Article Text
Abstract
Introduction The National Ovarian Cancer Audit (NOCA) for England and Wales was established in 2023 following the Ovarian Cancer Audit Feasibility Pilot. NOCA uses linked routine registration data to report on quality performance indicators (QPIs) mapped to healthcare improvement goals.
Methods Data were analysed for all 33,450 women diagnosed with stage II-IV or unstaged ovarian cancer in England between 2015 and 2021 at 124 National Health Service (NHS) trusts. We developed a two-phase algorithmic approach for identifying systems of surgical hubs and referral spokes using cancer registration data in England mapped to 2024 NHS trust configurations. We will use the data to evaluate the proportion of patients receiving surgery, chemotherapy, or any type of treatment, adjusting for confounders against established metrics.
Results The first phase of the approach identified 38 surgical hubs and 70 referral spokes attached to hubs for 108 (87%) of 124 NHS trusts. The remaining 16 NHS trusts required additional investigation within trusts before hub or spoke status could be designated. The resulting hub and spoke systems are then compared in terms of the proportion of care, including surgery and/or chemotherapy, survival, and positive outliers, adjusted for difference between the cancer systems in the distribution of patient age, tumour morphology, performance status and tumour staging.
Conclusion/Implications Routine cancer registration data can be used to identify surgical hub and referral spoke systems. This is the first step to establish treatment and survival rates and positive outliers by cancer centre and report on these to NOCA QPIs.