This trust offers the following services:

• Acute services:
• Specialist colorectal surgeon on-call at all times

• Diagnostic and pre-operative services:
• On-site PET-CT facilities
• On-site Cardio-Pulmonary Exercise Testing (CPET) facilities
• Routine Genetic Testing for Lynch Syndrome

• Surgical services:
• On-site thoracic surgical team
• Robotic surgery

• Advanced disease services:
• Dedicated Specialist Advanced Nurse
• Dedicated Specialist Advanced MDT
• Dedicated Specialist Advanced Outpatient Clinic
• Complex vascular reconstruction
• Distal sacrectomy
• High sacrectomy
• Extended lymphadenectomy

• Support service facilities:
• Dedicated nurses for ERAS services
• Availability of 24 hour palliative care advice

All Patients:	Trust	Network	National
Number of patients in Audit	436	1703	35779
Case ascertainment (%)	Good	Good	Good
Data completeness of:
– Pre-treatment TNM (%)	71	86	86
– Performance status (%)	27	76	89

Patients having major resection:	Trust	Network	National
Number of patients in Audit	162	821	19631
ASA grade 1 (%)	8	5	9
ASA grade 2 (%)	52	59	53
ASA grade 3 (%)	25	22	31
ASA grade 4+ (%)	N/A	1	2
ASA grade not recorded (%)	15	13	4
Data completeness of:
7 Audit items for risk-adjustment (%)	81	84	87

All Patients:	Trust	Network	National
Number of patients in Audit	436	1703	35779
Seen by Clinical Nurse Specialist (%)	66	76	88

Patients having major resection:	Trust	Network	National
Number of patients in Audit	162	821	19614
Distant metastases (%)	8	5	5
Urgent or emergency surgery (%)	6	20	15
At least 12 lymph nodes excised (%)	76	90	84
Laparoscopic surgery attempted (%)	65	81	72
Risk-adjusted length of stay > 5 days (%)	64	63	55

Patients having major resection for stage III colon cancer:	Trust	Network	National
Number of patients in audit	104	N/A	10747
Adjuvant chemotherapy (%)	61	N/A	62

Patients receiving chemotherapy after major resection for stage III colon cancer:	Trust	Network	National
Number of patients in audit	64	N/A	6608
Severe acute toxicity after adjuvant chemotherapy (%)	20	N/A	22

Patients having major resection:	Trust	Network	National
Number of patients in Audit	46	N/A	4251
Neoadjuvant therapy (%)	69	N/A	33
Circumferential resection margin: Recorded (%)	96	96	89
Circumferential resection margin: Negative (%)	85	90	83
Rectal volume	56	N/A	4377

Patients in APER/Hartmanns estimate:	Trust	Network	National
Number of patients in APER/Hartmanns estimate	323	909	19644
APER/Hartmanns (%)	37	31	37