.0%
0.5%
0.0%
0
1
2
Number of indicators where target was
achieved for1+ years
41
APPENDIX
Indicator definitions
43
Percentage of females aged 50–70 screened for breast cancer within 6 months of invitation
Aim to be above the national target (70%). Consider actively encouraging patients to participate in
screening programmes with letters or opportunistic prompts. GPs can be influential here.
Indicator definition
•
Number: The number of females aged 50 to 70 registered to the practice who were screened adequately within 6 months of
invitation.
•
Rate or proportion: 1-year screening uptake %: the number of females registered to the practice aged 50-70 invited for screening
in the previous 12 months who were screened within 6 months of invitation divided by the total number of females aged 50-70
invited for screening in the previous 12 months.
•
Method: Data was taken from the Open Exeter system without further processing. The data extracted represents the situation at
April 2013, and covers the period 2010/11-2012/13.
Binomial confidence intervals are calculated using the Wilson score method 1.
•
Source(s): Data was extracted from the NHAIS via the Open Exeter system. Data was collected by the NHS Cancer Screening
Programme.
•
Interpretation: This indicator measures the fraction of women invited in a specified period who are screened within 6 months of
their invitation date. Due details of local implementation the number of women invited for screening in the previous year may be
low (for example if screening is carried out by mobile units which revisit each area once in a screening round).
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
44
Percentage of females aged 25–64 attending cervical screening within target period
Aim to be above the national target (80%). Consider actively encouraging patients to participate in
screening programmes with letters or opportunistic prompts. GPs can be influential here.
Indicator definition
•
Number: The number of women registered at the practice screened adequately in the previous 42 months (if aged 24-49) or 66
months (if aged 50-64)
•
Rate or proportion: The overall cervical screening coverage: the number of women registered at the practice screened adequately
in the previous 42 months (if aged 24-49) or 66 months (if aged 50-64) divided by the number of eligible women on last day of
review period.
•
Method: Data was taken from the Open Exeter system without further processing. The data extracted represents the situation at
April 2013, and covers the period 2007/08Q3-2012/13.
Binomial confidence intervals are calculated using the Wilson score method 1.
•
Source(s): Data was extracted from the NHAIS via the Open Exeter system. Data was collected by the NHS Cancer Screening
Programme.
•
Interpretation: Women aged 25-49 are invited for routine screening every 3 years and women aged 50-64 are invited for routine
screening every 5 years. This indicator gives a combined coverage for the full age range so that it counts women aged 25-49
screened within a period of 3.5 years and women aged 50-64 within a period of 5.5 years prior to the report date and combines the
counts to give the final measure.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
45
Percentage of persons, 60–69, screened for bowel cancer within 6 months of invitation
Aim to be above the national target (60%). Consider actively encouraging patients to participate in
screening programmes with letters or opportunistic prompts. GPs can be influential here.
Indicator definition
•
Number: The number of persons aged 60 to 69 registered to the practice who were screened adequately within 6 months of
invitation.
•
Rate or proportion: Screening uptake %: the number of persons aged 60-69 invited for screening in the previous 12 months who
were screened adequately following an initial response within 6 months of invitation divided by the total number of persons aged
60-69 invited for screening in the previous 12 months.
•
Method: Data was taken from the Open Exeter system without further processing. The data extracted represents the situation at
April 2013, and covers the period 2010/11Q3-2012/13.
Binomial confidence intervals are calculated using the Wilson score method 1.
•
Source(s): Data was extracted from the Bowel Cancer Screening System (BCCS) via the Open Exeter system. Data was collected by
the NHS Cancer Screening Programme.
•
Interpretation: This indicator measures the fraction of people invited who have been screened adequately following an initial
response within 6 months of their invitation date. Caution should be used in interpreting the data as not all CCGs had full
implementation of the programme in the recorded period.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
46
Two Week Wait referral ratio (indirectly age standardised)
Aim to be referring within 20% of the England average two week wait referral rate.
Rates outside this range may indicate over/under use of the two week wait referral route.
You may wish to audit your referrals against NICE cancer referral guidance.
Indicator definition
•
Number: The number of Two Week Wait (GP urgent) referrals where cancer is suspected for patients registered at the practice in
question in 2012/13.
