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BCSS + information management questionnaire Screening centre analysis

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BCSS + Information Management Questionnaire

Screening Centre Responses

Detailed Analysis

Robin Beaumont

Friday, 09 October 2009 [email protected]


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Document details

Attribute Name/details Date Comments

name complete Draft 1 09/10/2009 19:36 Final version

Work to complete Textual/thematic analysis 07/09/2009 19:36 Completed 28/09/2009

Work to complete Multilevel modelling (p82) 07/09/2009 19:36 08/10/2009

Work to complete Help line aspect 07/09/2009 19:36 Completed 10/09/2009

Work to complete Add appendixes (separate pdfs) 29/09/2009 08/10/2009

Acknowledgements

Special thanks must go the all the respondents who took the time and effort to complete the arduous questionnaire to provide the information without which this report could not have been possible. Furthermore organisational problems meant that the questionnaire was frequently completed at home in their own time.

Thanks must also go to Claire Nickerson and Phil McCorry for working through various drafts and co-developing the thematic analysis key, Claire also provided help with navigating the intricacies of Adobe forms. Mary Richie, Diane Campbell and Gregg Waddup must also be thanked for providing help, advice and feedback when developing the SSP specific section. Nick Gulliver from CFH Exeter kindly helped clarify my original distribution data requirements and extracting the data most efficiently.

Finally I must thank Julietta Patnick for commissioning the work, and providing me with an interesting dataset to work with over the summer.

Robin Beaumont


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Contents 1. Executive Summary ................................................................................................................................................... 5

2. How to read this report ............................................................................................................................................. 7

2.1 Comparing what one would expect to that observed and benchmark setting ........................................................ 7

2.2 Re-grouping responses ............................................................................................................................................. 8 2.2.1 Combining categories appropriately ................................................................................................................................... 8

2.2.2 The neutral and adequate categories ................................................................................................................................. 8

3. Introduction .............................................................................................................................................................. 9

3.1 Purpose of the questionnaire ................................................................................................................................... 9

3.2 Questionnaire structure ........................................................................................................................................... 9

3.3 Questionnaire development ..................................................................................................................................... 9

3.4 Distribution and invitation ........................................................................................................................................ 9

3.5 Follow up .................................................................................................................................................................. 9 3.5.1 Reactive follow up .............................................................................................................................................................. 9

3.5.2 Proactive follow up ........................................................................................................................................................... 10

3.6 Response rate and sample characteristics .............................................................................................................. 10

3.7 Analysis of free text comments .............................................................................................................................. 10 3.7.1 Thematic coding scheme .................................................................................................................................................. 11

4. General Performance............................................................................................................................................... 12

4.1 Additional comments .............................................................................................................................................. 14

5. Overall Satisfaction.................................................................................................................................................. 18

6. Interaction with other systems ................................................................................................................................ 19

7. Information requests ............................................................................................................................................... 21

7.1 Current BCSS features considered useful by NON SSPs .......................................................................................... 23

7.2 Current BCSS features considered useful by SSPs .................................................................................................. 25

7.3 Negative features of current system ...................................................................................................................... 28

7.4 Additional information ........................................................................................................................................... 35

8. BCSS Support/Training............................................................................................................................................. 37

9. Knowledge ............................................................................................................................................................... 39

10. Documentation .................................................................................................................................................... 40

11. Ongoing Support for the BCSS .............................................................................................................................. 42

11.1 CFH helpdesk suggested enhancements ................................................................................................................ 44 11.1.1 Non SSP responses ............................................................................................................................................................ 44

11.1.1 SSP responses ................................................................................................................................................................... 45

12. Suggested BCSS enhancements ............................................................................................................................ 46

12.1 Non ssp ................................................................................................................................................................... 46

12.2 SSP .......................................................................................................................................................................... 49

13. Enquiries/Reports/Alerts ..................................................................................................................................... 55

13.1 Specific comments on reports ................................................................................................................................ 58

13.2 Additional general comments about enquires/reports/alerts ............................................................................... 60

14. Help Line function ................................................................................................................................................ 61


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15. The national office ............................................................................................................................................... 62

15.1 Quality and amount of communication .................................................................................................................. 62

15.2 Good practice guidelines ........................................................................................................................................ 62

15.3 Planned developments for the BCSS ...................................................................................................................... 64

15.4 Regular BCSS newsletter ......................................................................................................................................... 64 15.4.1 Topics for newsletter ........................................................................................................................................................ 65

15.5 General comments ................................................................................................................................................. 66

16. Information about respondents ........................................................................................................................... 67

16.1 Topics not covered in questionnaire ...................................................................................................................... 67

16.2 General comments concerning information management .................................................................................... 68

16.3 Length of time worked for BS and Liverpool course undertaken ........................................................................... 68

17. Screening Practitioner activities ........................................................................................................................... 69

17.1 Pre investigation ..................................................................................................................................................... 69 17.1.1 Other sources of information ........................................................................................................................................... 71

17.1.2 Creation of separate records for +ve fob assessment ...................................................................................................... 71

17.2 Communication within hospital .............................................................................................................................. 72

17.3 Use of BCSS during activities ................................................................................................................................... 73

17.4 Post investigation consultations ............................................................................................................................. 74 17.4.1 Creation of separate records for post investigation consultations ................................................................................... 74

17.5 Follow up of patients .............................................................................................................................................. 75 17.5.1 Nature of followup............................................................................................................................................................ 75

17.6 Support and training ............................................................................................................................................... 77

17.7 Other comments ..................................................................................................................................................... 78 17.7.1 Liverpool course................................................................................................................................................................ 78

17.7.2 Communication ................................................................................................................................................................ 79

17.7.3 Screening process ............................................................................................................................................................. 80

17.8 Length of time working for BC, satisfaction and workload ..................................................................................... 81

18. Variability within and between screening centres ............................................................................................... 82

19. Appendix A – Questionnaire ................................................................................................................................ 84

20. Appendix B – SPSS selected syntax ..................................................................................................................... 95


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1. Executive Summary

Reference

Section 3

Introduction A BCSS (Bowel Screening Software System) questionnaire was sent out to all screening centre BCSS users with follow up to obtain a response rate of approximately 83% (n=184)

How to read this report Much information is provided with the minimum of comment; however a section is included which provides guidelines concerning the interpretation and possible managerial use of the information

General Performance results For 10 questions concerning general performance the most frequent ranking was good or adequate with a similar distribution of responses for SSP’s and non SSP’s the exception being that for job satisfaction and source of stress where SSPs scored lower and higher respectively

Overall Satisfaction A derived overall satisfaction score indicated that respondents are happy with the BCSS system. Approximately 25% of the variance in the score can be attributed to statistically significant differences between screening centres.

Interaction with other systems Approximately one fifth of non SSPs regularly copy information from the BCSS this is slightly more for SSPs. Such systems are both computer and paper based

Information requests These are common with more than 50% being monthly or more frequent, screening endoscopists are a common source of such requests. Approximately three quarters of respondents consider that all requests are valid and the majority of such requests are considered to be manageable/difficult to fulfil

Current BCSS features considered useful by non ssps Alerts, QA reports screen design + navigation, data quality, letters and help desk

Current BCSS features considered useful by ssps Alerts, QA reports, screen design + navigation, data quality, letters and pathway management

Current BCSS features considered problematic by ssps and non ssps Reports (including alerts etc), screen design + navigation, data quality, data quality and pathway management

BCSS support and training Just over two thirds of respondents considered the help line to be good or excellent while just under a third placed the BCSS documentation in the same categories. Approximately half of screening centre staff have not received any ongoing training or had any involvement in user groups

Knowledge Half of SSPs would welcome additional BCSS training Documentation The most frequent category selected was ‘useful’ for the majority of questions. However the most common SSP response was ‘little use’ concerning the use of the documentation as a how to do it guide.

Section 2

Section 4

Section 5

Section 5

Section 7.1

Section 6

Section 8

Section 9

Section 7.2

Section 7.3

For information about data quality coding see table in section 3.7.1

Section 10

Section 18

Section 7


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Direct data entry into BCSS Never (%) Always (%)

+fob 73 21.2 Post invest. 50.4 32.7

Colonoscopy 40.7 44.2

SSPs and non SSPs rated the language of the documentation differently; ‘manageable’ versus ‘clear’

Approximately one fifth of respondents indicated that they had produced additional local BCSS documentation to help with the use of the BCSS.

Ongoing support Approximately 97% of SSP’s have used the CFH help desk compared to 85% of non SSPs. Over two thirds of respondents who had used the facility rated it as good/excellent, similar results were obtained for specific aspects such as ‘returning the call’ and ‘resolution of problem’

Suggested BCSS enhancements

Enquires/reports/alerts The majority of questions produced a most frequent response of neutral or happy

The national office Approximately two thirds of respondents felt that the amount and quality of information from the national office was adequate or good. A higher percentage of non SSP respondents, compared to SSPs, felt that it was inappropriate in their role to receive information from the national office concerning various aspects

70 – 80% of respondents felt that both various good practice guidelines and a regular BCSS newsletter would be useful/extremely useful. Suggestions were given for content of such a newsletter

Screening Practitioners (SSPs) SSPs carry out on average 8 +ve fob assessments per week, 2 (median) face to face post investigation consultations and 6 (median) non face to face post investigation consultations (pic). Half of SSPs have contact with patients following the pic, for a number of reasons

Between ½ and ¼ of pre investigation consultations involved obtaining medical notes of which over 95% of respondents found these useful/extremely useful. A wide range of other sources of information were also utilised

Three quarters of SSPs created a separate record of the +ve fob assessment, (72% in medical notes, 68% in other non BCSS records, and 65% in both systems), a similar percent created a separate post investigation consultation record

Support from local clinical histology/pathology departments was considered to be good/excellent by 75% of respondents and for colonoscopists this rose to 90%. Two thirds of SSPs felt they could adequately interpret histology/pathology reports in 75% of cases

Only 3.6% (n=4) of SSPs had shadowed a GP in the consultation using a computer

From one to two fifths of SSPs entered data directly into the BCSS, those who entered it directly for one activity tended to do so for others.

