The Royal Marsden NHS Foundation Trust

The Royal Marsden NHS Foundation Trust incorporates The Royal Marsden Hospital in London https://www.royalmarsden.nhs.uk/

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This trust offers the following services:

  • 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 hepatobiliary 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:
    • Availability of 24 hour palliative care advice
    • 7-day access to face-to-face palliative care services

Data Quality

All Patients: Trust Network National
Number of patients in Audit N/A 1310 28523
Case ascertainment (%) N/A Good Good
Data completeness of:
– Pre-treatment TNM (%) N/A 80 86
– Performance status (%) N/A 81 88
Patients having major resection: Trust Network National
Number of patients in Audit 34 813 15891
ASA grade 1 (%) 9 23 8
ASA grade 2 (%) 56 41 52
ASA grade 3 (%) 26 18 31
ASA grade 4+ (%) N/A 1 2
ASA grade not recorded (%) 9 16 7
Data completeness of:
7 Audit items for risk-adjustment (%) 91 79 87

Key:

> 80%
50 - 80%
< 50%

Management of all patients

All Patients: Trust Network National
Number of patients in Audit N/A 1301 28523
Seen by Clinical Nurse Specialist (%) N/A 82 85
All patients deemed potentially curative Trust Network National
Number of potentially curative patients N/A 332 7393
Undergoing major resection (%) N/A 87 82

Management of patients having major resection

Patients having major resection: Trust Network National
Number of patients in Audit 34 813 15855
Distant metastases (%) 26 9 7
Urgent or emergency surgery (%) 6 11 20
At least 12 lymph nodes excised (%) 93 85 86
Laparoscopic surgery attempted (%) 18 66 67
Risk-adjusted length of stay > 5 days (%) 84 74 56
Patients having major resection for stage III colon cancer: Trust Network National
Number of patients in audit N/A 503 10794
Adjuvant chemotherapy (%) N/A 58 60

Rectal cancer patients

Patients having major resection: Trust Network National
Number of patients in Audit 18 170 3481
Neoadjuvant therapy (%) 52 37 38
Circumferential resection margin: Recorded (%) 94 89 89
Circumferential resection margin: Negative (%) 89 85 82
Rectal volume 19 194 3374
Patients in APER/Hartmanns estimate: Trust Network National
Number of patients in APER/Hartmanns estimate 81 891 19595
APER/Hartmanns (%) 63 31 36

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