•
Rate or proportion: The crude rate of referral: the number of Two Week Wait referrals where cancer is suspected multiplied by
100,000 divided by the list size of the practice in question.
•
Method: Patient level Cancer Waiting Times (CWT) data (including patient identifiers) was downloaded from the NHS England
Cancer Waiting Times Database by the Knowledge and Intelligence Team (East Midlands). Each patient was traced to a GP Practice
using the Open Exeter Batch Tracing Service. Two Week Wait Referrals were identified for patients with a date first seen on the CWT
database in 2012/13. All records with a ‘Referral Priority Type’ of 3 (Two Week Wait) were counted, excluding patients referred for
non-cancer breast symptoms.
Poisson confidence intervals are calculated using Byar’s approximation1.
•
Source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the
NHS England Cancer Waiting Times Database.
•
Interpretation: The number of Two Week Wait referrals with a suspicion of cancer, whether or not cancer was subsequently
diagnosed. This indicator may be expected to be higher in practices with an unusually high proportion of persons of 65+ years of
age, due to the higher incidence of cancer at these ages.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
47
Percentage of Two Week Wait referrals with cancer
Aim to have conversion rate between 8-14%. Rates outside this range may indicate over/under use of the
two week wait referral route. You may wish to audit your referrals against NICE cancer referral guidance.
There is no target number for referral as this depends on practice size and demographics.
Indicator definition
•
Number: The number of Two Week Wait referrals treated for cancer for patients registered at the practice in question.
•
Rate or proportion: The ‘conversion rate’, i.e., the proportion of Two Week Wait referrals that are subsequently diagnosed with cancer: the
number of new cancer cases treated in 2012/13 who were referred through the two week wait route divided by the total number of Two Week
Wait referrals in 2012/13.
•
Method: Patient level Cancer Waiting Times data (including patient identifiers) was downloaded from the NHS England Cancer Waiting Times
Database by the Knowledge and Intelligence Team (East Midlands). Each patient was traced to a GP Practice using the Open Exeter Batch
Tracing Service. Patients on the CWT database who had received a cancer diagnosis were identified as those patients receiving a first treatment
in 2012/13, i.e. with ‘Cancer Treatment Event Type’ of 01 (First definitive treatment for a new primary cancer) or 07 (First treatment for metastatic
disease following an unknown primary).
It was not possible to directly identify which referrals were subsequently diagnosed with cancer. Therefore, the proportion of referrals diagnosed
with cancer was calculated by dividing the number of patients receiving a first treatment in 2012/13 who were referred through the two week
wait route by the number of two week wait referrals. Most of the Two Week Wait referrals first seen in 2012/13 who were diagnosed with cancer
will have started treatment in 2012/13 but a small number will have started treatment in 2012/13 and a small number of patients who started
treatment in 2012/13 will have been first seen in 2011/12. For a very small number of practices, this may result in a ‘conversion rate’ of more than
100% being calculated.
Binomial confidence intervals are calculated using the Wilson score method1.
•
Source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the NHS
England Cancer Waiting Times Database.
•
Interpretation: The number of Two Week Wait referrals with a suspicion of cancer, in which cancer was subsequently diagnosed.
The proportion is the ‘conversion rate’ for the practice. This varies by cancer type and so will depend on the case-mix of cancers diagnosed in
persons registered at the practice. Either an unusually high or an unusually low conversion rate may merit further investigation.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
48
Percentage of new cancer cases treated which are Two Week Wait referrals
Aim to be above the line and have more of your cancer cases diagnosed through the
two week wait referral route. Consider doing the RCGP cancer diagnosis audit.
Indicator definition
•
Number: The number of patients registered at the practice who have a date of first treatment in 2012/13 on the cancer waiting times
system.
•
Rate or proportion: The proportion of new cancer cases treated who were referred through the Two Week Wait route. This is
calculated as the number of persons referred as a Two Week Wait referral who were subsequently diagnosed with cancer divided by
the total number of patients registered at the practice who have a date of first treatment in 2012/13 on the cancer waiting times
system.
