In 2012 NoSPHN was involved in discussion with NOSCAN colleagues in respect of the implications of
new surgical volume QPIs which would impact on the delivery of HPB cancer surgical services in the NoS.
The QPI contained an indicator relating to the number of procedures undertaken which it was acknowledged that
each of the 3 centres in the north would struggle to meet. It was noted that future quality QPIs may also
have a similar impact.
The surgical volume and outcomes issue was similarly rehearsed with vascular services following the publication of the “A Quality Framework for Vascular Services” which outlined a number of recommendations for the improvement of vascular services within Scotland and recommended a model of care which indicated that there should be one major centre for vascular surgery in the North of Scotland. There was concern that if these changes were made this would have an impact on the sustainability of wider services.
These issues stimulated discussion within NoSPHN and NoSPG that on the presumption that there will be
similar issues arising in the future that it would be helpful to better understand (be updated on) the
evidence for and implications of low volume activity and outcomes for the NoS and how these might relate to the sustainability of services not only for specific clinical areas but wider systems of care and strategic
planning.
The following was completed by NoSPHN to inform this Regional Discussion:
Evidence reviews
Learning from previous review work and discussions with NoS colleagues
Scoping a framework for applying the learning.
All papers including the evidence reviews are password protected. These are available on request from kim.penman@nhs.scot