Quality statement 9: Access to specialist assessment

Quality statement

People with lung cancer are offered assessment for multimodality treatment by a multidisciplinary team comprising all specialist core members.

Quality measure

Structure: Evidence of local arrangements and written clinical protocols to ensure that people with lung cancer are offered assessment for multimodality treatment by a multidisciplinary team comprising all specialist core members.

Process: Proportion of people with lung cancer who receive assessment for multimodality treatment by a multidisciplinary team comprising all specialist core members.

Numerator – the number of people in the denominator who receive assessment for multimodality treatment by a multidisciplinary team comprising all specialist core members.

Denominator – the number of people with lung cancer.

Outcome:

a) Surgery rates.

b) Multimodality rates.

c) Radiotherapy rates.

d) Overall active treatment rates.

e) Chemotherapy rate for small‑cell lung cancer.

f) Chemotherapy rate for stage IIIB and IV (performance status 0 and 1) non‑small‑cell lung cancer.

What the quality statement means for each audience

Service providers ensure that services are in place for people with lung cancer to be offered assessment for multimodality treatment by a multidisciplinary team comprising all specialist core members.

Healthcare professionals offer people with lung cancer assessment for multimodality treatment by a multidisciplinary team comprising all specialist core members.

Commissioners ensure they commission services for people with lung cancer to be offered assessment for multimodality treatment by a multidisciplinary team comprising all specialist core members.

People with lung cancer are offered an assessment by their multidisciplinary team involving all of the key specialists to see if a combination of more than 1 treatment is suitable for them.

Source guidance

Lung cancer: diagnosis and management (2019) NICE guideline NG122, recommendations 1.4.19 and 1.4.33

Data source

Structure: Local data collection. The National Cancer Peer Review measure 08‑2C‑102 will collect data on the multidisciplinary team structure and named core members.

Process: Local data collection.

Outcome: a), b), c), d), e) and f) The Health and Social Care Information Centre National Lung Cancer Data Audit collects data on the proportion of patients submitted to the audit receiving treatment, broken down by treatment type.

Definitions

Specialist core members of a multidisciplinary team, as detailed in the National Cancer Peer Review Programme's Manual for Cancer Services in lung measure 11‑2C‑101, are:

  • designated respiratory physician(s)

  • designated thoracic surgeon(s)

  • a clinical oncologist

  • a medical oncologist (where the responsibility of chemotherapy is not undertaken by the clinical oncologist core member)

  • an imaging specialist

  • a histopathologist

  • a designated cytologist

  • a lung nurse specialist

  • a core member of the specialist palliative care team.