There are national cancer audits taking place for colorectal (bowel), head and neck, lung and oesophago-gastric cancer. Each audit produces an annual report identifying network outcomes and in some cases individual trust outcomes.

The extent to which trust level data is available from these reports or the audit databases varies between the audits. The network site specific groups use the available data to review teams' audit participation and to compare the audit outcomes between teams within the network and with others across the country.

A national audit has also taken place for mastectomy and breast reconstruction, however this audit is now closed.

Outcomes are reviewed by the network site specific group on an annual basis using the audit’s annual report. The latest annual report for 2008/09 shows that around 75% of the expected number of cases are being reported to the audit for the network and that these records are around 95% complete.

Some of the national audit standards are also used as key performance indicators. As part of it's programme of key performance indicators the network site specific group has considered outcomes up to and including cases operated in March 2011.

The 2010 national bowel cancer audit report for the audit period August 2008 to July 2009 is published on the bowel cancer audit pages of the Information Centre for Health and Social Care's website.

Outcomes are reviewed by the network site specific group on an annual basis using the audit’s annual report. In 2011 the network site specific group found that:

• Both Sandwell and West Birmingham NHS Trust and University Hospitals Birmingham NHS Foundation Trust participated in the audit.
• Pre-treatment stage is 96% complete and post-operative stage is 95% complete.
• Careplans are discussed by an MDT in 92% of cases.
• Sandwell and West Birmingham NHS Trust is one of a small number of trusts in the country that reports at least 60% of patients undergoing pre-treatment dietetic assessment and speech and swallowing assessment.

Teams are confident that contact with a clinical nurse specialist and MDT discussion of the careplan take place in every case prior to treatment and are recorded for audit purposes. However this is not reflected in the annual report.

The latest national head and neck cancer audit report for the audit period November 2009 to October 2010 is published on the head and neck cancer audit pages of the Information Centre for Health and Social Care's website.

Data submissions to the audit are reviewed at each meeting of the network site specific group. The group also considers the findings of the annual audit report when it is published. In 2011 the network site specific group found that MDTs in this network had exceeded the national averages in all of the agreed measures:

• 95.8% patients were reviewed by an MDT
• 78.9% had a histological or cytological diagnosis
• 60.4% had any cancer treatment
• 17.3% underwent surgical resection
• 70.4% of small cell lung cancer patients received chemotherapy

Each MDT has completed a local action plan and has shared this with the other members of the network site specific group. 

The latest national lung cancer audit report for the 2009 audit period published on the lung cancer audit pages of the Information Centre for Health and Social Care's website.

The network site specific group reviewed the third annual audit report in 2010 and found that:

• 80% of the expected cases were reported to the audit
• 49% of patients having breast reconstruction at trusts in this network have immediate reconstruction compared with a national average of 65%
• Information regarding the reason(s) that no offer of immediate reconstruction was made was poorly recorded.

The network site specific group is undertaking a prospective audit of breast reconstruction in order to evaluate current practice. The audit will take account of referrals into the network from other trusts (these were not accounted for in the national audit) and ascertain in greater detail the reasons that no offer of immediate reconstruction was made.

The national mastectomy and breast reconstruction audit reports for the audit period January 2008 to March 2009 are available on the mastectomy and breast reconstruction audit pages of the Information Centre for Health and Social Care's website.

The national oesophago-gastric cancer audit reports for the audit period October 2007 to June 2009 are published on the oesophago-gastric cancer audit pages of the Information Centre for Health and Social Care's website.

The audit closed in June 2009 but has reopened for cases diagnosed from 1 April 2011.