Support for professional development was considered to be good/excellent by just under 50% of responses as was the Liverpool course. Communication within the SSP community was rated as good/excellent by slightly more (54%)

Section 10

Section 15.4.1

Section 15.1

Section 15.4.1

Section 11

Section 13

Section 12

Section 17 and 17.4

Section 17.1 and 17.5.1

Section 17 and 17.4.1

Section 17.2

Section 17.3

Section 17.5

Section 17.6

Results obtained from thematic analysis of text entries


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2. How to read this report

"Lies, damned lies, and statistics"

This report presents a detailed analysis of the screening centre data from the BCSS evaluation questionnaire. It has deliberately been written in a non judgmental style with the minimum of interpretation.

The reader is encouraged to interpret and reflect upon the information presented rather than being spoon fed. This is because the author believes that the greater the degree of manipulation of data the greater the risk of misinterpretation. This report contains many tables and graphs which can be interpreted from a managerial perspective in several ways, three of which are given below.

2.1 Comparing what one would expect to that observed and benchmark setting In much of survey research the responses are expected to follow what is known as a bell shaped distribution, for example taking the question on the first page of the survey, how adequate is the overall response time of the BCSS, respondents were asked to indicate on a score of one to 5 how adequate they felt it was. The histogram below shows that the responses follow the common bell shaped (‘normal’) distribution. But does this help us interpret the data? In certain aspects it does, particularly concerning the validity of the responses however it does little in helping provide a bench mark or minimum level of acceptability, possibly the accompanying table is more useful here as we can set minimum acceptable values. We could say that we would hope in 12 months time that there should be a increase in the percent of good/excellent responses by say at least 5 percent from the present (37.7%) to at least 42%, ideally tolerance levels should be set which are not just reflecting natural variations over time (i.e. random sampling variability). Given the detailed information presented in this report it is possible to construct such indices.

It should not be assumed that the bell shaped curve is a ‘normal’ expectation for responses, for example, take the responses to the question, How often do you enter data directly into the BCSS during colonoscopy? Here the responses follow a U shaped or inverted bell shape also called a well distribution. In other words people either enter data directly for all the colonoscopies they are involved in or none of them.

enter data directly into BCSS during colonoscopy Frequency Percent Valid Percent Cumulative Percent

Valid

none 46 39.3 40.7 40.7 <1/4 1 .9 .9 41.6 <1/2 1 .9 .9 42.5 1/2 4 3.4 3.5 46.0

<3/4 1 .9 .9 46.9 >3/4 10 8.5 8.8 55.8 all 50 42.7 44.2 100.0

Total 113 96.6 100.0 Missing System 4 3.4

Total 117 100.0

The above U shaped distribution example brings us to the next area to consider when interpreting the results, how can we regroup the data to possibly help in managerial decision making.

overall response time

screening centre

Total NOT ssp ssp

far too slow Count 0 2 2

% .0% 1.7% 1.1%

too slow Count 9 22 31

% 13.6% 18.8% 16.9%

adequate Count 29 52 81

% 43.9% 44.4% 44.3%

good Count 23 35 58

% 34.8% 29.9% 31.7%

excellent Count 5 6 11

% 7.6% 5.1% 6.0%

Total Count 66 117 183

% 100.0% 100.0% 100.0%


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2.2 Re-grouping responses There are two issues to consider here, the combining of appropriate categories and what to do about the neutral and adequate categories present in some questions.

2.2.1 Combining categories appropriately

Many of the questions contain non- ordered categories (so called nominal data), for example, the ‘none given’ category in the training question section and the ‘not appropriate in my role’ option in the national office section. To help facilitate interpretation I have deliberately not included the missing values category in some results, however the total response rate is always provided so this value can always be easily calculated.

Whereas the ‘U’ shaped distribution demonstrated above relating to the direct data entry question (you will notice that it occurs throughout all the questioned activities) it is easy to combine the responses into two broad categories, however it is much more difficult to do this with responses that follow a bell shaped curve, and although is it possible to use some statistical techniques such as discriminant analysis it would probably be overly complex in this situation.

The combining/collapsing of categories is carried out for many reasons but it must always be based upon some sense of semantic equivalence of the categories involved. Reasons fr carrying out the procedure include the desire to possibly further highlight differences in certain subgroups, the removal of categories which have very small response rates, and the development of managerial measures. An example will help illustrate some of these concepts. Consider the question; the BCSS contributing to my job satisfaction, looking quickly at the bar chart below we notice that for SSP’s (green bars) the most frequent response is ‘neutral’ whereas for the non SSPs it is the ‘agree’ category. We also notice that for the least favourable categories there is a higher percentage of non-ssp’ responses compared to SSP ones whereas for the ‘agree’ and ‘strongly agree’ categories the trend is reversed.

The BCSS is a source of stress in my job?

screening centre

Total NOT ssp ssp

strongly disagree

Count 9 7 16 % 13.6% 6.0% 8.7%

disagree Count 35 42 77

% 53.0% 35.9% 42.1%

neutral Count 10 38 48

% 15.2% 32.5% 26.2%

agree Count 10 29 39

% 15.2% 24.8% 21.3%

strongly agree Count 2 1 3

% 3.0% .9% 1.6%


% 100.0% 100.0% 100.0%

If we consider the ‘neutral category as equivalent to disagree or agree changes the results markedly, as illustrated by the bar chart below. Considering the neutral category to affirm the disagreement with job satisfaction means there is a 15% difference between SSP’s and non SSP’s however if we believe that those who adopt a neutral stance felt that it does

minimally contribute to their job satisfaction there is less than a 2% difference.

2.2.2 The neutral and adequate categories

Many questions in the questionnaire contain a ‘neutral’ or ‘adequate’ category, of which there is much academic research literature, concerning the former, in the end it is a personal decision when combining categories in which way you combine these.

Interestingly in this example using the raw categories produces a significant result (n=184, M.V.U=28003.5, t-tailed p =.001), indicating that SSP’s gain significantly less job satisfaction from the BCSS than non ssp’s at screening centres.


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3. Introduction

This section describes the questionnaires purpose, development/distribution and approach taken to follow up.

3.1 Purpose of the questionnaire Quoting the invitation letter:

The Bowel Cancer Screening System (BCSS) has been in use for approximately three years, during which time users of the system have helped to develop it in many ways. I’d like to express thanks to everyone involved directly or indirectly in all the constructive help we’ve already had to date. The National Cancer Screening Programme team now feels it is an appropriate time to ask you, as a user of the system, for all your experiences and views to date. There are three main aims for this survey:

• to help us assess the overall effectiveness of the system in supporting you in your job. • to also help to inform the priorities and the direction for future development work on enhancing the system. • to ensure we get as wide a range of views as possible by inviting input from all users

[end of quote]

3.2 Questionnaire structure The questionnaire (see appendix) considered of 20 sections, some of which were only relevant to a particular subset of respondents such as hub staff, screening centre administrators or SSP’s. The questionnaire distributed to SSP’s contained an additional two pages enquiring about SSP specific aspects.

3.3 Questionnaire development Questionnaire development was based upon adaption of standard IT Systems/ information management evaluation questionnaires to fit the needs of the current project. Development included several prolonged meetings with the project commissioners (the National office) and prospective interest groups such as Hub managers, test kit readers and Specialist Screening Practitioners (SSP’s). Draft copies of the questionnaire were distributed to CFH Exeter but this failed to elucidate any response concerning the structure of the questionnaire.

3.4 Distribution and invitation An initial invitation e-mail was e-mailed out to all prospective participants approximately 2 weeks before the questionnaire. This strategy was adopted because it has been shown that a pre questionnaire invitation increases response rate. To provide legitimacy the letter was sent from the assistant director for the programme.

Acrobat forms (v. 8.02) were used to develop and distribute the final questionnaire, (15th July 2009). The initial email distribution list was provided by CFH Exeter who developed the BCSS software.

3.5 Follow up Respondents were initially asked to complete and return questionnaires within 4 weeks, because of initial poor response the deadline was extended for one week.

Follow up methods used for the Hubs were different to those for the screening centres and will not be discussed in this report.

3.5.1 Reactive follow up

Both the invitation e-mail and questionnaire and accompanying e-mail provided an e-mail address for contact, during the course of data collection (15th July – 21st August) this was made use of by numerous respondents.


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3.5.2 Proactive follow up

All completed questionnaires received a personalised e-mail response, and during the last two and a half weeks this included details of who had still not replied from the particular screening centre, which was also copied to the non responders.

Duplicate questionnaires were distributed after 7 days along with a e-mail reminder to non responders. Telephone follow up commenced at the end of week 2 and finished at the end of week 4. Phoning strategy consisted of targeting those screening centres with the lowest response rate, and besides discussing the questionnaire the validity of the original screening centre e-mail distribution list was considered, often resulting in removal of names or additions of new ones.