•
Method: Patient level Cancer Waiting Times data (including patient identifiers) was downloaded from the NHS England Cancer
Waiting Times Database by the Knowledge and Intelligence Team (East Midlands). Each patient was traced to a GP Practice using the
Open Exeter Batch Tracing Service.
Binomial confidence intervals are calculated using the Wilson score method 1.
•
Source(s): Knowledge and Intelligence Team (East Midlands) based on Cancer Waiting Times data for England, 2012/13, held on the
NHS England Cancer Waiting Times Database.
•
Interpretation: This indicator shows the proportion of cancers that were first diagnosed following a two week wait referral. This
varies by cancer type and so will depend on the case-mix of cancers diagnosed in persons registered at the practice.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
49
Rate of emergency admissions with cancer, per 100,000 population
Aim to minimize the number of cancer patients requiring emergency admissions. Try to proactively
manage cases. Consider using the RCGP Significant Event Audit to reflect on cases.
Indicator definition
•
Number: The number of persons admitted to hospital as an inpatient or day-case via an emergency admission, with a diagnostic
code that includes cancer.
•
Rate or proportion: The number of persons admitted to hospital as an inpatient or day-case via an emergency admission multiplied
by 100,000 divided by the number of persons in the practice list, expressed as a rate per 100,000 persons.
•
Method: All emergency admissions with an invasive, in-situ, uncertain or unknown behaviour, or benign brain cancer (ICD-10 C00C97, D00-D09, D33, and D37-48) present in any of the first three diagnostic fields were extracted from the inpatient HES database.
•
Source(s): Hospital Episode Statistics (HES) data for 1st March 2012 to 28th February 2013 was taken from the UKACR “Cancer HES”
offload originally sourced from the NHS Information Centre for Health and Social Care HES dataset.
•
Interpretation: The number and crude rate per 100,000 persons of emergency in-patient or day-case admissions, sourced from HES
data, with a diagnosis that includes cancer. These may occur at any stage of the cancer pathway and will include persons diagnosed
with cancer in prior years. This indicator may be expected to be higher in practices with an unusually high fraction of persons of 65+
years of age, due to the higher incidence of cancer at these ages.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
50
Rate of persons diagnosed with cancer via an emergency admission (2010 to 2012)
Aim to have as few emergency presentations of cancer and more of the cases detected through managed
referral routes. Consider using the RCGP significant Event Audit to reflect on cases and using
Risk Assessment Tools to help guide investigation and referral.
Indicator definition
•
Number: Number of persons diagnosed via an emergency route, as defined by the Routes to Diagnosis project methodology 1
•
Rate or proportion: Number of persons diagnosed via an emergency route multiplied by 100,000 divided by the number of persons
in the practice list, expressed as a rate per 100,000 persons
•
Method: The data for the pool of patients diagnosed with cancer (ICD-10 C00-C97 excluding C44) in 2008 cancer registry records
was examined. These were linked at a patient level to the Routes to Diagnosis
In brief, the Routes to Diagnosis project method was that data sources of Screening, Inpatient HES, Outpatient HES, and Cancer
Waiting Times were used to trace the history of each patient diagnosed with cancer in the year 2008. Patient histories in the datasets
above prior to diagnosis were used to categorise the route that the patient took to arrive at the point of diagnosis.
Eight main routes were defined in the Routes to Diagnosis project, these are aggregated into three broad routes in these Practice
Profiles – Emergency Presentation, Managed Presentation, and Other Presentation. Emergency presentations are those initiated by
an emergency event of some type, Managed Presentations consist of those following a routine or Two week Wait referral from a GP,
Other Presentations are those via screening, death certificate only, Inpatient Elective, Other outpatients, and Unknown. See the
Routes to Diagnosis Project for further information1.
Binomial confidence intervals are calculated using the Wilson score method 2.
•
Source(s): Routes to Diagnosis project database.
•
Interpretation: The number of persons who present as an emergency. The rate is the estimated fraction of all presentations that are
emergencies, though patients who were diagnosed with multiple independent cancers in the same year were excluded.
