Table 1

Summary of implementation rates across individual recommendations for single-entity and networked SIHMDS

NICE NG47 recommendations assessedCompliance among single-entity SIHMDS
Compliance among networked SIHMDS
Overall compliance among all SIHMDS
Laboratory configuration recommendations
 Should serve child, adolescent and adult populations2 (66.7)6 (85.7)8 (80.0)
 Should serve a population of >500 0003 (100.0)7 (100.0)10 (100.0)
 Should be managed by a single trust2 (66.7)3 (42.8)5 (50.0)
 Should have a central reception for all specimens3 (100.0)5 (71.4)8 (80.0)
 Should have an IT system set up for specimen booking at central reception3 (100.0)6 (85.7)9 (90.0)
 Should be accredited by recognised independent organisation3 (100.0)7 (100.0)10 (100.0)
 Should have an IT system enabling two-way communication between SIHMDS and other healthcare professionals1 (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 reporting3 (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 authorisation3 (100.0)6 (85.7)9 (90.0)
 Should issue final integrated reports3 (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 need3 (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 reporting1 (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.