Further reminders were sent out during week three and this included a ranked list of response rate for each screening centre, in an attempt to further stimulate responses, and also validate them.

No visits were conducted to screening centres during the data collection stage.

3.6 Response rate and sample characteristics The tables below provide details of the response rate for each screening centre (sc) with an overall response rate of 83% (median 100%). The expected response value for each sc was obtained from the individual centre during the followup period, at which time individual e-mail addresses were also verified.

3.7 Analysis of free text comments At several points in the questionnaire respondents were invited to provide free text comments, and in agreement with the aims of the questionnaire these provided information about the overall effectiveness of the system or issues concerning its future development.

While the focus of this report is rightly the analysis of the quantitative data, in some instances analysis of the ad hoc comments helps provide additional insight, but it is important to realise that, in contrast to the quantitative data, it would be very unwise to generalise from these comments without collaborative evidence, such as the associated quantitative data in this report.

Two members of the national office helped develop a simple thematic coding scheme by analysing approximately 150 comments. These collaborators were deliberately chosen to carry out this task to ensure a useful valid coding scheme that would support achieving the aims of this questionnaire.

Screening centre returned expected Returned % 1 6 6 100 2 5 5 100 3 2 2 100 4 4 4 100 5 4 4 100 6 4 4 100 7 3 3 100 8 7 7 100 9 5 5 100

10 10 10 100 11 4 4 100 12 4 4 100 13 5 5 100 14 3 3 100 15 5 5 100 16 3 3 100 17 5 5 100 18 5 5 100 19 6 6 100 20 6 6 100 21 3 3 100 22 2 2 100 23 4 4 100 24 3 3 100 25 6 6 100 26 6 7 86 27 6 7 86 28 5 6 83 29 5 6 83 30 5 6 83 31 5 6 83 32 4 5 80 33 4 5 80 34 3 4 75 35 2 3 67 36 6 9 67 37 3 5 60 38 3 5 60 39 3 5 60 40 3 5 60 41 2 4 50 42 1 2 50 43 2 4 50 44 2 4 50 45 2 5 40 46 1 3 33 47 1 3 33 48 0 3 0

Total 188 (including

4 damaged) 226 83

screening centre Frequency Percent

screening centre - NOT

ssp 67 36.4

screening centre - ssp

117 63.6

Total 184 100.0


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3.7.1 Thematic coding scheme

Code value

Descriptor

1 Slow performance + ‘frozen’

2 Other performance issues (negative)

3 Other performance issues (positive)

4 Reporting/searching output issues (negative) including: No reports for . . . + questionnaire, PCT requests, keeping additional spreadsheets

5 Reporting/searching output issues (positive): Including alerts, QA reports, operational reports, downloads, last subject search, FOB tests, excluding incomplete dataset report

6 Screen design + navigation (negative) including: forced route (+back button problem), forced dataset creation, Silent log off, inappropriate edit/deletion of text , inability to open >1 window, Colon required for date entry, polyp data display, No alphabetical display option. Procedural help while carrying out a task.

7 Pathway management (problems) including: unable to change test results, inability to cope with unusual pathways, need to ring help desk to edit data (when using interrupts + mistakes)

8 Letter issues (negative) including: ‘too letter orientated’, no colonoscopy refusal letter offering alternative follow-up advice/options, GP/consultant letters

9 Letter issues (positive) including: mail merge, templates

10

Data quality (negative) excluding cancer datasets and dummy datasets but including: inaccuracy of data, desire to be able to appropriately edit append text/add new fields/codes (e.g. actual colonoscopy appointment, additional clinical data, patient medication, sub-pedunculated option in polyp type, faecal tagging CT, histology turnaround). Desire to clarify data items (e.g. smoking, therapeutic/diagnostic colonoscopies). Desire for spell checker. Data lose when updates occur. ‘Not all people keeping the same data’. Unable to remove patients from alerts.

11 Data quality (positive) including: ‘data all in one place’, appointments system, incomplete datasets report, Contemporaneous, easy to edit, Able to view other screening centres data, Patient questionnaires

12 Help desk (negative) including ‘no clinical support’, support for dataset completion

13 Help desk (positive)

14 Training including improvements to user manual, update training and regular tips and tricks but excluding: Difficulty entering cancer datasets Desire for dummy/training datasets

15 Cancer datasets (negative) + ‘datasets’, including ‘time consumming’ + no point etc.

16 Desire for dummy/training datasets

17 Duplicate data entry excluding Spreadsheets

18 Patient Minority Group (PMG) Issues including language issues.

19 Communications issues (negative) including: ‘updates just appearing’, ‘no feedback concerning change requests’, user group access

20 Communications issues (positive)

21 Trust issues (positive)

22 Trust issues (negative) including Hardware and IT support

23 Other + security + management issues (e.g. ‘time consuming’)

24 Screen design + navigation (positive)

25 Pathway management (positive) excluding ability to edit individual fields but including: advancing episodes, closing episodes,

26 System enhancements including: organisational calander, patient diary, integreation with MS word for letter writing, Website of Faqs, Email archive, online ad hoc tutor.


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4. General Performance

The questionnaire began with a set of ten questions concerning general performance, the results are given below. For most of the questions a similar distribution of responses occurred for SSP’s and non SSP’s the exceptions being for both job satisfaction (details see previous section) and source of stress (n=183, M.W.U=2939.5, t-tailed p=.005).

How often do you have problems logging onto the BCSS

screening centre

Total NOT ssp ssp

more than daily Count 2 2 4

% 3.0% 1.7% 2.2%

daily Count 0 2 2

% .0% 1.7% 1.1%

weekly Count 1 4 5

% 1.5% 3.4% 2.7%

monthly Count 9 19 28

% 13.4% 16.2% 15.2%

3 monthly Count 19 32 51

% 28.4% 27.4% 27.7%

yearly Count 7 17 24

% 10.4% 14.5% 13.0%

never Count 29 41 70

% 43.3% 35.0% 38.0%


% 100.0% 100.0% 100.0%

overall response time

screening centre

Total NOT ssp ssp

far too slow Count 0 2 2

% .0% 1.7% 1.1%

too slow Count 9 22 31

% 13.6% 18.8% 16.9%


% 43.9% 44.4% 44.3%

good Count 23 35 58

% 34.8% 29.9% 31.7%


% 7.6% 5.1% 6.0%


% 100.0% 100.0% 100.0%

Adequacy of menu system in BCSS

screening centre

Total NOT ssp ssp

grossly inadequate Count 0 0 0

% .0% .0% .0%

inadequate Count 3 7 10

% 4.5% 6.0% 5.4%


% 44.8% 47.0% 46.2%

good Count 31 50 81

% 46.3% 42.7% 44.0%


% 4.5% 4.3% 4.3%


% 100.0% 100.0% 100.0%

Ease of navigation between screens

screening centre

Total NOT ssp ssp

grossly inadequate

Count 0 2 2 % .0% 1.7% 1.1%


% 13.4% 16.4% 15.3%


% 38.8% 36.2% 37.2%

good Count 29 51 80

% 43.3% 44.0% 43.7%


% 4.5% 1.7% 2.7%


% 100.0% 100.0% 100.0%


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Contributes to job satisfaction?

screening centre

Total NOT ssp ssp

strongly disagree Count 1 4 5

% 1.5% 3.4% 2.7%


% 11.9% 22.2% 18.5%


% 31.3% 45.3% 40.2%


% 47.8% 25.6% 33.7%


% 7.5% 3.4% 4.9%


% 100.0% 100.0% 100.0%

Reduces productivity

screening centre

Total NOT ssp ssp


% 6.2% 2.6% 3.8%


% 44.6% 39.3% 41.2%


% 33.8% 42.7% 39.6%

agree Count 9 17 26

% 13.8% 14.5% 14.3%


% 1.5% .9% 1.1%


% 100.0% 100.0% 100.0%

The BCSS is easy to use?

screening centre

Total NOT ssp ssp


% .0% 2.6% 1.6%


% 13.4% 23.3% 19.7%


% 17.9% 25.9% 23.0%


% 61.2% 44.8% 50.8%


% 7.5% 3.4% 4.9%


% 100.0% 100.0% 100.0%

The BCSS is a source of stress in my job?

screening centre

Total NOT ssp ssp


% 13.6% 6.0% 8.7%


% 53.0% 35.9% 42.1%


% 15.2% 32.5% 26.2%


% 15.2% 24.8% 21.3%


% 3.0% .9% 1.6%


% 100.0% 100.0% 100.0%


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Supporting tasks in my job?

screening centre

Total NOT ssp ssp

grossly inadequate Count 3 0 3 % 4.5% .0% 1.6%

inadequate Count 13 12 25 % 19.4% 10.3% 13.6%

adequate Count 20 71 91 % 29.9% 60.7% 49.5%

good Count 27 30 57 % 40.3% 25.6% 31.0%

excellent Count 4 4 8 % 6.0% 3.4% 4.3%

Total Count 67 117 184 % 100.0% 100.0% 100.0%

How happy are you with the BCSS?

screening centre

Total NOT ssp ssp

very unhappy Count 2 0 2 % 3.0% .0% 1.1%

unhappy Count 11 14 25 % 16.4% 12.1% 13.7%

neutral Count 15 44 59 % 22.4% 37.9% 32.2%

happy Count 34 52 86 % 50.7% 44.8% 47.0%

very happy Count 5 6 11 % 7.5% 5.2% 6.0%

Total Count 67 116 183 % 100.0% 100.0% 100.0%

4.1 Additional comments Respondents were invited to add optional comments concerning the general performance questions presented in the previous section. The responses, divided into those made by Non SSps and SSPs, are provided below, both the original comments and summaries of the thematic analysis.

