Cancer represents a comparatively small part of the work of the general practitioner and attracts a maximum of only twelve points for General Medical Services (GMS) practices under the New GMS Contract Quality & Outcomes Framework (QOF), yet it remains one of the most complex areas in terms of understanding and therefore of determining accurate clinical coding.

The Primary Care Data Quality Team, based in the South Staffordshire Health Informatics Service, have been helping practices understand the following topics:

• Why is cancer part of the QOF?
• How do morphology codes cause problems in general practice?
• Why are the morphology codes outside the QOF?
• Which Read codes are included for nGMS quality payments?
• What can help the primary care coder?

And the team also provide advice and guidance on:

• Retrospective validation of a practice-based cancer register
• Validation toolkit
• Understanding the terminology
• What to look for in clinical letters

Their work surrounding Cancer coding was further developed into a poster for the PRIMIS Conference 2005, which was designed to summarise their work and pass on information to other health informatics personnel about this specific area of clinical coding. The poster won an award by being voted the best overall at the conference by delegates.

The South Staffordshire team commented: "The work described in our poster accompanies a short training module for GPs and practice-based clinical coders around the common problems faced with incoming cancer data. We also offer practices register validation, and for those practices who have taken up this service we have been able to identify cases missing from this important disease register and to advise on improved coding strategies. Some clinical systems, such as IPS Vision, utilise an 'event type' and it is important for practices to carefully consider how this function is applied when recording cancers, where multiple sequelae are commonplace. Practices are benefiting from this two-stage approach of validation and training, where the validation ensures that correct codes for the Quality & Outcomes Framework are in place and the training allows practices to maintain their registers once validated."