Aggregated data may give slightly different totals for England than previously published as it applies only to those patients who can
be traced to a practice database.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 3.0, December 2012)
1Routes to Diagnosis methodology, available online at: http://www.ncin.org.uk/publications/routes_to_diagnosis.aspx
2APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
51
Rate of persons diagnosed with cancer via an emergency admission (2013)
Aim to have as few emergency presentations of cancer and more of the cases detected through managed
referral routes. Consider using the RCGP significant Event Audit to reflect on cases and using
Risk Assessment Tools to help guide investigation and referral.
Indicator definition
•
Number: Number of persons diagnosed via an emergency route, as defined by a first admission with a cancer code in the patient's
HES record which is an emergency.
•
Rate or proportion: Number of persons diagnosed via an emergency route multiplied by 100,000 divided by the number of persons
in the practice list, expressed as a rate per 100,000 persons.
•
Method: Each person with a inpatient HES record containing a cancer diagnostic code (ICD-10 C00-C97 excl C44) in one of the first
three diagnostic fields is identified. This cohort is deduplicated by matching to previous years HES records and cancer registration
records. Any duplicates are removed 15 and the remaining patients can be considered the remainder are an estimate of the
members of the cohort of patients diagnosed with a new cancer in the period of interest. The numbers by practice are counted by
allocating the patients to a practice according the practice as recorded by inpatient HES. The emergency status of the diagnostic
episode is taken from the ADMETH field.
•
Source(s): Hospital Episode Statistics, The Health and Social Care Information Centre. Copyright © [2013], re-used with the
permission of the Health and Social Care Information Centre. All rights reserved.
•
Interpretation: Emergency presentation is linked to lower short term survival in newly diagnosed patients. However is strongly
affected by case-mix: more emergency presentations can be expected in older practice populations and the mix of tumour types is
also highly significant (for example, lung cancers have a higher fraction of emergency presentations while breast cancers have a low
fraction of emergency presentations). More emergency presentations can therefore be expected in practices with an older or more
deprived population. Note: Aggregated data may give slightly different totals for England than previously published as it applies
only to those patients who can be traced to a practice. The “Rapid” Routes to Diagnosis emergency data remain experimental, and
are a proxy indicator. They are used to provide more timely data, but are not as rigorous as the figures found in Routes to Diagnosis.
As such the figures may differ from other published sources and care should be taken in their interpretation.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
APPENDIX
Demographic definitions
53
Practice Population aged 65+
Indicator definition
•
Number: The number of persons registered at the practice aged 65+.
•
Rate or proportion: The percentage of persons registered at the practice aged 65+, defined by the number of persons registered at
the practice divided by the list size of the practice.
•
Method: Data is taken from the Attribution Dataset, extracted April 2012. The number of persons aged 65+ is the sum across the
population in the 65-69, 70-74, 75-79, 80-84, and 85+ age-bands. The fraction of the practice population aged 65+ is calculated by
dividing the number aged 65+ by the list size of the practice sourced from the 2012/13 QOF data.
Binomial confidence intervals are calculated using the Wilson score method 1.
•
Interpretation: The percentage of the population over the age of 65 may be expected to have a significant effect on the burden of
cancer in the practice population. The percentage of the population is taken as at April 2012 and will not reflect changes since then.
•
Source(s): Data sourced from the Attribution Dataset provided by the South East Public Health Observatory.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
54
Socio-economic deprivation
Indicator definition
•
Number: The estimated quintile of deprivation of the practice.
•
Rate or proportion: The estimated income domain score for the practice, which is the percentage of the practice list that is income
deprived1.
•
Method: Index of Multiple Deprivation (IMD) scores for each deprivation domain have been estimated for each practice by the
English Public Health Observatories using the Index of Multiple Deprivation (IMD) 2010 by Lower Super Output Area (LSOA) 2. Briefly,
the overall socio-economic deprivation of the practice is estimated by averaging the socio-economic deprivation of each person on
the practice list based on their LSOA of residence. Practices were ranked nationally by Income Domain score and allocated into
equal population quintiles (1 being coded as the most affluent quintile, and 5 as the most deprived quintile).
Binomial confidence intervals are calculated using the Wilson score method3.
•
Interpretation: Several common cancers have a known dependence on the socio-economic status of the population. A more
deprived population may be expected to have a higher incidence rate of lung cancer but lower incidence rates of prostate and
breast cancer.