Non ssp Frequency Percent

Reporting (output) issues –negative including: keeping additional spreadsheets

11 42.3

slow performance 5 19.2

Difficulty with (Cancer) datasets 3 11.5

other 3 11.5

Other performance issues (positive) 1 3.8

Screen design + navigation (negative) 1 3.8

Pathway management (problems) including: unable to change test results

1 3.8

Trust issues (negative) including Hardware and IT support

1 3.8

Total (from 20 respondents) 26 100.0

ssp Frequency Percent



10 17.2

Data quality (negative) excluding cancer datasets and dummy datasets but

including: add new fields + clarify data 6 10.3



Training excluding: Difficulty entering cancer datasets + dummy/training

datasets 3 5.2

Communications issues (negative) 2 3.4

Reporting (output) issues –negative including: keeping additional

spreadsheets 2 3.4

Help desk (negative) 1 1.7

Help desk (positive) 1 1.7

other 1 1.7

Letter issues (negative) 1 1.7

Total (from 45 respondents) 58 100.0


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ID Text comments from NON SSPs code

7

Too many datasets that are impossible to fill in and everything is thrown back at me as an administrator with clinical terms that I would not understand anyway because the SSP's are unable to help or do it. The reports and graphs etc are inaccurate. I currently audit the whole of my trust (3 hospitals) and produce better figures.

15

19 The BCSS is not very user friendly when trying to produce reports and extract data 4

27

1. The biggest problem for me is that people and their progression through the system do not always fit what is provided on the system. Many times we have not been able to enter exactly what the circumstances for a particular patient has been and are told by the helpdesk to choose something which will move the patient on. This sits uncomfortably on me because when the BCSS becomes the only record we will have in the office (getting rid of our paper copies), 'walk rounds' on the system will not show the truth. Yes, we do write in the patients medical notes but these are not kept with us. There should a free text space at the end of each outcome. So that 'misfits' can be recorded. 2. The other problem I have is that there is not way to record ad hoc patient contacts. Because the system is a timed one, the patient contact is only available at certain stages. There are many instances where one contacts patients before they have their investigations and these simply cannot be inputted unless in the episode. 3. Not being able to 'tick' someone as attended assessment clinic before the exact time of the appt is a nuisance. Sometimes people are early, or someone in the middle of a list does not turn up and you cannot attend the next one before their scheduled time. this means no dataset on screen and we either wait or do a manual one. We moved to inputting directly onto the BCS to save time. Not being able to attend someone before their schedule time hinders us. Can this be changed please?

7

31 I find this questionnaire slightly difficult to answer as I use only a small part of it. 23

33 Main source of stress is associated with downloads and reports! The issues are not all associated with the BCSS - there are still issues with incomplete datasets, issues with data input and trying to understand sequence of events (especially if SSP's have tried to correct errors with pathway).

4, 15

34 Too slow, drop down boxes on some datasets are too close together, not very easy to navigate from one area to another. Does not provide reports needed so we have to duplicate info on in- house systems which is a gross waste of time.

1

37 Data retrieval is cumbersome and inadequate at present. Have issues with QA reports and the drivers, but this is possibly a training issue and perhaps more time needs to be given to completion of datasets at training?

4,15

64 Reporting system is not adequate and needs updating. 4

65 The system does not give any information on cancer patients or patients who have been referred for surgery. 4

76 The reporting mechanisms and reports available are inadequate in relation to the data that is entered into the various datasets. The reports are also not up to date and are of no value in presenting information to the present date.

4

81 Accessing of reports could be made easier. QA is not very good. 4

97 I am not a daily user. I generally view appointments and compile reports. 23

101 I FEEL THAT THE TIME SLOT IS TO SHORT FOR DOING THE JOB THAT I DO AS ADMINISTRATOR. 23

110

RE navigation, it can sometimes be a bit slow to use the 'back' command, other than that I do find general navigation of the site quite easy. Although I have had some feedback to suggest that windows could be used to display more than one screen at once I don't know how viable this would be. The only negative feature is with regard to ease of use of downloads of information - can be quite tricky when required at short notice.

1, 6

138

There are some ambiguities in how the datasets should be completed - not easy to work out as not every option is given. The system does not allow stats to be produced which would be useful for reporting and audit. The Path ProForma is not on the system. i.e. diagnostic or therapeutic Colonoscopy - the aim is for all to be therapeutic therefore do we use the term diagnostic ONLY if this is the purpose OR do we use it for instances when we have gone in, found nothing and therefore no therapy was needed?????

15

153 Improvements need to be made to the accessing of reports and data 4

156 The BCSS does not allow me to access the information I need to undertake my role. A large amount of information is entered into the system but very little is available in report form.

4

159

As a patient reminder system i think the BCSS is good, but for the more strategic and operational functions i find it grossly inadequate. Our team triplicates data entry (paper in clinic, the BCSS after and a local database) in order to capture vital Quality Assurance information. Obviously this is a waste of time and a source of stress.

4, 17

160 Unfortunately adequate data/ reports are not available from BCSS therefore we have to have our own tracking system in place 4, 17

176 The BCSS provides a good way of accessing and storing information on the patients and is simple to use, I think some of the delays are due to the computer hardware in this Trust.

3,22

ID Text comments from SSPs code

1 The BCSS does an adequate job to record all the patient data for their episode of care. It does not make the job of an SSP any easier. There is a lot of to-ing and fro-ing between different areas of the system which just prolongs the length of time spent using it.

6

9 Can take a long time when looking at alerts (inactive episodes) to refresh page. 1

12

The user name system is frankly silly; what's wrong with 'initial surname', as used by most others? The system is quite clunky, and fails to cater to different needs - it could be much better customised for different postholders. Much of the system is counter intuitive (eg 'colonoscope inserted yes/no' after 15 questions that could only have been answered if the scope had been inserted), plus questions on one dataset that cannot conceivably answered at that time. Because the system is so dedicated to the audit needs of BCS, it fails to be helpful to users - eg little flexibility in inserting 'non-standard info', or recording non-BCS essentials in chronological order (eg a patient complaint can only be recorded in list episode/events, which is failry inaccessible, is not a permanet record

1,6,7, 4


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(it's editable), and cannot easily be printed. None of the system is printer friendly, which can cause frustration when taking info to (eg) MDM.

14 No one has had training on completing datasets and correct advancing - there is a lot of guess work going on, especially when centres are new to the system. There should be clearer more informative guidelines.

15

22 I find it frustrating having to scroll up and down the pages when trying to input polyps to add another when adding a few. 6

25 The menu is far to hard to navigate around, the pages refresh to slowly, and there is not enough options to free text as patients do not always fit some of the fixed options in the system.

6

28 Once you get used to how it works it is relatively straightforward. Problems can arise when you send people down wrong pathway. It would be convenient if you could easily move step back and alter mistake.

7

30 MAIN PROBLEM IS HAVING TO FILL IN CANCER DATASETS, WE ARE DUPLICATING INFORMATION THAT IS BEING DONE ELSWHERE AND IT IS VERY, VERY TIME CONSUMING. OTHERWISE I WOULD BE HAPPY.

15

35

Now that we are due to host 3 year surveillance and have seen some patients x2 for surveillance the system does not always suit the circumstances, for instance a patient wishing to opt out of this surveillance but wishing to remain in the system. The cancer audit takes +++ hours to complete and this information is hard to source from many different hospital. On a positive note, I do find the help desk to be SUPERB.

7, 13

40 No recording of actual colonoscopy appointment Documentation of patients medication

10

42

when experiencing a problem with moving a patent through Exeter I find it frustrating to first Log a call rather than telephone someone direct as duplicating information and waste time. Often the call is answered by someone who is not a clinician so difficult explaining proceedurer , they log into your account but dont appear able to exactly view where you are so why log in.

12

47

I don't love the system, but then I may not like any system. Certainly going from page to page is a pain at peak office hours, but that is to do with connection speed, not the system. Things go much quicker after 6pm and before 9am. Why does the system have to time-out all the time? It is obvious that if you are in the middle of using it, then a request to time out isn't needed. If there haven't been any key strokes for 30min, then I could see the point.

6

55 It is a good system and covers the majority of the pathways covered by patients but there is no room for unusual patients. 7

56 Not having more flexible pathways can be frustrating and time consuming in trying to clarify 7

57 I FEEL WE NEED AN "ADD POLYP" BUTTON FURTHER DOWN THE SCREEN IN THE INVESTIGATION DATASET, AS IF YOU HAVE MANY POLYPS YOU HAVE TO KEEP SCROLLING BACK UP TO THE TOP TO ADD ANOTHER POLYP AND THEN SCROLL DOWN AGAIN.

6

61 I quite often find the system frustrating as the pathways do not always appear logical, for example when no patient letter is generated to inform the patient of a plan of care. Also the system does not allow adequate space to input all episode notes (this is in the process of being changed).

7,10

63 I feel that in order to go forward on the system sometime your have to take two steps back, as it is supposed to be a legal document I feel that there should be more than 4000 characters in the episode notes, as with complex patients this maybe needed.

