ALK IHC is a robust screening technique, but there is concern that some diagnostic laboratories are using inadequate staining methods, which has a direct impact on final interpretation. External assessment helps provide laboratories with continued confidence in their ALK IHC testing.

BackgroundComparative data are an important resource for management of integrated care. In 2001, the English Department of Health created 34 cancer networks, broadly serving populations of half to three million people, to coordinate cancer services across providers. We have investigated how national and regional routine data are used by the cancer network management teams.MethodsTelephone interviews using a standardised semi-structured questionnaire were conducted with 68 participants in 29 cancer network teams. Replies were analysed both quantitatively and qualitatively.ResultsWhile most network teams had a formal information strategy, data were used ad hoc more than regularly, and were not thought to be as influential in network decision making as other sources of information. Data collection was more prominent in information strategies than data use. Perceptions of data usefulness were mixed and there were worries over data quality, relevance, and potential misuse. Participants were receptive to the idea of a new limited dataset collating comparative data from currently available routine data sources. Few network structural factors were associated with data use, perceptions of current data, or receptivity to a new dataset.ConclusionComparative data are underused for managing integrated cancer services in England. Managers would welcome more comparative data, but also desired data to be relevant, quality assured and contextualised, and for the teams to be better resourced for data use.

As part of a wider strategy to reduce health inequalities, England's National Health Service has introduced health trainers (HTs) to facilitate healthier behaviour among disadvantaged groups. This study reports baseline data from the first English HT service: assessing whether the HTs reached socially disadvantaged clients engaging in unhealthy behaviours and describing client belief characteristics relevant to the delivery of the service. Data from 864 clients show that the service reached disadvantaged groups and that those groups were engaging in risky health behaviours. Self-efficacy about changing behaviour was not strong and clients were unlikely to have made explicit behaviour-change plans prior to attending the service. Implications for HT services around targeting those most in need and supporting psychological triggers for change are discussed.

Health service managers have been criticized for placing more emphasis on the collection of data than on their use for the improvement of care. The present study examined how routine aggregate data on cancer services are perceived by management teams and how such data are used to inform strategic decision-making and planning. Semi-structured interviews were conducted with 19 members of four cancer network teams in England. The interviews were transcribed and thematically analysed independently by two researchers. Respondents said that routine aggregate data were not highly prioritized as an information resource, although their use had produced some beneficial impacts, such as reduced waiting times. Limited use of aggregate data appeared to relate to problems of accessibility, lack of resources to turn the data into meaningful information and service improving action, and poor data quality and relevance. These factors apparently lead to inability or reluctance to use routine data to monitor and improve cancer services at the network level. Data-user concerns should be addressed to facilitate greater use of available routine data.