Press Release

Minister Harney Launches National Quality Assurance Standards for Symptomatic Breast Disease Services to Improve Quality of Care for Patients

The Minister for Health & Children, Mary Harney, today (Friday, 18th May 2007) launched ‘Quality Assurance Standards for Symptomatic Breast Disease Services in Ireland’.

The Standards are about improving the quality of care for women with breast disease in Ireland and addressing the current fragmentation of services nationally.

The Minister welcomed the Standards saying ‘The most important objective in the delivery of breast disease services is that all patients get the best treatment and have the best opportunity for best outcome, regardless of where they live. National and international evidence shows that patients with breast cancer have the best chance of survival if they are treated in centres with multi-disciplinary teams of medical professionals working in partnership and treating high numbers of patients.’

Recent analysis undertaken by the Department of Health & Children demonstrates that there is a year on year increase in the national volume of cancer related procedures carried out by hospitals and surgeons across the country between 1997 and 2005. This can be anticipated to continue.

The Minister said: ‘This trend creates urgency for change. The fragmentation in the delivery of cancer treatment services must be addressed to improve the quality and outcome of cancer care while still assuring relative ease of geographical access. Care of women with breast disease should be managed by specialist centres which will also allow as much care as is appropriate to be delivered locally.’

There have been improvements since 1997 – for example, the percentage of clinicians undertaking treatment for breast cancer who performed at least 50 procedures per year, rose from 4% in 1997 to 23% in 2005. As a result, while in 1997, 23% of patients treated for breast cancer had procedures performed by clinicians who performed at least 50 procedures per year, this proportion was 71% by 2005.

The National Cancer Control Strategy which I published last year articulated a clear mandate for the improved organisation and delivery of quality cancer care nationally. The Health Information and Quality Authority, which I established on 15 May will have a major role in monitoring compliance with the Standards by the HSE.’

Professor Niall O’ Higgins, Chair of the Expert Group, said ‘Breast cancer remains the most common fatal cancer in women and the incidence of the disease is increasing. Patients are more likely to survive if they are treated in specialised centres. This report set out the requirements of a functioning specialist breast centre and defines how the quality of service provided in such centres can be measured. It deals with administrative, clinical and technical indices needed to assess performance.

Defined indicators of good quality (i) allow the performance of centres to be compared with each other, (ii) help provide reassurance to patients and the general public of the standard of care (iii) assist formulation of public health policy and (iv) lead to improvements in standards.

As result of this important initiative taken by the Minister for Health and Children, it is now of critical importance that a small number of Specialist Breast Centres be officially designated and that the staffing and infrastructural needs for the functioning of such centres be provided in a purposeful fashion. An integrated information technology arrangement is necessary so that the performance of centres can be assessed and compared with each other regularly. It is hoped that external review of centres by international expert groups will also take place from time to time as occurs with the BreastCheck screening programme. I look forward to the implementation plan from the HSE to ensure the co-ordinated and speedy establishment of this system of critically important patient care. These Standards should also be applied and adopted in the private sector.’

Dr. Tracey Cooper, Chief Executive of the Health Information & Quality Authority, said ‘Implementation of these Standards will ensure that women have access to the best quality breast care. The Standards will be formally mandated by the Authority shortly. Discussions have already taken place between the Authority, the Department of Health and Children and the HSE in order to ensure effective implementation and compliance.’

Dr. Mary Hynes, HSE Assistant National Director of Quality Risk & Customer Care, welcomed the Standards and said ‘The HSE is fully committed to ensuring women receive the best quality care for breast disease and will ensure compliance with the Standards as rapidly as possible. This will involve evaluating the current provision of services to ensure quality and equity of provision in breast disease services across the country. This will be the central focus of our Implementation Plan for Quality Breast Disease Services, which will include provision for the performance management of specialist centres and will be submitted to HIQA and the Department of Health & Children in June.’

The Standards were prepared by the National Quality Assurance Group for Symptomatic Breast Disease Services established by the Minister. The Group was comprised of experts in the major cancer disciplines, including surgery, pathology, radiology, medical oncology, radiation oncology, nursing and general practice. It also included patient advocates from the Irish Cancer Society and Europa Donna.

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