6,10

73 The system is often quite slow; it is unclear if this is a local problem or a BCSS problem. Although the menu system is ok overall it is sometimes difficult to navigate for some of the more complex patients

1,6

75

Inexpensive update training needed. Each SSP uses the system in a different way, ie surveillance: if have had a surv colo for high risk which is normal do you record normal and expect the system to calculate the next surv which should be 3 yrs or record intermediate polyps which would give you 3 yr surv?. I'm sure i only use a small portion of the options as i do not know the rest!

14

77 Often very slow, times out a lot of the time or freezes. 1

78 IT's sometime frustrating when you can't enter the information because it's not an option. Eg pipe, tobacco, cigar and self rolled cigarette smokers. 10

84 feel have to go back and forward alot to advance etc. sometimes unsure if advanced patient correctly 6

85 More access to data for audit purposes 4

90 The information required for data sets is not in a logical order 6,15

92

Having to go back after inputting information is wrong it would be more beneficial if we could advance from this page and not have to go back all the time, also when we have put forward for another appointment we cannot advance until a letter has been printed this wastes so much time having to go back to advance after letter has been printed which might not be until later that day this is not good practice and hinders work load

6

102 There is a lot of information that is required to complete datasets on the BCSS. This can be very time consuming and I feel that my priority is patient care. I do not feel that the inputting of this information is always necessary.

15

104 What is made it more stressful is the loss of data that happens as a result of upgrades for many centres. 10,19

109 It is very rigid causing problems sometimes when patients don't always fit into these boxes 7

114

I am happy with the system as it allows me to cut down on time by filling in the datasets at clinic and colonoscopy directly onto the system rather than making more work if this was done in written form first. And most of the pathways are understood although there have been changes that we are not aware of until questioning the open Exeter staff. I think regular study day updates would be beneficial this is something that I am planning to do as a part of the QA of the programme being the QA rep for London.

14

115

The BCSS increases productivity for our clinics as we type directly during consultation. I find some of the data required for cancer datasets difficult to complete (There has never been any guidelines as to how to do this correctly). The system can be stressful when new updates are performed and no one has informed you of the new pathways(this will mean you spend a lot of time on the phone calling the support line).

15,19

116

The identifying information is not visible when filling in datasets - this makes data entry unsafe. It is very easy to inadvertently change information in the boxes where you have a selection of answers to choose from as unless you immediately click the mouse it scrolls to the next answer There are so many datasets that it would be useful if you could see at a glance if they are complete or not without having to go into each dataset.

6,15

117 i would say that the way information is presented to the user is illogical and poorly thought through 6

118 Sometimes difficult to navigate a participant through if the pathway is not on the BCSS 7

120 Alerts often take a while to refresh.I have got used to the workings and pathways on the BCSS,however when supporting new new staff they find it difficult to use particularly when moving patients through a more complicated episode. Training could be improved because staff find dataset explanation rushed through

1,14


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when this is what they deal with on a day to day basis. Possibly have admin and SSP training separated to focus on more pertinent/relevant issues. Cancer audit datasets have caused a great deal of stress in understanding terminology -perhaps link histology sessions at LJMU with looking at blank datasets. An online facility to practice entering data would be useful.

126 I find it frustrating that you have to keep going backwards and forwards to advance episodes not straight forward. 6

127 IT IS TOO LETTER OREINTATED 8

131 only just gone live so probably not the best time to complete the survey 23

137 Some ambiguity in questions on the datasets- does the patient smoke? How many years do they have to have stopped to be considered a none smoker?Type of test?

10

139 sometimes i find it difficult to navigate my way around the system 6

142 Find it frustrating that you can't go back and alter test results easily. 6

143

It is difficult for patients to always fall into the exact options one has for choices within the system. I do not like the way we cannot enter patient contacts until after a procedure has been performed and then only in reference to the post investigation outcome. I realize I can enter in episode notes but I think a simple log would be better. I find it very irritating having a drop down box for choice of yes / no not known as it is very easy to click on the wrong one - why can't it respond to Y or N? Also why do we have to put a colon :, inbetween time ??? The system is not flexible as I would like but I appreciate it has to be suitable for all and standard.

7,6

144 As a new screening service I don't feel I'm entirely familiar with the BCSS. There are obviously many pathways that patients can follow, this seems convoluted but no doubt with time it will become more straight forwarded.

6

149 WHILST THE ACTUAL SYSTEM IS RELATIVELY EASY TO USE, IT CANNOT ALWAYS ACCOMODATE THE VARIOUS CLINICAL SCENARIOS WHICH OCCUR, AND YOU HAVE TO SUPPLEMENT YOUR ENTERIES IN THE EPISODE NOTES

7

150 If you make a mistake it is difficult to rectify. 6

171 would like an audible sound warning imminent log-off as have lost data loads of times whilst looking away from screen. Would be easier to use if drop down boxes were alphabetical.

6


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5. Overall Satisfaction

The ten questions from the General performance section were used to create an overall satisfaction score for each respondent who answered all the questions, (questions 6 and 8 reverse scored), the scores were then transformed to provide a scale with a possible range of 0 to 10.

The 0 to 10 range can be interpreted as equivalent to very unhappy (0-2), unhappy (2-4), neutral (4-6), good (6-8) and excellent (8-10). Given this interpretation we can say that overall the respondents are happy with the system.

Considering these results in more depth presents some interesting details. The means and even the interquartile ranges are very similar, with both a standard two sample t test (t=1.869, df=177, 2-tailed p=.063, mean difference .3977) and Mann Whitney U (n=179, U=3055, 2-tailed p=.060) producing insignificant results. As would be expected the significant differences between SSPs and non SSPs for job satisfaction has been diluted to insignificant taking the results as a whole. Because of this the pooled results are provided below.

screening centre Statistic Std. Error

Mean NOT ssp (=64) 6.3170 .19090

95% Confidence Interval for Mean Lower Bound 5.9355 Upper Bound 6.6984

5% Trimmed Mean 6.3153 Median 6.4286

Variance 2.332 Std. Deviation 1.52719

Minimum 2.62 Maximum 10.00

Range 7.38 Interquartile Range 2.56

Skewness -.075 .299 Kurtosis -.238 .590

Mean ssp (n=115) 5.9193 .11799




Minimum 2.86 Maximum 8.81

Range 5.95 Interquartile Range 1.90

Skewness .141 .226 Kurtosis -.724 .447

Overall Satisfaction – Screening centres

Freq

uenc

y

0

15

10

5

20

25

Very unhappy unhappy neutral happy very happy


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6. Interaction with other systems

Respondents were asked how often they found it necessary to manually copy i.e. onto paper or by 'cut and paste', information from the BCSS. Four fifths of non SSPs never carried out this activity compared to slightly less SSPs.

How often do you copy data from the BCSS

screening centre

Total NOT ssp ssp

more than daily Count 11 7 18 % 16.9% 6.0% 9.9%

daily Count 11 16 27 % 16.9% 13.7% 14.8%

weekly Count 4 21 25 % 6.2% 17.9% 13.7%

monthly Count 6 9 15 % 9.2% 7.7% 8.2%

3 monthly Count 5 15 20 % 7.7% 12.8% 11.0%

yearly Count 2 6 8 % 3.1% 5.1% 4.4%

never Count 26 43 69 % 40.0% 36.8% 37.9%

Total Count 65 117 182 % 100.0% 100.0% 100.0%

computer based system

Total 0 computer based system

NOT ssp

Count 40 27 67 % 59.7% 40.3% 100.0%

ssp Count 86 31 117

% 73.5% 26.5% 100.0%


% 68.5% 31.5% 100.0%

Other system response = 0

paper based system

Total 0 paper based system

NOT ssp

Count 51 16 67 % 76.1% 23.9% 100.0%

ssp Count 81 36 117

% 69.2% 30.8% 100.0%


% 71.7% 28.3% 100.0%

While it appears that non SSPs transfer information from the BCSS onto other computer based systems more frequently than SSPs this was found not to be statistically significant (Fishers exact, 2-tailed p=.069), the case for paper based systems resulted in a similar result (Fishers exact, 2-tailed p=.395)

Case Number NOT SSP responses - other type of system details:

5 We have to keep a paper diary, as there is no alert or trail to follow when the Hub moves patient's appointments between our three sites and/or by changing time/date of appointments.

6

We need to keep a diary of SSP clinic appointments separate to the system due to the hub being able to change them without notifying us. Perhaps there should be an alert for screening centres when a patients appointment is changed or cancelled by the hub? I also find it is much easier to keep a spreadsheet as a quick reference as it is impossible to search for a patient based on the point they are at in their episode or the overall outcome of the screening.

7 From our patient system.

19 information is stored on a separate database for all of our patients, it is much easier to extract data for reports from this system than from the BCSS Information provided in table format to the consultants re performance. SSP clinic appointments are copied onto a word document and attached to notes for each clinic

27 This manual copying is done for quickness of identification of correct patient and result. We print off a clinic sheet which gives us the FOBT results as we explain what an abnormal result means, we need to know how the person got to that end result. This has proved quicker than trawling through the system for each person in clinic.

31 Not had to do this

33 Clinic lists do not contain enough information to be able to print and use at reception. Also the patient assessment documentation requires admin staff to complete demographic details from BCSS onto paper.

