The development of a national oncology pharmacy audit database in the United Kingdom of Great Britain and Northern Ireland

Abstract

Audit has become an important facet of service and patient management over the last 5 to 10 years. The importance of Audit has received particular emphasis in the UK through the endorsement of both its concepts and its practice from the government via the National Health Service Executive and professional bodies such as the Royal Pharmaceutical Society and the General Medical Council.

Within specialities, such as pharmacy services to oncology departments, the relative scale of operation makes self or even local peer-reviewed audit inappro priate. There needs to be a more broad based and less isolated comparison of standards, ideally with exter nal peer review. Furthermore because oncology phar macy tends to be run from small, very busy units the audit process would require additional time, re sources, or data collection. An appropriate audit process should, therefore, be based around existing work practices and not require additional resources. Bearing in mind these principles, a collaboration between a group of oncology pharmacists and a specialized health care firm was developed and the JANUS project and the NOPAD (National Oncology Pharmacy Database) established. The scheme relies on computer extraction of core data from existing working records. While being completely anonymous of patients and reporting centre. Data are then pro cessed into the NOPAD database which can be used by a reporting centre to compare their internal audit data to a national core data set, and for academic research into pharmacy practices in oncology phar macy. Furthermore information from the database has to be sold in a "washed out" form to oncology firms to pay for the running costs of the service. Although not universally subscribed to throughout the UK, there has been around an 80% uptake of the concept and further project looking to extend the database to cover support therapies, and/or other therapeutic areas as well as linking this drug usage picture to the UKs cancer registries disease distri bution picture.

Some of the background to this unique UK initiative are presented, and the mechanism by whic the project works for UK centres is described.