The commissioning arrangements for the National Head and Neck Cancer Audit (HANA) are changing for the reasons outlined below. HANA will continue as a national audit under new funding arrangements, and due to this change it will no longer be part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). This is not the first audit to undergo such a change in status: the national IBD audit has also recently left the NCAPOP and transitioned to sustainable funding within the new IBD Registry.
Head and neck cancer has been commissioned in England and Wales since 2005 as a topic in the centrally-funded National Clinical Audit and Patient Outcomes Programme. The audits in this Programme are commissioned and managed by the Healthcare Quality Improvement Partnership (HQIP) on behalf of the funding bodies, NHS England and the Welsh Government. The audit was delivered for many years by NHS Digital who ran the first head and neck audit DAHNO, and more recently by Saving Faces -The Facial Surgery Research Foundation (SF) who have been running the new Head and Neck Audit (HANA) for 18 months.
Auditing the topic of Head and neck cancer has always posed particular design and delivery challenges because of the complexities of pathologies and patient pathways that are covered. This has been reflected in the difficulties experienced firstly by NHS Digital who ran the first head and neck audit DAHNO, and more recently by Saving Faces.
It took longer than SF and HQIP expected for SF to receive the historic DAHNO data collected at NHS Digital before 2014. This delayed the production of the Clinical Outcomes Publication (COP) report on this data. In addition, the establishment and roll out of the new audit, HANA, did not meet the expectations agreed at the outset of the contract. These issues have resulted in the cessation of central funding of HANA from spring 2017.
HQIP and the NCAPOP funders recognise that SF and HANA’s clinical leadership and engagement with local MDTs has been strong and that through their efforts there has been considerable participation by clinicians around the country. HQIP and the funders are pleased that Saving Faces have offered the sustainable funding to continue developing and delivering the audit building on the investment received from NCAPOP. HQIP will provide expertise and support during a brief transition period over the spring and early summer of 2017.
After the summer, HQIP will continue to offer the same support to Saving Faces and HANA as it provides to other independently-run national audits, sharing the joint aim of providing the NHS with a high quality audit effective in improving outcomes for these patients for whom the impact of head and neck cancer can be so profound.