37 Mainly EIP data

58 Keep our own log of activity for quick reference and activity monitoring and to assist planning. I

64 excel database

66 We copy patient information on to a paper copy of the patient assessment for SSP clinic.

80 I need to relay information from BCSS to our Patient administrative system 'PAS' every time a new patient is booked in for an SSP clinic. This information is also copied onto our Cancer 18 week pathway tracker.

91 When collating data for the QA Directors meeting on Endoscopy QA reports the data is not provided in the format required, therefore have to copy and paste to excel and do calculations in order to obtain the correct data.

97 Monthly reports for endoscopy

106 copying and pasting patient information for the preassessment clinics held in the medical outpatients department

110 i.e. screen dumps etc for ease of dissemination when querying certain issues.


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138 Like other centres, I need to provide more information in a report form than BCSS permits

156 Information needs to be entered onto other Trust information systems

159 As above. We currently copy information out of BCSS onto excel so we can report on our data, as the BCSS function itself is inadequate.

162 for my own references

168 we cut and paste onto our diary system the names of patients attending clinics.

176 Copying information into spreadsheets so that annotations can be made and the information shared with the rest of the team for completion

Case Number SSP responses - other type of system details:

9 Communication sheets kept in patients files which has as much information on so that when we are in areas where there is no computer access we can identify the pt needs.

10 We have a communication sheet for each patient so that wen we are at clinics/colonoscopy lists where we do not have IT support we can find out any communication that has occured with the patient.

12 While I appreciate the info is input for BCS purposes, the info is also part of the patient's record, and should be (a) capable of being a permanent dated record and (b) easily printed.

15 We copy for every patient their FOB kit results onto our paper patient assessment form. We may copy cut and paste any episode notes and keep a paper copy in our Bowel Screening Notes.

24 Individual GP letters 36 initial colonoscopy assessment is done on paper in clinic and transferred onto system

47 I copy bits on to patients' medical notes. Unavoidable really.

54 We copy and paste patient demographics and GP details into word documents for storage on local drive and for emailing to second site for clinic preparation of notes etc prior to clinics.

78 Some of the information is required for care plans for procedure so it means having a hard copy eg of the health check questions

99 all information is kept as paper evidence

102 The wording of the letters produced on the system is not always accurate enough to send to a patient hence the need to cut and paste letters. The difficulty here is the signature on the letter remains the screening centre director. In fact, it is the SSP sending the letter and expecting a reply so this often confuses matters.

113 WRITTEN RECORD FOR MEDICAL NOTES & CENTRE ACCESS DATABASE 114 Printing off clinic lists and printing a hard copy of the pre-assessment form for the patients notes.

115 Printing off clinic lists, having a 'hard copy' for the notes. Updating a daily excel sheet with updated information. 119 Have to manually produce letters for certain patients and GP letters which is extremely time consuming.

120 File Maker Pro .9 data base used to ensure we can provide accurate data relating to patient episodes for consultants . Paper based back up in endoscopy rooms should our internet access to BCSS fail due to virus to ensure accurate data collection. Also used when 10 + polyps are removed to ensure accurracy of recording details.

127 REFERRAL LETTERS GET PUT ON THE SYSTEM 133 We duplicate the whole care episode including nursing assessment onto paper so it can be filed in the case notes and a local access database. 136 We print out copies of the assessment dataset for the patient colonoscopy care pathways 171 Useful back up tool, as otherwise can loose data when system logs you off silently

177 detail of SSP assessment written down then information transferred to dataset 183 Only when writing individual letters.


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7. Information requests

Respondents were asked to indicate how often they were asked for information

How often are you asked for information

screening centre

Total NOT ssp ssp

more than daily Count 4 1 5

% 6.1% .9% 2.8%

daily Count 8 7 15

% 12.1% 6.1% 8.3%

weekly Count 5 23 28

% 7.6% 20.0% 15.5%

monthly Count 18 34 52

% 27.3% 29.6% 28.7%

3 monthly Count 17 20 37

% 25.8% 17.4% 20.4%

yearly Count 0 8 8

% .0% 7.0% 4.4%

never Count 14 22 36

% 21.2% 19.1% 19.9%


% 100.0% 100.0% 100.0%

Respondents were also asked to indicate who made the requests for this information/data.

Those who selected the ‘other’ category were asked for further details which are given below. As elsewhere in this report responses have been divided into those from non SSPs and SSPs.

Case Number Other people that request data (screening centre - NOT ssp) 18 Cancer information 19 Screening centre manager. 33 Clinical Director of screening centre, research fellows for endoscopy & and other local screening centres. 58 QA 91 QA data - usually on a 2-3 monthly basis 97 finance/commissioning purposes 138 Pathology 140 histopathology department 141 GP/Surgeries 153 cancer network, QA 156 Cancer division / MDT trackers

Case Number Other people that request data (screening centre - ssp) 12 line manager, in case of incidents, other professionals in cases where patient has other current investigations treatment in progress 15 All audit purposes 21 COLORECTAL NURSES 28 Clinical lead. Research requests. 30 MANAGER 35 cancer services querying 62 day target dates 39 other screening centres, 53 Endoscopy staff and Admin

54 Our local Trust Finance department require clinic dates and numbers through. Our local MDT co-ordinator also requires fob positive patient details to enter onto the cancer register.

73 managers 77 programme manager 78 Clinical Nurse Specialist (MacMillan Nurses), Lead Nurse and Outpatients department 88 Patients to show evidence of turn around of specimens as appears quick to them 93 For audit purposes - number of colonoscopies/cancers and dataset completion 99 cancer wait teams and MDT co-ordinators

Who requests the data? NOT ssp (n=67) Ssp (n=117)

count % count % total

Colorectal surgeons + MDT requests for data 12 11.8 30 18.0 42 PCT requests for data 15 14.7 25 15.0 40

Screening endoscopists requests for data 26 25.5 56 33.5 82 SSP's requests for data 30 29.4 31 18.6 61 Hub requests for data 4 3.9 4 2.4 8

National office requests for data 5 4.9 3 1.8 8 Other requests for data 10 9.8 18 10.8 28

Total 102 100 167 100 269


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114 Information is provided quarterly for the PCT's, screening colonoscopist asks for local figures and other SSP's 115 For regular meetings for either the unit or PCT's 120 see below only due to File Maker Pro9 have we been able to provide this information promptly and accurately to date. 121 my manager 124 Less often from national office 126 Patients may ask information about test kits 144 SHA lead nurse 155 PERFORMANCE MONITORING ANALYST 165 Endoscopy manager for local/ hospital yearly audit 166 patients 175 management team

Respondents were asked to indicate both the appropriateness and ease of fulfilling such requests, the details of which are provided below.

What proportion of requests are considered appropriate?

screening centre

Total NOT ssp ssp

none of them Count 0 0 0

% .0% .0% .0%

about a quarter Count 1 0 1

% 2.6% .0% 1.0%

about half Count 4 5 9

% 10.5% 7.5% 8.6%

about three quarters Count 7 10 17

% 18.4% 14.9% 16.2%

5=about all of them Count 26 52 78

% 68.4% 77.6% 74.3%


% 100.0% 100.0% 100.0%

How easy is it to provide data for appropriate requests?

screening centre

Total NOT ssp ssp

impossible Count 0 2 2

% .0% 2.9% 1.9%

extremely difficult Count 8 10 18

% 20.5% 14.7% 16.8%

difficult Count 12 13 25

% 30.8% 19.1% 23.4%

manageable Count 12 26 38

% 30.8% 38.2% 35.5%

easy Count 4 14 18

% 10.3% 20.6% 16.8%

extremely easy Count 3 3 6

% 7.7% 4.4% 5.6%


% 100.0% 100.0% 100.0%


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7.1 Current BCSS features considered useful by NON SSPs Respondents were asked to list and then rank up to five useful features in the current BCSS, most respondents ranked the features they suggested in a orderly manner, however this was not always the case, one respondent ranked all three suggestions they gave as ‘1’! As elsewhere in this report the responses have been divided into those from SSPs and non SSPs, we will consider the non SSP responses first.

Case Number NOT ssp Current useful feature ranked 1st (most important) code

18 all patients information on same screen 11,24

23 Quality Assurance Reports 5

37 Easy to track patients episodes 11

44 alerts 5

64 QA reports although they need improvement 3

65 Alerts 5

76 Ability to see patient pathway for each subject. 24

81 As an administrator it is useful for me to see the events box and the comments that have been entered by the screening practitioners and staff at the hub.

