Summary of implementation rates across individual recommendations for single-entity and networked SIHMDS
| NICE NG47 recommendations assessed | Compliance among single-entity SIHMDS (%) | Compliance among networked SIHMDS (%) | Overall compliance among all SIHMDS (%) |
| Laboratory configuration recommendations | |||
| Should serve child, adolescent and adult populations | 2 (66.7) | 6 (85.7) | 8 (80.0) |
| Should serve a population of >500 000 | 3 (100.0) | 7 (100.0) | 10 (100.0) |
| Should be managed by a single trust | 2 (66.7) | 3 (42.8) | 5 (50.0) |
| Should have a central reception for all specimens | 3 (100.0) | 5 (71.4) | 8 (80.0) |
| Should have an IT system set up for specimen booking at central reception | 3 (100.0) | 6 (85.7) | 9 (90.0) |
| Should be accredited by recognised independent organisation | 3 (100.0) | 7 (100.0) | 10 (100.0) |
| Should have an IT system enabling two-way communication between SIHMDS and other healthcare professionals | 1 (33.3) | 4 (57.1) | 5 (50.0) |
| Overall implementation for laboratory configuration | 80.9% | 77.6% | 78.6% |
| Reporting recommendations | |||
| Should have an IT system set-up for integrated reporting | 3 (100.0) | 5 (71.4) | 8 (80.0) |
| Should have a full range of age-appropriate specialist haematologist and haematopathology input for diagnosis and report authorisation | 3 (100.0) | 6 (85.7) | 9 (90.0) |
| Should issue final integrated reports | 3 (100.0) | 4 (57.1) | 7 (70.0) |
| Final integrated reports should contain all disease management information. | 3 (100.0) | 3 (42.8) | 6 (60.0) |
| Diagnostic pathways should have a robust process for report validation including double reporting. | 3 (100.0) | 6 (85.7) | 9 (90.0) |
| Should issue and release individual reports prior to final integrated report if there is an urgent clinical need | 3 (100.0) | 6 (85.7) | 9 (90.0) |
| Send-away results sent to external laboratories should be integrated into the final report. | 3 (100.0) | 4 (57.1) | 7 (70.0) |
| Integrated reports should contain disease subtype reporting based on WHO guidelines. | 3 (100.0) | 6 (85.7) | 9 (90.0) |
| Overall implementation for report recommendations | 100% | 71.4% | 80% |
| Multidisciplinary meeting recommendations | |||
| MDTs should be undertaken at least once per week. | 3 (100.0) | 7 (100.0) | 10 (100.0) |
| MDTs should discuss all cases and integrated reports. | 2 (66.6) | 3 (42.8) | 5 (50.0) |
| MDTs should review of all new diagnoses for integrated reporting. | 1 (33.3) | 1 (14.3) | 2 (20.0) |
| MDTs should review of all newly relapsed patients for integrated reporting. | 1 (33.3) | 0 (0.0) | 1 (10.0) |
| MDTs should review of all cases of diagnostic uncertainty for integrated reporting | 1 (33.3) | 5 (71.4) | 6 (60.0) |
| MDTs should discuss response to treatment during and completion of therapy. | 3 (100.0) | 5 (71.4) | 8 (80.0) |
| MDTs should assess disease extent (staging and prognosis) and probable course. | 3 (100.0) | 7 (100.0) | 10 (100.0) |
| MDTs should work out treatment plans for all new diagnosis and relapsed patients. | 3 (100.0) | 7 (100.0) | 10 (100.0) |
| MDTs should review treatment decisions made in the interval between MDTs. | 3 (100.0) | 4 (57.1) | 7 (70.0) |
| MDTs should discuss discontinuing treatment when effectiveness has become limited. | 3 (100.0) | 5 (71.4) | 8 (80.0) |
| MDTs should agree on dates for discussing patient progress. | 3 (100.0) | 4 (57.1) | 7 (70.0) |
| MDTs should discuss clinical trials and audit results. | 3 (100.0) | 5 (71.4) | 8 (80.0) |
| MDTs should review all SIHMDS reports of lymphocyte and plasma cell proliferation of uncertain significance (which overlap with lymphoma and myeloma). | 1 (33.3) | 3 (42.8) | 4 (40.0) |
| MDTs should review all SIHMDS reports of borderline conditions such as aplastic anaemia and other non-malignant bone marrow failure syndromes which may overlap with hypoplastic myelodysplastic syndrome. | 2 (66.6) | 5 (71.4) | 7 (70.0) |
| MDTs should record the minimum dataset for all cases of haematological malignancy within its specified catchment area, in line with the cancer registry. | 3 (100.0) | 6 (85.7) | 9 (90.0) |
| MDTs should discuss all EQA exercises and outcomes. | 1 (33.3) | 2 (28.6) | 3 (30.0) |
| GPs should be given information about their patients' illness, treatment, changes in management and the names of MDT members responsible for their patients' management. | 3 (100.0) | 7 (100.0) | 10 (100.0) |
| Overall implementation for MDT recommendations | 76.5% | 63.9% | 67.6% |
| Overall compliance with recommendations assessed | 83.8% | 68.8% | 73.1% |
EQA, External Quality Assessment; GP, general practitioner; IT, information technology; MDT, multidisciplinary team; NICE, National Institute for Health and Care Excellence; SIHMDS, Specialist Integrated Haematological Malignancy Diagnostic Services.