BLOG: "The data in SCRIS is levelling up opportunities across Scotland" | Dr John Murphy

Dr John Murphy is a former Consultant Haematologist in NHS Lanarkshire. He spoke to IHDP and the SCRIS team about his experiences using data from the SCRIS dashboards, and how he has supported cancer services in Scotland during the COVID-19 global pandemic

I’ve worked as a haematologist in Lanarkshire since 1995, and in that time, I’ve seen huge changes in clinical practice and in haematology itself.

As well as working directly with patients, I hold several regional and national roles relating to Systemic Anti-Cancer Therapy (SACT) and its governance. In the past five years, I’ve had a role in reviewing the practice of delivering SACT to patients, and consent around this. Consequently, I not only have a view of cancer care services at my local clinic level, but also on a regional and national basis too.

Using data to challenge our practice

In the west of Scotland, we’ve used regional data to challenge ourselves about the ways that we’ve been managing patients for some time now. We’re aware some patients don’t do so well with conventional chemotherapy. We’ve identified which patients are not as likely to respond as well and this has made us rethink our approach to therapy in these patient groups. Having the right data available helped us make some of those decisions.

As cancer clinicians, we want to be confident that we are managing patients to the highest clinical standards and to the best of our personal abilities. We also want patients across the country to have uniform opportunity (e.g. access to a particular operation or a certain drug), and to be confident that when a patient is recommended treatment, they are offered the same in Aberdeen as they are in Lanarkshire or Edinburgh, and that this fits pretty closely with what would be available elsewhere in the UK and internationally.

We hadn’t been able to compare what’s been happening in the west with the rest of Scotland until very recently. Using the data in the Scottish Cancer Registry and Intelligence Service (SCRIS) has helped us do that.

Depending on levels of access, data available in the SCRIS dashboards allows clinical teams to see what their patients' treatment consists of, compare tumour groups within their board, their region, and on a national level. For example, tumour group leads and managers can pull out data for use at their team updates. It also lets them work on the data of their own patients, in a very flexible and adaptable way, and compare it with colleagues’ aggregated data elsewhere on a very collaborative basis.

Rather than relying on the published reports, the SCRIS dashboards are interactive and allow users to choose how data are presented. They allow teams to interrogate the information and ask questions, like ‘why do we appear to have a surge in a particular tumour type?’. It’s a management tool that can be used to drive team achievement and development. Clinical teams should feel ownership of their patients’ data and feel confident about using it. The SCRIS dashboards hold a wealth of clinical data which we should use to our patients’ advantage.

Another benefit of SCRIS data is that it is population-wide. Clinicians are aware of and learn from peer-reviewed research studies, but those studies can be selective in the participants they are using. Having nationwide data for a particular tumour group gives a real picture of how cancer incidence, diagnosis, treatment and outcomes look across the country.

Understanding the impact of the pandemic on cancer services

The global COVID-19 pandemic hasn’t slowed everything down: paradoxically in some areas of cancer work, it’s pushed things forward. We've probably gained about a year as far as data analysis is concerned, and it’s bringing clinicians together more and more.

The National COVID-19 Cancer Treatment Response Group was established in March 2020 to develop a national clinical consensus on cancer treatments for all cancer types during the pandemic. I was asked to participate as the lead representative for SACT.

We wanted to understand what impact the pandemic was having on SACT delivery. A weekly activity report is now produced for the Group to update us on the position across Scotland. We saw a dip in activity at the height of the first lockdown but there was a recovery and things are almost back to where they were pre-pandemic, but not entirely. Analysing the figures has uncovered that the same numbers are being treated but with some changes to practice. An example of this is building longer intervals between treatments, with no detriment to patients. Having this information is important from a clinical point of view as it can reassure clinicians and patients about the impact of new approaches to treatment brought about by the pandemic. Additionally, any differences between regions can also be identified and interrogated and best practice shared between boards.

If the pandemic had happened 18 months earlier, we wouldn’t have been able to gather this data and understand the national outlook for cancer patients in Scotland. A lot of that is down to the work of the SCRIS team and their analysts.

Future for Scottish cancer data in practice

It is important that we continue the ‘Once for Scotland’ approach to cancer so that everyone can expect equitable access to treatment and care no matter where they live in Scotland. Having the SCRIS dashboards and analytical service as a resource for management teams to use for audit purposes will help this approach. At the end of the day, our key goal is to improve cancer outcomes across Scotland while keeping the patient front and centre.

I believe some of the clinical benefits of the data in the SCRIS dashboards are yet to be uncovered. However, it has been a good example of showing how national data can support something as dramatic as a pandemic response. If it can do it for that, it has the potential to do the same for our day-to-day business as usual.

SCRIS for Healthcare Professionals

This blog is part of a collection of materials giving healthcare professionals:

• insights on the use of the SCRIS dashboards
• guidance on the use of the dashboards in the form of videos and text 

All these resources can be found on the SCRIS for Healthcare Professionals page on the Public Health Scotland SCRIS website.

SCRIS for Healthcare Professionals on the Public Health Scotland SCRIS website