11,24

106 ease of finding subject 24

138 Alerts when we all receive them! 5

153 Alerts 5

156 It is easy to set up clinic templates and monitor capacity 24

161 It is user friendly system 24

164 It shows you which PCT each Subject is from 11

Ranked first in second slot:

66 Individual letter facility. 9

76 Several ways to find a participant e.g. NHS no, name, dob etc 11

91 Appointments section is excellent 11

Ranked first in third slot:

76 Lots of detail within datasets 11

Ranked first in fourth slot:

65 Appointment screen 11

176 Linkage of incomplete data sets straight to dataset to allow rapid access to these for corrections to be made 24

Ranked first in fifth slot: [no records]

Non ssp - good feature ranked second

33 Efficient in keeping track of patients - no patient seems to have become 'lost in the system' that I am aware of. 11

91 Alerts on home page 5

97 Reporting 5

Second slot

18 easy to navigate 24

44 QA reports 3

64 Ability to link between screens 24

65 Letter production 9

97 Ease of using some reports 5

106 ease of finding subject's episode path 24

138 Last subject search 24

153 Quality assurance reports 5

161 Operational reports 5

Third slot

65 Operational Reports 5

66 Ease of setting availability for SSP clinics. 24

138 Patient Demographics 11

Fourth slot

156 Data set completion report useful 5

Fifth Slot

176 Ability to cut and paste NHS numbers from spreadsheets to BCSS 24

Non SSPs current BCSS features considered useful

Frequency Percent

Reporting (output) issues –positive: Including alerts and QA reports

22 33.3

screen design + navigation (positive) 21 31.8

Data quality (positive) 16 24.2

Letter issues (positive) 3 4.5


Other performance issues (positive) 2 3.0

Total 66 100.0


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Case Number screening centre –NOT ssp Current useful feature ranked third code

66 GP code is available. 11

110 Extraction of information - very useful feature though not utilised enough 5

176 Ability to add in patient contact details 11

Second slot

33 Appointment system is easy to use when booking, cancelling or rearranging appointments. 11

156 The alerts are useful to ensure work is as up to date as possible 5

Third slot

64 patients with abnormal episodes and incompete datasets 5

106 ease of advancing subject's episode 24

161 Useful to have the individual facility 24

Fourth slot

138 Reports but would be better if could be more stats availability 5

Fifth slot

65 Surveillance 11

Case Number Non SSP Current useful feature ranked fourth code

Position 1 [no records]


Position 3

156 Some of the QA reports can identify data input error although individual detail is not then available 5

Position 4

106 ease of completing and saving subject's dataset following preassessment 24

161 Generate letters to GP and patientsOperational reports 9,5


Case Number Non SSP Current useful feature ranked fifth code


89 Availability of help desk 13




Position 5

106 ease of adding preassessment & post investigation slots 11

161 Last subject search 24,5

Case Number NON SSP Current useful feature unranked code

Position 1

4 Back button 24

27 system itself is easy to use 24

58 Improvements made from getting from one screen to next (from last major update) 24

82 being able to access all patients details even if under different screening centre. 24

Position 2

27 friendly helpline staff 13

58 'Patient's with Positive FOBT Results' report useful for seeing number of positives per day (before hub books appointment). 5

82 Alerts. 5

Position 3

82 Incomplete data set section. 11,5




of 84

7.2 Current BCSS features considered useful by SSPs

Respondents were asked to list and then rank up to five useful features in the current BCSS. The table opposite provides a thematic analysis of the combined responses.

Feature considered useful- ranked 1st by SSPs code

8 able to navigate system well, especially when searching for pt`s 24

12 secure system 24

15 Alerts - very useful 5

53 Pre written letters 9

54 Letter printing works well 9

56 Extremely user friendly 24

61 Ability to easily track patients by using patient search function. 24

63 being able to navigate to patient letters whilst being in screening subject instead of having to come out . 24

72 easy to navigate around the system 24

73 good links between pages eg from patient appointment to subject demographics etc 24

87 Alert reminders 5

93 Easy to fill in 24

99 the alert system to ensure nothing is omitted 5

105 most of the alert information 5

109 alerts most of them 5

113 ACCESSIBILTY 24

116 Reminder to set appointment slots 5

120 alerts general and -surveillance due 5

127 ALL THE INFORMATION IS THERE THAT I NEED 11

143 Last subject searched button 5,24

151 easy to use 24

169 straight forward system for easy patients 24

171 Opens quickly 3

174 Initial interview data 11

177 Main menu alerts 5

180 BEING ABLE TO ADD MUTIPLE POLPYS AT ONE TIME 24


15 User friendly 24

28 Contemporaneous, tracks patients from time positive FOBt. Very useful for capacity / demand for colonoscopy / clinics 11

40 Screening subjects telephone numbers 5,11

62 Patients with active episode and incomplete datasets alert 5

92 alerts very good for keeping track of active patients 5

116 Screening subject search works well 5

120 Patients with abnormal FOBt incomplete datasets report to aid weekly trawl through 5,11

137 Patient demograghics 5

174 Colonoscopy data 5,11


120 template letters for individual letters 9

179 Options of finding a screening subject 5


78 Ability to see forthcoming patients in the alerts and then check clinics 5,11

Ranked first in fifth slot [no records]

SSPs current BCSS features considered useful Frequency Percent

Reporting (output) issues –positive: Including alerts and QA reports

41 31.8


Data quality (positive) 25 19.4

Letter issues (positive) 8 6.2

Pathway management (positive) excluding individ.field edits

7 5.4

other + security + management 5 3.9


Other performance issues (positive) 1 .8

Total 129 100.0


of 84

SSP ranked 2nd good feature code

28 Manages patients appropriately if sent on correct pathway 25

40 Episode notes 25

62 QA reports 5

77 last subject search 5

83 can access some information from other screening centres 5

92 easy to use once you are used to the system 24

119 being able to access patient information on bcss when GP or patients request information 5

137 Last subject search 5

149 BEING ABLE TO GO BACK TO CURRENT PATIENT BY CLICKING INTO LAST INDIVIDUAL BOX 24

Second slot

8 alerts helpful 5

53 Viewing FOB kits is useful 5

54 Viewing FOB kits is useful 5

56 Can correct errors 11

73 mail merge letters 9

77 link to data set form subject screen 24

93 Appointment slots- easy communication between the hub and the screening centre 11

99 reports available 5

105 list of incomplete datasets is useful as it highlights what we may have missed 11

127 IT IS EASY TO LOOK BACK AND REVIEW THINGS 24

151 easy to find information and clear. 24

169 Closing episodes 25

171 Good response to changing areas 23

177 Incomplete data set report 11

Third Slot

53 Viewing patients dates for test kit delivery 5

78 Ability to check outstanding datasets 11

113 TRACKING INDIVIDUALS / UNABLE TO LOSE 11,25

143 Telephone display on front screen 24

Fourth Slot

179 Alerts 5

Case Number screening centre ssp Current useful feature ranked 3rd code

36 you can see the sequence of events that the patient has gone through at every step on the pathway 25

78 'Quick log in' saves extra clicks - be nice if this was the default setting! 24

115 Easy to navigate in the menu 24

117 appointment system 11

126 patient information 11

165 being able to set my own clinics (f/u) 11

Position 2

36 if polyps have been removed but not retrieved 11

113 PERMANANT ELECTRONIC RECORD 23

115 For most patient pathways I find the system practical and easy to use. 25

117 alerts 5

143 Links to letters ' more' button 9

165 able to see straight away how full clinic lists are 24

179 New 'clicks' on the back button allowing quicker return to previous page 24

Position 3

40 more... is an easier link to subject letters to be retrieved / printed 24,9

56 Alerts updated very regularly 5

93 blue link system 24

115 Information between local screening centres is easily accessible. 11

127 IT REMINDS US WHEN WE NEED TO DO THINGS 24,5

137 Alerts 5

Position 4

115 Flashing alert to inform you that your session is coming to a close is very useful. 24

Position 5

115 Patient alerts are helpful. 5


of 84

Case Number SSP Current useful feature ranked 4th code

16 'last subject' button 24

24 Appointments 11

111 easy to navigate with training 24

179 Surveillance health check form and reminder 24

Position 2

16 'more' so i can go straight to active batch 24

78 Ability to check timings for patients yet to be called - as the programme rolls-out there's a more widespread knowledge of screening and we frequently get calls asking "when will I get my kit?"

23

111 back up staff helpful 13

Position 3

36 you can go to datasets from clinic appointment screen without going back to main screen 24



Case Number SSP Current useful feature ranked fifth code

Position 1

114 Can directly input all the information straight onto the system at the pre-assessment clinic appointment-saves heaps of time 24,11

Position 2

114 the system updates the patients change of address etc 11

Position 3

114 Designed well for ease of use in advancing a patient episode 24,25


114 The information is accessible to other screening centres making it a smooth transition from one SC to another 11


Case Number SSP Current useful feature unranked code

Position 1

1 Link between nursing assessment to the screening subject summary. 24

9 Individual letters. 9

10 Individual letters 9

14 Having alerts on the main page 5

30 SURVIELLANCE SYSTEM IS EASY TO INSTIGATE 24

57 QA REPORTS ARE BENEFICIAL 5

84 like alerts, so not to miss patients 5

102 Relatively easy to use 24

133 information accessable from many Trusts - able to enter data from clinics. 5,24

183 easy to navigate 24

Position 2

9 Alerts. 5

10 Alerts 5

57 PATIENT QUESTIONNAIRES 11

133 Does not appear to allow patients to "slip through the net" 11

Position 3

77 ability to search with limited patient info 5

111 The hub and open exeter staff are really helpful if you have any problems. 23,13

133 Permanent electronic record. 23,11




of 84

7.3 Negative features of current system As with the positive features of the BCSS respondents were asked to provide a list of up to five negative features of the current BCSS. They were also asked to rank them in importance from 1 to five, 1 being the most important.

Case Number

Negative feature of current system- ranked 1st by NON- SSPs code

5 No alerts when patient's appointments are changed 4

7 Reports, QA Reports 4

18 unable to obtain up to date reports correctly 4

23 Navigation 6

27 reporting system does not meet our requirements. It is 'bitty' and we depend a lot on getting information in a better format from national office or the hub

4

33 Having to keep separate records (spreadsheets) is a necessity for quality assurance as information is not always accurate from reports downloaded on BCSS.

