Quality statement 5: Surgical skills

Quality statement

Surgeons performing planned resections of sarcomas are core or extended members of a sarcoma multidisciplinary team (MDT).

Rationale

Sarcoma resection carried out by a specialist sarcoma surgeon, who is a core member of the sarcoma MDT, is generally more likely to result in improved patient outcomes. However, in some cases the most appropriate surgeon to carry out a sarcoma resection may not be a sarcoma specialist, but a surgeon with skills relevant to the age of the patient or the site of the tumour. In these cases the surgeon should be an extended member of a sarcoma MDT.

Quality measures

Structure

Evidence of local arrangements and protocols to ensure that people who have planned resection of their sarcoma have it performed by a surgeon who is a core or extended member of a sarcoma MDT.

Data source: Local data collection.

Process

Proportion of planned sarcoma resections that are performed by a surgeon who is a core or extended member of a sarcoma MDT.

Numerator – the number in the denominator that are performed by a surgeon who is a core or extended member of a sarcoma MDT.

Denominator – the number of planned sarcoma resections.

Data source: Local data collection. National Cancer Intelligence Network Cancer outcomes and services dataset.

Outcome

a) 30‑day mortality rate post‑sarcoma resection.

Data source: Local data collection.

b) Recurrence within 2 years of initial surgery.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as hospitals, sarcoma specialist centres) ensure that operational policies and procedures are in place for people having planned resection of their sarcoma to either have it carried out by a surgeon who is a core member of a sarcoma MDT or, when appropriate, by a surgeon who is an extended member of a sarcoma MDT with tumour site‑specific or age‑appropriate skills.

Healthcare professionals ensure that people having planned resection of their sarcoma have it carried out by a surgeon who is a core member of a sarcoma MDT or, when appropriate, by a surgeon with tumour site‑specific or age‑appropriate skills who is an extended member of a sarcoma MDT.

Commissioners (NHS England and clinical commissioning groups) should ensure that policies and procedures are in place for people who are having planned resection of their sarcoma to either have it carried out by a surgeon who is a core member of a sarcoma MDT or, when appropriate, by a surgeon who is an extended member of a sarcoma MDT with tumour site‑specific or age‑appropriate skills.

What the quality statement means for patients, service users and carers

People with sarcoma (a rare type of cancer that develops in a bone or in soft tissue such as muscle or fat) who are having surgery to remove their tumour have their operation done either by an experienced surgeon who specialises in sarcomas and is part of the sarcoma multidisciplinary team (a specialist team of healthcare professionals who have training and experience in bone or soft tissue sarcoma) or by a surgeon who has other suitable specialist skills and works with a sarcoma multidisciplinary team.

Source guidance

  • Sarcoma (2006) NICE cancer service guidance, Key recommendations (page 8) and Section 5: Improving treatment: sarcoma multidisciplinary teams (page 56)

Equality and diversity considerations

When considering appropriate surgeons for referrals, any potential difficulties in accessing services, which may include distance, age, disability and financial barriers, should be taken into account.