Head and neck cancer Quality Performance Indicators
Patients diagnosed between 1 April 2021 and 31 March 2024

About this release

This release by Public Health Scotland (PHS) summarises recent national performance, measured using the national Quality Performance Indicators (QPIs) relating to the diagnosis and treatment of cancer of the head and neck. 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 patients.

This dataset includes patients who were diagnosed with cancers of the head and neck (including cancers of the tongue, salivary glands and larynx - see full list of included anatomical sites in the PHS data definitions document) between April 2021 and March 2024.

Main points

Please see the table in the spreadsheet accompanying this publication for the head and neck cancer QPI performance data, expressed as percentages, along with target levels.

• The numbers of patients included in these cancer audit records were:
  • 1,321 patients diagnosed between April 2023 and March 2024
  • 1,310 patients diagnosed between April 2022 and March 2023
  • 1,265 patients diagnosed between April 2021 and March 2022

The head and neck cancer QPI targets have proven challenging to achieve, highlighting several areas where regional networks acknowledge there is room for improvement (QPIs 4, 5, 6, 7 and 14).

• At Scotland level for April 2023 to March 2024, 12 of the twenty targets were met. 
• QPI 2(ii) (imaging) performance was met in April 2021 to March 2022, then fell and was narrowly below the target in April 2023 to March 2024. 
• Regional reports mentioned significant recording issues around QPI 4 (smoking cessation). The formal review process led to the decision to archive this indicator, which will therefore no longer be recorded.
• Targets relating to oral and dental rehabilitation plans (QPI 5) were missed. Regional reports cited recording issues that have been addressed, and workforce capacity as a contributing factor.
• Some components of QPI 6 (on nutritional screening) were missed in several years. Regional reports stated improvement actions are in place.
• QPI 7 on speech and language therapy was missed in all three years of the reporting period. Challenges hiring speech and language therapists were mentioned as an issue in regional cancer network reports.
• Regional reports stated that the target for QPI 8 (surgical margins) was met comfortably as a result of improvement actions taken in previous years.
• Performance against QPI 14, time from surgery to adjuvant radiotherapy/ chemoradiotherapy was twenty per cent short of the target in April 2022 to March 2023 and thirteen percent short in April 2023 to March 2024. 

These national cancer programme figures do not include patients treated in private healthcare as the audit teams work in the NHS Boards.

Background

The QPIs were put in place to support quality improvement in the treatment of a range of cancers - see About the QPIs. The indicators and associated targets for all the included cancers were developed by, and periodically undergo formal review 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 (eCASE electronic Cancer Audit Support Environment) by specialised cancer audit teams working in NHS Boards within the regional networks.

Scottish territorial health boards are required to report their performance against these nationally agreed indicators and targets 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 released reports in respect of QPI performance in their region for recent years: 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

QPI publications cover a three-year period, so this publication's next release will be in May 2028.