•
Source(s): Data provide by the English Public Health Observatories.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1The English Indices of Deprivation 2010. Communities and Local Government. Available online at: http://www.communities.gov.uk/publications/corporate/statistics/indices2010
2GP practice IMD 2007 – Calculation Notes, South East Public Health Observatory, 2010.
3APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
55
New cancer cases
Indicator definition
•
Number: The number of persons diagnosed with any invasive cancer excluding non-melanoma skin cancer (ICD-10 C00-C97,
excluding C44) in 2011.
•
Rate or proportion: The crude incidence rate per 100,000 persons: the number of new cases diagnosed multiplied by 100,000
divided by the practice list size.
•
Method: All invasive cancers diagnosed in 2011 registered by cancer registries and present in the 2010 Office of National Statistics
analysis dataset were included. These patients were matched to a GP surgery by tracing them by NHS number to find their current
and previous practice. Persons were allocated to their practice at their time of diagnosis. If this was not possible (for example, due to
the patient having moved practice more than once in the time between diagnosis and trace) they were not included. The resultant
total number of cancer diagnoses across England is 93% of the Office of National Statistics total number of cases for the country.
•
Source(s): Office of National Statistics 2011. Each patient was traced to a GP Practice using the NHS Personal Demographics Service.
•
Interpretation: This indicator gives the number of new cases and incidence rate of invasive cancer (excluding non-melanoma skin
cancer) in the practice population, as estimated from cancer registry data for calendar year 2011. Cancer registry data includes
persons diagnosed solely through their death certificate or who died shortly after an emergency presentation in secondary care, so
may be larger than number of persons known to the practice. However, as 7% of cases could not be traced to a specific practice
and are not included numbers at an individual practice may be undercounted by approximately this much. Numbers of cases may
also fluctuate year to year meaning that caution should be used in comparing this indicator to other indicators such as the number
of new cancer cases treated in 2012/13 taken from the Cancer Waiting Times database.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
56
Cancer deaths
Indicator definition
•
Number: The number of deaths with an underlying cause of death which is any invasive cancer (ICD-10 C00-C97) in 2011/12.
•
Rate or proportion: The crude mortality rate per 100,000 persons: the number of deaths due to invasive cancer multiplied by
100,000 divided by the practice list size.
•
Method: Records of all deaths in England occurring in 2011/12 were downloaded from the Primary Care Mortality Database. These
were filtered on the Underlying Cause of Death by ICD-10 code to exclude all deaths not due to invasive cancer (ICD-10 C00-C97))
and aggregated to GP Practices using the built-in practice codes.
Binomial confidence intervals are calculated using the Wilson score method 1.
•
Source(s): The Primary Care Mortality Database, which is a collaborative project between the Office of National Statistics and the
Information Centre.
•
Interpretation: This indicator gives the number of cancer deaths and crude mortality rate in the practice. Numbers of cases may
fluctuate year to year meaning that caution should be used in comparing this indicator to other indicators such as the number of
new cancer cases in 2010.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
57
Prevalent cancer cases
Indicator definition
•
Number: The number of persons registered on the practice cancer register.
•
Rate or proportion: The proportion of persons on the practice cancer register: the number of persons on the practice cancer
register divided by the practice list size.
•
Method: Data is taken from the QOF dataset without further processing.
Binomial confidence intervals are calculated using the Wilson score method 1.
•
Source(s): Data sourced from the cancer prevalence field of the QOF 2012/13 data2.
•
Interpretation: The prevalence data is taken from QOF data for 12/13, and originally sourced from each practice’s cancer register.
Recording methodology varies by practice and may underestimate the true cancer prevalence.
Source: NCAT General Practice Profiles for cancer: meta-data for profile indicators (Version 4.0, December 2013)
1APHO Technical Briefing 3: Commonly used public health statistics and their confidence intervals. Available online at: www.apho.org.uk/resource/view.aspx?RID=48457
22011/12 QOF data. Available online at: http://www.ic.nhs.uk/webfiles/publications/002_Audits/QOF_2011-12/Practice_Tables/QOF1112_Pracs_Prevalence.xls