Development of Key Performance Indicators for a National Head and Neck Cancer Audit Feasibility Study

To develop key performance indicators (KPIs) for evaluating quality, equity, and outcomes of head and neck cancer (HNC) care.

A mixed-methods study combining literature review, measurability assessment, and multi-stakeholder consultations to identify, prioritise, and refine a set of consensus-based measurable, actionable KPIs for HNC occurrence, diagnosis, treatment and multidisciplinary care, and outcomes for the ongoing National Head and Neck Cancer Audit (NaHaNCA) Feasibility Study. National cancer audits, national guidelines, and standards were first reviewed to identify potential performance indicators, followed by measurability assessments based on the National Cancer Registration Dataset linked to national datasets curated by the National Disease Registration Service. A broad range of clinicians (eg, surgeons, oncologists, Speech and Language Therapists, allied health professionals) and patients across the country were consulted in the prioritisation and refinement of the indicators. The process was overseen by a multidisciplinary Study Steering Committee, comprising clinicians from 12 stakeholder organisations and patient representatives. We also worked closely with the Getting It Right First Time (GIRFT) team to ensure that this work complements the GIRFT programme by enabling ongoing monitoring of care quality and the impact of service improvements.

Eight high-priority measurable and actionable KPIs were identified through national consultation. These address timeliness of treatment, stage distribution, curative and palliative care, recurrence, survival, and multidisciplinary involvement.

This study provides the foundation for evaluating health service performance at a national level. While the work highlights the potential for a feasible and scalable national audit approach for HNC, it also identifies substantial variation in data completeness and consistency across NHS care providers, which may be the key challenges in evaluation. Addressing current data limitations through standardisation and collaboration will be essential for delivering a sustainable, impactful national audit.