Skin cancer

Process

Proportion of people with melanoma, high-risk squamous cell carcinoma or a rare skin cancer who have access to a skin cancer clinical nurse specialist.

Numerator – the number in the denominator who have access to a skin cancer clinical nurse specialist.

Denominator – the number of people with melanoma, high-risk squamous cell carcinoma or a rare skin cancer.

Data source: The National Cancer Patient Experience Survey reports the proportion of respondents with melanoma who had a specialist nurse as a main contact person within the team looking after them who would support them through treatment (Q17). Data for people with high-risk squamous cell carcinoma or a rare skin cancer can be collected from information recorded locally by provider organisations, for example from patient records.

Outcome

a) Quality of life among people with melanoma, high-risk squamous cell carcinoma or a rare skin cancer.

Data source: The Cancer Quality of Life survey reports quality of life reported by people with melanoma, including functional categories for quality of life (EORTC QLQ-C30), overall health (EQ-5D) and summary scores. Data for people with high-risk squamous cell carcinoma or a rare skin cancer can be collected from information recorded locally by provider organisations, for example from patient surveys.

b) Satisfaction with support received from skin cancer clinical nurse specialist, reported by people with melanoma, high-risk squamous cell carcinoma or a rare skin cancer.

Numerator – the number in the denominator who were satisfied with the support received.

Denominator – the number of people with melanoma, high-risk squamous cell carcinoma or a rare skin cancer supported by a skin cancer clinical nurse specialist.

Data source: Data can be collected from information recorded locally by provider organisations, for example from patient satisfaction surveys. The National Cancer Patient Experience Survey includes a number of questions and responses on satisfaction with cancer services by people with melanoma.

Rare skin cancer

Including epidermal and appendage tumours and dermal and subcutaneous tumours. [NICE's guideline on improving outcomes for people with skin tumours including melanoma, appendix 1]

Access to a skin cancer clinical nurse specialist

People with melanoma, high-risk squamous cell carcinoma or a rare skin cancer should be able to access support from a skin cancer clinical nurse specialist. Roles include dermatology, surgery and oncology skin cancer clinical nurse specialists and may encompass nurse consultants and advanced clinical practitioners. Skin cancer clinical nurse specialists provide information and patient advocacy to people with melanoma, high-risk squamous cell carcinoma or a rare skin cancer from the time of diagnosis to treatment periods, points of transition and during follow-up. They provide practical support, such as during the postoperative period, psychosocial support and advise on appropriate referral. They may perform risk factor assessment, holistic needs assessment and personalised care and support planning. They may also carry out skin cancer surveillance and follow-up clinics in parallel with an appropriately trained doctor. [Adapted from NICE's guideline on improving outcomes for people with skin tumours including melanoma, section 3; core membership of the local multidisciplinary team (LSMDT), page 53, the National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset – Core, data fields for clinical nurse specialist and risk factor assessment, clinical nurse specialist – holistic needs assessment and clinical nurse specialist – personalised care and support planning, and expert opinion]