Six trusts named as 'outliers' in lung cancer audit

Six trusts were identified as outliers in the National Lung Cancer Audit. Their responses to the audit were disclosed after a Freedom of Information Act request by HSJ.

After a rule change in 2015, national clinical audit providers are obliged to notify the CQC of any outliers identified in their work.

The information released to HSJ by the CQC revealed 63 trusts, which had received outlier notification letters since 2015.

Six trusts were designated outliers on the most recent National Lung Cancer Audit report, published earlier this year.

These were: Shrewsbury and Telford Hospitals Trust, Portsmouth Hospitals Trust, Northampton General Hospital Trust, Mid Essex Hospital Services Trust, East Kent Hospitals University Foundation Trust and Manchester University FT.

The trust responses to the Royal College of Physicians, which hosts the national audit, showed Shrewsbury and Telford Hospital Trust putting together a business case for two lung cancer specialist nurses after receiving its outlier notification.

Shrewsbury had been identified as an outlier for one year survival rates, but said this was down to not recording its data properly.

The other five trusts were outliers for the number of patients with advanced non-small cell lung cancer receiving systemic anticancer treatment.

Mid Essex’s response said its lung cancer team “had struggled to be quorate due to difficulty covering our oncology service”.

It said the long term difficulties staffing this had seen it merge its service with that of the neighbouring Southend University Hospital FT. Both trusts are now merging with Basildon and Thurrock Hospitals FT.

Manchester’s medical director’s response said it was a data reporting issue but the trust had recently recruited a medical oncologist for the lung cancer team.

Northampton said it was only an outlier because it had not recorded its data properly.

Portsmouth said it was trying to resolve an issue with West Sussex Hospitals Trust around receiving late referrals, but said its outlier status was explained by a data quality issue. East Kent also blamed the way it recorded its data.

The details of a further 16 letters have not yet been disclosed to HSJ, because the clinical audits are not ready to be published.

The list from the CQC also details outliers against other clinical audits including the national hip fracture database, the national maternity and perinatal audit and the national bowel cancer audit.