Tumour standards are an internationally accepted approach to driving quality improvement in cancer care. They describe the level of service a person with cancer should have access to, and enable unwarranted variation in care to be identified and addressed.
The Ministry of Health is working alongside the sector to review and finalise the provisional tumour standards. The review includes development of:
- tumour-specific standards of service provision covering diagnosis, treatment and follow-up to replace the existing provisional standards
- a person-centred standard of care which will apply across the care continuum, from prevention and early detection to follow-up and end of care. This standard will apply to all tumour groups, regardless of whether they already have a provisional standard
- development of standards of service provision for prostate, kidney and bladder cancers
- quality performance indicators and person-reported outcome measures that can be reported on to understand system performance across all standards.
The tumour standards review commenced with the revision of the bowel cancer standard as a pilot. This has involved working closely with the National Bowel Cancer Working Group to select, develop and publicly report a range of quality of care measures (including outcomes data) across the bowel cancer diagnosis and treatment pathway. Consumers, colleges, professional bodies and clinicians have all been involved in defining and selecting relevant outcomes and process measures.
The quality performance indicators selected will be supported by clear evidence and their ability to enable continuous improvement in the quality and safety of cancer services. The measures will have meaning for both people with cancer and the clinicians who provide their care.
Data quality improvement project options
The bowel cancer standard pilot has informed a project to scope other data improvement options. Each bowel cancer indicator selected for development is assessed to determine if data is available and of the quality required to provide an accurate and complete picture of the quality of cancer care. The data gaps are being assessed and prioritised for investigation and evaluation. This will involve development of potential solutions to improve data capture to allow national reporting. This work will inform future direction and funding decisions for the Cancer Health Information Strategy.
Development of the provisional standards
The provisional tumour standards were developed by sector working groups and consumer health representatives led by the Regional Cancer Networks. The first tumour standards to be developed were the Standards of Service Provision for Lung Cancer Patients, published in 2011, followed by provisional tumour standards for breast, bowel, head and neck, lymphoma, melanoma, myeloma, gynaecological, sarcoma, thyroid and upper gastrointestinal cancers in 2013.
The provisional standards are based on established national and international evidence-based guidelines, or expert opinion. The tumour standard working groups had access to expert advisors including Māori and consumer health representatives. The provisional tumour standards were informed by wider consultation from key sector stakeholders and relevant professional organisations. Draft standards were circulated for feedback in April and May 2013 and more than 160 submissions were received.