Melanoma cancer Quality Performance Indicators
Patients diagnosed from July 2021 to June 2024

About this release

This release by Public Health Scotland (PHS) summarises recent national performance, measured using the national Quality Performance Indicators relating to the diagnosis and treatment of melanoma also known as skin 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 patients. The indicators 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.

This dataset includes patients who were diagnosed with melanoma cancer (see full list of included anatomical sites in the PHS data definitions document) between July 2021 and June 2024.

Main points

The national performance statistics for each QPI can be found in the spreadsheet below.

• The numbers of patients included in these cancer audit records were:
  • 1,717 patients diagnosed between July 2023 and June 2024
  • 1,492 patients diagnosed between July 2022 and June 2023
  • 1,396 patients diagnosed between July 2021 and June 2022

• At Scotland level for July 2023 to June 2024, ten of the fifteen targets were met.
• The results presented in this report illustrate that some of the QPI targets remain challenging, with room for further service improvement. The main areas for improvement relate to QPIs 7, 9 and 10.
• With respect to QPI 7(i), regional cancer network reports state that capacity in pathology services has hindered efforts to meet the target; whereas on QPI 7(ii) they cite operating theatre capacity as one of the factors affecting performance.
• Performance against QPI 9 was a long way short of the target. Performance improved in 2022/2023 but slipped back down again in 2023/2024. Regional reports highlighted some health boards had made steady progress on this measure in earlier years. Meanwhile, some eligible patients were judged too frail for CT or PET CT scans.
• QPI 10(i) involved relatively small numbers of patients, a small proportion of those who undergo SACT, leading to wide variation in percentage performance (just 70 patients in the last three years were eligible to be included in this QPI). Regional reports stated that many patients eligible for this QPI were not sufficiently fit for systemic therapy, and that the role of adjuvant therapies in melanoma management is evolving.
• It is encouraging that targets relating to QPIs 1, 2, 5, 6, 8 and 14 were consistently met by all networks in this reporting period.

Background

The QPIs were put in place to support quality improvement in the treatment of a range of cancers - see About the QPIs. Scottish territorial health boards are required to report their performance against these nationally agreed 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.

Two of the networks released reports in respect of QPI performance in their region for recent years:  NCA 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 June 2028.