Guide to understanding the reports

This page explains each section listed in the Reports.  It also defines some of the terminology we use on this website.  You might read some unfamiliar terms that you also hear in hospital.  If there are any terms you don’t understand, you might find it useful to check our Glossary.

Report Type

There are four different types of Reports: self-assessment, internal validation, external verification and peer review.

Report summary section on report

Self Assessment

This means the service has assessed its own performance.  The service assesses itself against the measures for the relevant cancer service and judges if each measure has been achieved.

Internal Validation

Every three years, the trust is required to validate the accuracy of its previous self-assessments.  The trust makes comments against the self-assessment report and adjusts its percentage score to reflect its current performance.

External Verification

External verification is carried out following by the National Peer Review team.  It provides a further, independent check on self assessment and accuracy of internal validation.

Peer Review

Some services require a peer review visit.  This is when a team of 4-6 people who are specialists in, or have experience of, a particular area of cancer care, visits a service.  These teams can include doctors, nurses and allied health professionals (e.g. physiotherapists, occupational therapists and dieticians), as well as patients, carers and managers.  The team members then write a report on the service.

A peer review visit may happen because:

  • the team was less than 50% compliant
  • the team has not implemented the service’s action plan for making improvements
  • immediate risks have been identified and not resolved
  • a visit has been requested from other organisations
  • the team isn’t performing well
  • There are concerns regarding the internal validation process
  • The team is selected from a random sample

Amnesty

Some Reports will show the word ‘Amnesty’ next to the Report Type.  This refers to services that were given an option to ‘opt-out’ of being reviewed for one year.  This is only granted to very high-performing teams which, in their previous assessment, achieved an overall compliance equal to or greater than 85%, and had no serious concerns or immediate risks.

Service – Local vs. Specialist multi-disciplinary teams (MDTs)

In the Service part of the Report, you will see the terms ‘local’ or ‘specialist’.  This refers to the type of mulitdisciplinary team (MDT) in that service.

An MDT is a group of doctors and other health professionals with expertise in a specific cancer, who together discuss and mange your care.  They plan treatment that’s best for you, based on your test results.  You can find out more about the roles you might have in your MDT (in the glossary or on Macmillan’s Cancer Support’s website).

MDTs may include any of the following health care professionals, depending on the type of cancer and what services are available in your area:

Medical oncologist specialise in chemotherapy
Clinical oncologist specialise in radiotherapy
Specialist surgeons perform specialist surgery for specific cancers
Specialist physicians focus on non-surgical aspects of treatment
Haematologist specialise in blood cancers
Pathologist analyse and report on biopsy samples
Radiologist specialise in taking and analysing x-rays and related scans.
Clinical Nurse Specialists give you and your carers specialist information and support
Allied health professionals include additional expects who you may need for specialist help and support during your treatment e.g. dieticians, occupational therapists, physiotherapists, psychologists, speech pathologists and social workers.
General practitioners (GPs or family doctors) may be included in the MDT if a service is also delivered by primary care staff in the community.

Local MDTs

Local MDTs work closely with GPs to make sure people with suspected cancer are referred to hospital.  Once a referral is received from the GP (or, in some cases, from another consultant or MDT), the local team ensures the right diagnostic tests are arranged.

If cancer is diagnosed, the local MDT is responsible for deciding how best to treat patients with common cancers, such as breast, lung and colorectal cancers.  They are also responsible for treating people who require more common treatments and/or procedures.

However, depending on the tumour type, some local MDTs will only arrange the tests to diagnose cancer and won’t arrange treatment.  If this is the case, all patients with a confirmed cancer diagnosis will be referred to a specialist MDT.

Specialist MDTs

Specialist MDTs look after patients with less common or more challenging cancer types.  The teams include specialists who have expertise in doing more complex procedures and providing specialist care.

Most specialist MDTs also provide a local service (as above), for their local population.

Specialist MDTs are usually only available in the larger hospitals where all the required facilities are in one place.  This may mean that you may have to travel to receive treatment from a specialist MDT.

Overall Compliance

This part of the Report shows how well a cancer service has performed against their specific set of quality measures.  This involves assessing whether each measure has been achieved or not.  The overall percentage is based on the total proportion of measures achieved.  The higher the percentage, the better the service is doing at achieving its measures

National Benchmark PositionBenchmark example

This part of the Report shows how a service compares to other, similar services.  It is calculated using the teams’ percentage compliance against their specific measures, compared with all other similar services (treating the same type of cancer) across the country.

The blue dot on the diagram shows how well the team is performing compared to the national medium (the national average, shown by the grey line in the box).  The white box shows the performance range for the majority of the teams in the country.  The two grey dots indicate the lowest and highest performing services.

Serious Concerns and Immediate RisksSerious concerns and immediate risk section on report

A Serious Concern is an issue that requires urgent action.  While it may not present an immediate risk to your safety, it could seriously affect the quality or outcome of your care.

An Immediate Risk is an issue that requires immediate action.  It is likely to result in harm to patients or staff, or to have a direct impact on the outcome of care.

 

If a Report shows a Serious Concern or Immediate Risk, you can follow the link to see what the problem is and how it’s being resolved. This will take you to another section, further down the Report, for more detail.

