Bladder cancer Quality Performance Indicators
Patients diagnosed from 1 April 2020 to 31 March 2023

About this release

This release by Public Health Scotland (PHS) summarises recent national performance in respect of a set of nationally agreed Quality Performance Indicators for the diagnosis and  treatment of bladder cancer. The aim of the indicators is to ensure that efforts to improve treatment are focussed on those aspects that are most important in terms of improving survival and individual care experience whilst reducing variation and supporting the most effective and efficient delivery of care for people with this type of cancer.  The indicators are developed and formally reviewed by Healthcare Improvement Scotland, PHS and the three regional cancer networks (NCA - North Cancer Alliance; SCAN - South East Scotland Cancer Network; and WoSCAN - West of Scotland Cancer Network).  Data are gathered and recorded in a central database by specialised cancer audit teams working in NHS Boards within the regional networks.

This release summarises performance for these indicators for patients who were diagnosed with bladder cancer between April 2020 and March 2023.

Main points

The data for Scotland can be found in a spreadsheet provided alongside this summary.

• There were 1,517 patients diagnosed with Bladder cancer between April 2022 and March 2023. This is an increase from previous years (1,465 and 1,375 diagnosed between April 2021 and March 2022 and April 2020 to March 2021, respectively).
• Only six of the targets were met in April 2022 to March 2023, while fifteen were not.
• These QPIs are kept under regular review and are responsive to changes in clinical practice and emerging evidence. The following recent changes should be noted.
  • Definitions of several indicators were amended after March 2021 following agreement through the consultation process. The new indicators are no longer comparable with previous years. We therefore display these revised QPIs on separate rows of the spreadsheet (e.g. QPI 6, Lymph Node Yield).
  • Several of the indicators were not reported in April 2021 to March 2022 because of the time changes agreed at the consultation took to implement e.g. QPI 10 (Radical Radiotherapy Treatment with a Concomitant Radiosensitiser).
  • QPI 13 (Early Recurrence in Patients with Non-Muscle Invasive Bladder Cancer (NMIBC)) is a new QPI, for which April 2022 to March 2023 is the first year of data.
  • QPI 5 (Pathology reporting) was no longer reported after April 2020 to March 2021 because the target was being met consistently over a number of years and consistent pathology reporting according to guidelines is now considered standard practice.

Please see the separate PDF for QPI 8 Volume of Cases per Surgeon, which shows how many bladder cancer procedures surgeons in Scotland perform each year, measured against the best practice standard.  

All three regional cancer networks found several of the targets very challenging. In some cases, the availability of operating theatres and of staff impacted on performance. The networks have commented that some targets were ambitious, and some should be adjusted as to how they are measured, that the current measures do not always take account of all the patients who should be excluded. However, there is acknowledgment of room for improvement; a range of specific steps have been identified to achieve improvement, including the need in some cases for more training and work to be done in raising awareness of best practice.

Background

QPIs are in place for the treatment of a range of cancer types to support quality improvement in their treatment - see About the QPIs. Scottish territorial health boards are required to report on their performance against these indicators under the national cancer quality programme - see Scottish Government letter CEL 06 2012 setting out the details. Reporting in this current format was first undertaken in 2012. Performance for other cancers can be found in QPI reports.

Each of the networks release reports in respect of QPI performance in their region: NCA, SCAN and WoSCAN. In addition, those directly involved in service improvement can access more detailed information through the Cancer QPI Dashboard within SCRIS (Scottish Cancer Registry and Intelligence Service). Due to the level of detail, access is strictly controlled. New users may apply for authorisation (to access the data) via https://useraccess.nhsnss.scot.nhs.uk.

Further information

The QPI publications look at a three-year period, so the next release of this publication will be in November 2027.