The management of cervical carcinoma within the South West Region of England



I read with interest the two editorial comments on the development of cancer services (Vol 104, February 1997)1,2 which referred to our paper (Vol 104, February 1997)3.1 am delighted that the professional integrity of the Consultant Gynaecologists in the South West who contributed their data to the study has been recognised. The problems we have highlighted are not confined to Gynaecological Oncology in the South West as has been shown by the activities of other Expert Tumour Panels within the Regional Cancer Organisation. I fully agree with the suggestion that gynaecologists in other UK regions would probably identify the same deficiencies if they undertook a similar exercise.

This is only a start. We originally planned to carry out the same process with the other main cancers but abandoned the idea, believing that we would get similar results. The Gynaecological Tumour Panel has therefore initiated prospective data collection using a tight minimum dataset covering the four main gynaecological cancers. We will produce an annual report of activity in the region based on this. We will be able to complete the audit cycle for cervical cancer looking for dramatic improvements in the quality of information. This process will provide a firm base for assessing quality assurance in cancer care provision across the region. Additionally, the Panel is undertaking targeted audits of other aspects of gynaecological cancer care, for example lymphoedema services, psychosexual support, inter—specialty communication about patients with gynaecological cancer, and gynaecological cancer care provided by nongynaecologists We are also developing consensus protocols for the consideration of clinicians in the region.

I believe that the Tumour Panel set up within the Regional Cancer Organisation is an excellent vehicle to deliver the information needed to make the aspirations of the Calman—Hine report a reality. It is an organisation run by the clinicians who look after patients daily and who need to control audit to ensure it is directly relevant to their needs so that they can improve the services and the outcome for their patients. It is my belief that participation in regional audit like this should be a key quality issue in the assessment of the service provided by Cancer Centres and Units alike.