New CCG ratings: Over 85 per cent failing on cancer performance

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Controversial “Ofsted style” ratings suggest 180 out of the 209 CCGs are failing on cancer performance
Just seven CCGs rated “top performing”, while 22 rated as “performing well”

Over 85 per cent of clinical commissioning groups are failing to hit required standards on cancer performance and must improve, according to ratings launched by the health secretary today.

The controversial ratings published by NHS England labelled 180 of the 209 CCGs as either “needs improvement” (156 CCGs) or “greatest need of improvement” (24 CCGs).

Just seven CCGs secured a top rating of “top performing”, while a cohort of 22 were rated as “performing well”.

In the information from NHS England, CCGs are split into four rating groups but then within the groups they are placed in alphabetical order.

NHS England said the overall rating for cancer was based on four indicators or metrics: early diagnosis, one year survival, 62 day waits after referral, and overall patient experience.

The new cancer metric is part of the CCG improvement and assessment framework, which provides an “initial baseline rating for six clinical priority areas, including cancer”, NHS England said.

The lowest ranked group included a number of London CCGs including Haringey, Newham, Tower Hamlets, and Waltham Forest CCGs. The top seven included Harrogate and District and Leeds North CCGs (See table).

The ratings were launched by health secretary Jeremy Hunt today. During his speech to the Conservative party conference, he said: “Our new cancer plan will introduce a maximum four week wait from GP referral to diagnosis; bring in Ofsted-style cancer ratings for CCGs; do more molecular diagnostics and immunotherapy and save an estimated 30,000 lives a year.

“I’m publishing those Ofsted ratings today and although they don’t make comfortable reading everyone will now see our commitment to build a safer NHS doing more than ever to fight cancer for you and your family.”

Under Mr Hunt’s initial proposals for CCG ratings in specific clinical areas, announced at HSJ’s annual lecture last October, they were due to employ the Ofsted-style terms also employed by the Care Quality Commission, including “inadequate” and “requires improvement”.

This was dropped in favour of the less blunt terms after opposition from CCGs and within NHS England, as HSJ revealed in July.

The worst performers

CCG Name	Early Diagnosis	One year survival	62 day wait (GP)	Overall Patient Experience	Summative Assessment
NHS BASSETLAW CCG	36.7%	67.9%	78.9%	88.1%	Greatest Need for Improvement
NHS BLACKBURN WITH DARWEN CCG	45.6%	67.7%	81.0%	83.9%	Greatest Need for Improvement
NHS BLACKPOOL CCG	43.7%	67.7%	84.5%	84.6%	Greatest Need for Improvement
NHS BRADFORD CITY CCG	48.6%	65.8%	81.8%	66.7%	Greatest Need for Improvement
NHS CITY AND HACKNEY CCG	54.2%	67.7%	79.2%	75.8%	Greatest Need for Improvement
NHS COASTAL WEST SUSSEX CCG	51.7%	68.9%	83.5%	85.7%	Greatest Need for Improvement
NHS DONCASTER CCG	37.8%	68.5%	81.0%	91.5%	Greatest Need for Improvement
NHS EAST STAFFORDSHIRE CCG	39.2%	68.7%	74.7%	89.6%	Greatest Need for Improvement
NHS EASTBOURNE, HAILSHAM AND SEAFORD CCG	38.8%	68.8%	75.3%	87.2%	Greatest Need for Improvement
NHS HARINGEY CCG	46.2%	69.8%	81.0%	83.0%	Greatest Need for Improvement
NHS HASTINGS AND ROTHER CCG	40.6%	67.2%	72.9%	90.7%	Greatest Need for Improvement
NHS LEICESTER CITY CCG	45.5%	65.9%	74.8%	83.2%	Greatest Need for Improvement
NHS LINCOLNSHIRE EAST CCG	36.5%	68.8%	72.1%	85.9%	Greatest Need for Improvement
NHS MANSFIELD AND ASHFIELD CCG	39.4%	66.6%	84.8%	91.0%	Greatest Need for Improvement
NHS MEDWAY CCG	44.6%	65.3%	71.3%	87.4%	Greatest Need for Improvement
NHS NENE CCG	51.8%	69.3%	79.7%	86.0%	Greatest Need for Improvement
NHS NEWHAM CCG	39.5%	63.9%	81.8%	82.6%	Greatest Need for Improvement
NHS NORTH KIRKLEES CCG	46.4%	68.6%	82.1%	89.7%	Greatest Need for Improvement
NHS REDBRIDGE CCG	45.5%	67.0%	72.6%	83.6%	Greatest Need for Improvement
NHS SANDWELL AND WEST BIRMINGHAM CCG	53.6%	65.8%	84.7%	84.4%	Greatest Need for Improvement
NHS THANET CCG	42.3%	65.5%	73.2%	88.0%	Greatest Need for Improvement
NHS TOWER HAMLETS CCG	43.9%	66.5%	81.3%	85.8%	Greatest Need for Improvement
NHS WALTHAM FOREST CCG	45.1%	68.7%	86.5%	78.9%	Greatest Need for Improvement
NHS WARWICKSHIRE NORTH CCG	44.2%	69.0%	71.6%	91.3%	Greatest Need for Improvement

The best performers

CCG Name	Early Diagnosis	One year survival	62 day wait (GP)	Overall Patient Experience	Summative Assessment
NHS HARROGATE AND RURAL DISTRICT CCG	52.40%	72.60%	86.00%	92.20%	Top Performing
NHS LEEDS NORTH CCG	55.20%	72.20%	91.50%	88.20%	Top Performing
NHS SOLIHULL CCG	59.70%	71.00%	86.70%	87.30%	Top Performing
NHS SOUTH DEVON AND TORBAY CCG	55.20%	73.30%	88.50%	91.90%	Top Performing
NHS STOCKPORT CCG	50.80%	72.30%	88.30%	92.00%	Top Performing
NHS VALE OF YORK CCG	55.90%	70.80%	86.60%	90.80%	Top Performing
NHS WILTSHIRE CCG	56.20%	70.80%	86.90%	91.80%	Top Performing

The full data is available on the MyNHS website, and in the table attached to this story (see link below).

In February, NHS England appointed high profile chairs for the panels developing the ratings metrics, with Cancer Research UK chief executive Sir Harpal Kumar appointed to oversee cancer.

The other metrics were for mental health, dementia, learning disabilities, and diabetes and maternity.

Publication of the various metrics were initially delayed after experts leading the work raised concerns the information available may not be adequate to give credible ratings and more time was needed to develop robust methodologies.

NHS Clinical Commissioners said the baselines would be used to “get an understanding of where each CCG area currently [was] with the delivery of cancer services”.

NHSCC chief executive Julie Wood added: “This provides commissioners with valuable information in identifying where improvements are need and will enable them to measure progress in future years. It is important that meaningful support is provided to those CCGs who need it and that there is learning from those who have done well. Our members will look to Cancer Alliances to support them.

“Cancer care has been improving and continues to do so but commissioners are determined to do more. Our members wholly recognise the devastating impact that cancer has on patients and their families and see continuing to improve standards around early diagnosis and treatment for their local population as an absolute priority.”