Although these terms sound alarming, the majority of services with this status will have already resolved the issue or be in the process of resolving it.

The service has a complete teamComplete team section of report

Depending on your type of cancer, there are specific types of professionals who should form a full team to be able to carry out your care.  You can find out more about the sort of roles the team may have (in the glossary or Macmillan’s website).  For more information on the roles you team should have, please see the set of quality measures relevant to your cancer type.

2014 National Cancer Patient Experience Survey Results for Team


This part of the Report gives a summary of how this particular NHS trust was rated by patients in the 2014 National Cancer Patient Survey. This survey covered all 153 NHS trusts in England that provide adult cancer services.

Over 118,000 NHS patients with a primary diagnosis of cancer took the survey. Each had had treatment in the hospital between 1st September and 30th November 2013.

The results span all cancer services in the given hospital, so aren’t specific to one type of cancer. The survey asked patients 70 questions but we only show five on the Reports. These five were selected by a group of patients, who felt they were the most important to highlight

2014 National Cancer Patient Experience Survey Results for Trust


This part of the Report gives a summary of how this particular NHS trust was rated by patients in the 2014 National Cancer Patient Survey. This survey covered all 153 NHS trusts in England that provide adult cancer services.

Over 118,000 NHS patients with a primary diagnosis of cancer took the survey. Each had had treatment in the hospital between 1st September and 30th November 2013.

The results span all cancer services in the given hospital, so aren’t specific to one type of cancer. The survey asked patients 70 questions but we only show five on the Reports. These five were selected by a group of patients, who felt they were the most important to highlight

Waiting Times for Trust: July – September 2014

This part of the Report shows what percentage of patients were seen and treated within a set timeframe. 100% of patients who are willing and able to do so, and for whom it is clinically appropriate, will be treated within the standard timescales below (2 weeks, 31 days or 62 days).

It’s important to remember that there are many reasons why a service can’t always achieve meet these timeframes – and these reasons may be out of the service’s control. For example, the patient may not be well enough to attend clinic, they may want more time to think about their treatment options, or want to take a holiday or attend a special event before starting treatment.

The trust waiting times shown in the Reports span all cancer services and so aren’t specific to one type of cancer.

Two week wait

Patients should wait no more than two weeks from an urgent General Practitioner (GP) referral for suspected cancer to date first seen by a specialist for all suspected cancers.

One month (31 day) wait

Patients should wait no more than 31 days from the decision to treat to the start of their first treatment. It is also expected that any subsequent surgical, drug or radiotherapy treatments will be delivered within 31 days.

Two month (62 day) wait

Patients should not wait no more than two months (62-day) from urgent GP referral for suspected cancer to First Definitive Treatment for all cancers.

The maximum 62 day wait also applies to:

  • A referral from a cancer Screening Programme to first treatment for all cancers.
  • From a consultant’s decision to upgrade the urgency of a patient they suspect to have cancer to first treatment for all cancers.

Structure and Function of the service

This section of the Report includes information about how the MDT is structured and how it operates.

Here, you will see comments on leadership, membership, meeting arrangements and the processes that are in place to ensure all members of the MDT work together to discuss and agree the best treatment options for you.

How your care/pathways is coordinated

This section of the Report includes information about how your care is planned each step of the way, so everything is coordinated and done without delay. (This process is often referred to as the ‘pathway’.) It also contains information about how you’re supported through key stages of your treatment.

Patient experience

This section of the Report describes how the MDT provides patient-friendly care and treatment that takes account of your individual needs and preferences. It includes details of any feedback from patients with a description of the action taken to resolve and improve the service.

Clinical Outcomes/Indicators

This section of the Report contains information on the team or service’s performance against specific clinical outcomes/indicators. These have been developed for most tumour types to provide a means of reviewing outcomes of care e.g. mortality rates, survival rates, diagnostic tests, surgical techniques, treatment options for specific cancers.

Good Practise

This part of the Report shows any examples of good practice that were identified in the team and hospital. This might be related to excellent leadership and teamwork within the trust, or be linked to special initiatives e.g. initiatives focused on symptom awareness and early diagnosis.

Immediate Risks

Immediate Risks are highlighted in the top half of the report in Team Results.  If there is an Immediate Risk highlighted in the summary report, you should read this part of the report, which will explain the reasoning behind the decision. It may also include how the team will or have resolved the issue.

Serious Concerns

Serious concerns are highlighted in the top half of the report in Team Results.  If there is an Immediate Risk highlighted in the summary, you should read what the risk is in more detail here.

Concerns

This part of the Report shows any concerns about an aspect of the service that is affecting the delivery or quality of care, but does not require immediate action.

General comments

This section can include any additional comments that the service may want to add.  It may also be used to summarise the service’s offering.

Have you found this page useful?

We hope this page has helped you understand the detailed information in the Reports. If you think we can improve the information on this page, please get in touch.

Making decisions about your cancer treatment can be difficult. If you need more support after using our Reports, Macmillan can help.

Acknowledgements

My Cancer Treatment would like to acknowledge and thank NHS Choices, Department of Health, National Cancer Intelligence Network and Macmillan as information sources, referenced to support the information provided in My Cancer Treatment.