Quality standard

Quality statement 1: Local health promotion activities

Quality statement 1: Local health promotion activities

Quality statement

Integrated care boards work with local partners to implement strategies to raise awareness of skin cancer and the risks of over-exposure to sunlight and exposure to artificial UV light, particularly for people in at-risk groups. [new 2024]

Rationale

Skin cancer is the most common form of cancer and, even though most types are preventable, its incidence is increasing. People can recognise changes to their skin in early stages of the disease, but some are still seeking help too late. Integrated care boards should adopt a consistent multiagency approach to implement strategies to ensure consistent, relevant messages on the risks of over-exposure to sunlight and exposure to artificial UV light. This will increase the likelihood of behaviour change, particularly for people in at-risk groups. They should work with partners such as local authorities, members of their cancer alliance or equivalent local partnership, local skin cancer multidisciplinary teams, community pharmacies, and voluntary and community organisations.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

a) Evidence that integrated care boards use joint strategic needs assessments to determine local needs related to skin cancer awareness.

Data source: Data can be collected from information recorded locally by integrated care boards, for example from a joint strategic needs assessment.

b) Evidence that integrated care boards have an action plan that identifies key strategies to raise awareness of skin cancer and the risks of over-exposure to sunlight and exposure to artificial UV light, particularly for people in at-risk groups.

Data source: Data can be collected from information recorded locally by integrated care boards, for example from an action plan.

c) Evidence of local campaigns to raise awareness of skin cancer and the risks of over-exposure to sunlight and exposure to artificial UV light, particularly for people in at-risk groups.

Data source: Data can be collected by information recorded locally by integrated care boards and partners, for example from campaign materials such as posters, leaflets, skin-type charts, texts and social media messaging.

Outcome

a) Proportion of melanoma diagnosed at stage 1 or 2.

Numerator – the number in the denominator diagnosed at stage 1 or 2.

Denominator – the number of melanomas diagnosed.

Data source: NHS Digital's Cancer registration statistics England, reports annual counts, age-specific and directly age-standardised rates of cancer incidence by ICD-10 codes including melanoma of the skin and stage at diagnosis.

b) Proportion of non-melanoma skin cancer diagnosed at stage 1 or 2.

Numerator – the number in the denominator diagnosed at stage 1 or 2.

Denominator – the number of non-melanoma skin cancers diagnosed.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers (such as local authorities) ensure that they work with integrated care boards to address local needs for improving skin cancer awareness, particularly for people in at-risk groups identified by a joint strategic needs assessment. They should ensure training provided to public health practitioners and health care professionals covers the risks of over-exposure to sunlight and exposure to artificial UV light and the importance of conveying consistent, tailored messages.

Public health practitioners and healthcare professionals (such as members of the local cancer alliance or equivalent local partnership, local skin cancer multidisciplinary team, community pharmacists and those working with voluntary and community organisations) support local health promotion activities that focus on raising awareness of skin cancer and the risks of over-exposure to sunlight and exposure to artificial UV light, particularly for people in at-risk groups. They deliver consistent, tailored messages.

Commissioners ensure that they have a joint strategic needs assessment that includes skin cancer awareness and the risks of over-exposure to sunlight and exposure to artificial UV light, particularly for people in at-risk groups. They work with partners such as local authorities, cancer alliances or equivalent local partnerships and voluntary and community organisations to address local needs. They identify local opportunities to raise awareness of the risks of over-exposure to sunlight and exposure to artificial UV light, such as identifying health, social care and other practitioners in contact with people in at-risk groups, including in specific settings such as schools, workplaces, communal and leisure environments.

People who should take extra care to avoid skin damage and skin cancer and those identified as at increased risk of skin cancer, are given advice about how to prevent skin cancer and how to recognise early signs, through health promotion activities from local services.

Source guidance

Definitions of terms used in this quality statement

Raise awareness of skin cancer and the risks of over-exposure to sunlight and exposure to artificial UV light

Communication of consistent, balanced messages about sunlight exposure, including risks from excessive exposure. This should include:

  • environmental, biological and behavioural factors

  • how to minimise the risks and maximise the benefits of sunlight exposure

  • the strength of sunlight at different times of day, and different times of the year

  • advice for at-risk groups, including children and young people, and according to people's skin type, including people with brown or black skin

  • approaches to protecting skin

  • information on how to apply suncream

  • checking for possible signs of skin cancer

  • clarifying common misconceptions about sunlight exposure and artificial UV light.

[Adapted from NICE's guideline on sunlight exposure, recommendations 1.1.2, 1.1.3 and supporting information for practitioners, and expert opinion]

At-risk groups

  • Groups of people who should take extra care to avoid skin damage and skin cancer, including:

    • children (particularly babies) and young people

    • people who tend to burn rather than tan

    • people with white skin, fair or red hair, blue or green eyes, or who have lots of freckles

    • people with many moles

    • people with medical conditions associated with an increased risk of developing skin cancers

    • people who are immunosuppressed (that is, they have less resistance to skin problems as a result of a disease or use of particular drugs)

    • people with a personal or family history of skin cancer (even if their natural skin colour is darker than that of the family member who had cancer).

  • Groups who spend a lot of time in the sun and so are at increased risk of skin cancer, such as:

    • outdoor workers

    • those with outdoor hobbies, for example, sailing or golf.

  • Groups with high, but intermittent, exposure to sunlight and who are therefore at increased risk of skin cancer. This includes people who sunbathe or take holidays in sunny countries.

  • People frequently exposed to artificial UV light, including from a sunbed, before the age of 25.

[NICE's guideline on sunlight exposure, recommendation 1.1.1, NHS website, Are sunbeds safe? accessed 30 June 2023, NICE's clinical knowledge summary on melanoma, risk factors, and expert opinion]

Equality and diversity considerations

People should be provided with information that they can easily read and understand themselves, or with support, so they can communicate effectively with health and social care services. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate and age appropriate. People should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.