Quality Improvement

Our work to promote quality improvement among providers of treatment for Oesophago-Gastric cancer.

NOGCA Quality Improvement Plan 2024

NOGCA Quality Improvement Plan

The National Oesophago-Gastric Cancer Audit (NOGCA) Quality Improvement Plan sets out the scope, care pathway, five quality improvement goals and ten performance indicators for the Audit. To inform the development of this Quality Improvement Plan, the NOGCA Project Team held several meetings with stakeholders (in March 2023, August 2023 and February 2024), and circulated key documents (Scoping Document, draft improvement goals, indicators) for consultation. Stakeholders included those representing key clinical specialties, cancer data services in England and Wales, patient organisations, quality improvement experts, NHS England, NHS Wales, National Quality Improvement and Clinical Audit Network (NQICAN), NATCAN and HQIP, as well as members of the NOGCA Project Team.

Based on this work, NOGCA proposes to include all NHS patients with a histologically confirmed diagnosis of invasive epithelial cancer of the oesophagus, gastro-oesophageal junction (GOJ) or stomach in England and Wales. The Audit will evaluate OG cancer care from the point of diagnosis through to the completion of primary treatment delivered in hospital settings, including surgery, systemic anti-cancer therapy, radiotherapy and endoscopic therapies with curative and noncurative intent. This will cover diagnostic and staging processes including routes to diagnosis and use of staging investigations.

The following quality improvement goals have been identified for NOGCA:

  1. Reduce rates of emergency and late stage diagnosis of OG cancer
  2. Reduce the percentage of patients with OG cancer waiting more than 62 days from referral to first treatment
  3. Increase the percentage of people with OG cancer who have access to a clinical nurse specialist (CNS)
  4. Improve outcomes of potentially curative treatment for people with OG cancer
  5. Improve completion and reduce complications of palliative chemotherapy for people with OG cancer.

NOGCA has identified ten performance indicators, mapped to these five quality improvement goals and clinical guidelines. This Quality Improvement Plan sets out improvement methods, improvement activities and approaches to evaluation of these goals and activities.

For any queries relating to this please contact [email protected].

Introduction to Quality Improvement

Links to organisations providing essential reading and background to Quality Improvement

Source Title
Royal College of Surgeons of England Quality improvement in surgery
Royal College of Radiologists Quality Improvement in Clinical Radiology
Hughes, RG Tools and strategies for quality improvement and patient safety
Health Foundation Quality improvement made simple
HQIP HQIP elearning
NICE Putting NICE Guidance into practice
NHS Wales Improvement Cymru

Quality Improvement Methods and Tools

Links to useful Quality Improvement methods and tools including templates

Source Title
NHS Improvement QSIR – Tools by patient pathway
NHS Improvement QSIR – Tools by type of task
Institute for Healthcare Improvement Quality Improvement Essentials Toolkit
HQIP Good governance handbook
HQIP Clinical audit: a guide for NHS Boards and partners
HQIP A guide to quality improvement tools
East London NHS Foundation Trust Quality Improvement Resources
National Institute of Clinical Excellence Quality Improvement resources for commissioners 

Quality Improvement Case Studies

Below is a list of QI case studies.

Source Title
NHS Scotland QI Case Studies
Journal of Thoracic Disease Benchmark analyses in minimally invasive esophagectomy-impact on surgical quality improvement
Annals of Surgical Oncology Quality Improvement in Minimally Invasive Esophagectomy: Outcome Improvement Through Data Review
Journal of Gastrointestinal Surgery Evolution of Standardized Clinical Pathways: Refining Multidisciplinary Care and Process to Improve Outcomes of the Surgical Treatment of Esophageal Cancer
European Journal of Surgical Oncology Control chart methods for monitoring surgical performance: A case study from gastro-oesophageal surgery

National Quality Improvement programmes

National programmes working to improve the quality of care and use the findings from the NOGCA to underpin their work

Source Title
National Clinical Audit Benchmarking Benchmarked NOGCA data utilised for CQC hospital inspections
Getting it Right First Time Variation in general surgery delivery and clinical practice