4,10

37 Difficult to access data 4

44 can't have more than one screen open at a time 24

64 You can select area's within your hospital that are not linked to bowel screening - which can lead to incorrect information being submitted. 10

65 Cannot extract data on cancer patients, i.e Nos, tumour site, staging etc. 4

76 Reports - available dates not in real time 4

80 During particular times of the day it runs extremely slow at updating and refreshing information. 1

81 The number of participants with polyps is recorded as a percentage. I am always being asked for a breakdown of polyps i.e. high, medium or low risk and this cannot easily be done on the system.

4

106 screen often freezes with the command 'back' 2

138 Things not stored alphabetically in datasets 6

140 data extraction should be easier 4

161 There is no GP Fax number 10

162 unable to pull records for post codes - for uptake purposes 4

164 Logs off every 30min even if using the system 6

176 PID not on screen at all times 6


18 reports are difficult to obtain 4

19 XML batch downloads - almost impossible to interpret the data. Needs to be transferred onto another database and is very time consuming. 4

33 Datasets - should be compulsory fields and no blanks if possible. This is a big problem when trying to analyse data from downloads. 10

65 No Cancer waiting times report 4

66 Administrator doesn't get access to the letter library? 23

76 Reports - ability to manipulate data to provide information to several different sources (as above) 4

97 Can't just go back one or two screens screens in reports section 6

current negative features non ssp Frequency Valid

Percent


33 36.3


Data quality (negative) excluding cancer datasets and dummy datasets but including: add new fields + clarify data

19 20.9


5 5.5


Training excluding: Difficulty entering cancer datasets + dummy/training datasets

2 2.2


Other performance issues (negative) 1 1.1



Duplicate data entry excluding Spreadsheets 1 1.1

Patient Minority Group (PMG) Issues 1 1.1



Total 91 100.0

current negative features ssp Frequency Valid

Percent


Data quality (negative) excluding cancer datasets and dummy datasets but including:

add new fields + clarify data 58 26.4


32 14.5


18 8.2





5 2.3



Help desk (negative) 2 .9

Duplicate data entry excluding Spreadsheets 2 .9

Patient Minority Group (PMG) Issues 2 .9

Pathway management (positive) excluding individ.field edits

2 .9

Help desk (positive) 1 .5

Desire for dummy/training datasets 1 .5

screen design + navigation (positive) 1 .5

Total 220 100.0


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138 Alerts lost as soon as opened by one person and lost totally if further report sent 4

153 Back button 6

156 inability to query system for site specific information - current reports do not provide the information I need 4


138 Obvious things not first on the drop down menus in datasets 6


76 Estimates of subjects to be invited not being accurate and can be higher or lower than the estimate on the report - not helpful when demand & capacity planning.

10

138 Things missing from datasets 10

Ranked first in fifth slot:

76 Patient Questionnaires have to be manually evaluated even though all responses are entered into the dataset. Needs to be a report based on these completed datasets that Programme Managers can produce. Very time consuming to manually evaluate these to ascertain patient satisfaction & develop action plans based on patient feedback.

10,4

148 set up support inadequate, poor coding. 14,10

Case Number

Negative feature of current system- ranked 1st by SSPs code

2 Unable to access the information on the system for audit 4

8 can be time consuming 6

12 inability to record patient-relevant info that is not (currently) BCS relevant 10

14 Re investigation dataset: Unable to put if a patient has been admitted as a precaution. 10

15 Extremely difficult to extract specific data from the BCSS 4

42 Return calls from Exeter help desk often several hours later than call logged therefor often unable to take the call as in clinic or list with patients making it difficult to move patients through system efficiently.

12

50 Unable to retrieve data for audit purpose, have to keep additional excel spreadsheet in order to conduct internal audit/research. 4

53 Screens very complicated and long when delivering results to patients i.e The post investigation dataset, contact with patient screen(not always relevant if NAD found at colonoscopy) so you have to fabricate to pass. There appears to be no natural progression through the screens.

6

56 Pathways do not allow for individual circumstances or drs preferences 7

57 SHOULD NOT GENERATE A DATASET IF THE PATIENT DOES NOT ATTEND THE SSP CLINIC. 6

61 Lack of letters to patients explaining plan of care e.g. when patients refuse colonoscopy. 8

62 Episode notes are editable 6

63 having to ring helpdesk when using interupts even if you could deal with the problem quickly and simply yourself 7

72 wished that we would be able to be logged in for a longer period, without a time out period 6

73 difficulty in getting relevant reports, ie colonoscopy details for individual colonoscopists 4

78 Not able to specify smoking type - eg tobacco/pipe/cigar/roll-up 10

79 Cancer Datasets asks for too much information 15

83 too fix 24,7

87 cannot access data for statistics, eg number of cancers, polyps etc. 4

88 An option to await histology from surgery if colonoscopy biopsies do not confirm suspicion of cancer seen at colonoscopy 6

92 having to back track pages all the time should be able to go forward from the page you are on not go back all the time i.e contact with patient re appointment you have to go back to then advance !

6

93 It takes longer to log on to some data from the main menu 6

99 time taken to refresh the pages 1

113 UNABLE TO EXTRACT DATA / AUDIT 4

117 illogical listings 6

119 Having to manually type and produce letters 8

126 very black and white patients are not like this! 7

127 IT IS TOO SLOW AND IT GETS FRUSTRATING 1

137 Lists not in alphabetical order 6

142 can't change test results or alter surveillance time 10

145 TOO SLOW AT TIMES 1

150 difficult to undo mistakes 10

151 entering cancer data set can be very confusing 6

169 I find it difficult to change patient's pathways 25

171 silent log off 6

177 unable to log additional patient contact except in episode notes. You only get access to patient contact page at specific intervals in the patient pathway.

10,25

179 Coming out of a subjects data to print letter. 6

180 IF MUTIPLE POLYPS HAVE TO GO TO TOP OF PAGE TO PRESS ADD POLYP BUTTON RATHER THAN ANOTHER BUTTON AT BOTTOM BEING AVAILBLE TO ADD THEM

6


2 Having to keep our own spreadsheets to be able to access information 4

28 Unpicking mistakes 10,23

39 not being able to correct input of data if wrong. Not easy to do and takes forever. 10


of 84

47 Could there be a spell-checker installed please? 10

54 Screens very complicated and long when delivering results to patients i.e The post investigation dataset, contact with patient screen(not always relevant if NAD found at colonoscopy) so you have to fabricate to pass. There appears to be no natural progression through the screens.

7,6

61 System closes patient after certain amount of inactive time even if the SSPs have a plan for the patient. 7

70 The cancer audit data set is too complicated. 15

84 have difficulty completing the cancer dataset 15

105 Cannot always interupt or correct episode myself, have to get admin manager to do it or go through help desk 7

109 Investigation dataset when adding polyps if you are adding alot you have to keep going back to the top of the screen to add another polyp, this can be very time consuming if you have numerous polyps

6

119 When filling in datasets bcss often throws you out of system which means having to refill data set and this can take up to half hour for each one so this doubles workload.

6

120 cancer waits reports dates not being accurate- reported 10

149 FUNCTIONS ARE AVAILABLE ON THE SYSTEM, AND THEN WE LEARN WE SHOULDNT BE USING THEM! EG. UNDER ALTERNATIVE SURVEILLANCE FUNCTION...IF PATIENT HAS COLITIS AND WE HAVE REFFERED TO ANOTHER CONSULTANT FOR ON GOING CARE

7


2 having to duplicate information very time consuming 17

17 Communication barriers not identified prior to nurse positive clinic 18

78 Patients added to clinics and then opting out not always apparent - if you hadn't happened to see them added to clinic, you might not see them 6

84 would like more time, stop logging out when working on datasets 6

114 When there are changes to the system we are not always informed and it is only when we contact Open Exeter that we become aware of these 19

115 Not always informed of changes and how to adequately use new pathways. 19

117 lack of direction 19

143 Drop down choice box for yes / no / not known 6


1 Some of the letters are still worded inappropriately for patients even though they have been authorised by the "letter workshop" patients are still commenting on the wording of the +ve Fobt letter giving abnormal results.

8

2 not everyone keeps the same information nationally 10

9 Unable to record all contact with pt, has to be put in episode notes. 10

10 Unable to record each patient contact have to write all in episode notes 10

40 no dummy data sets to trial, learning on a live system is quite stressful and time consuming as mistakes take a long time to rectify 16

84 events, should not be able to delete someone else's entry 6

Ranked first in fifth slot [no records]

Case Number

Negative feature of current system- ranked 2nd by NON- SSPs code

58 Not easy to Obtain specific data on activity /diagnosis etc (by PCT etc) . Also, usually info on BCSS is a bit behind actual work done (which is probably unavoidable).

4

66 Can't open more than one page at a time. 6

97 Not able to report on all data items 4

156 inability to access basic information - number of DNAs, performance at PCT level 4

Ranked second in second slot:

5 The alert for new FOBt are not visible to anyone once one person at the Screening Centre has clicked on the alert. It should be visible for each of us until we have clicked on it ourselves (at least!)

4,6

37 Datasets need mandatory fields 6

44 screen doesn't scroll up as data is entered 6

64 Elapsed time between decision to procedd with colonoscopy and first offered colonoscopy - this report would be of more use if it was of the same format as the cancer waits report and as named patients whose first offered colonoscopy is booked more than 14 days in advance. This would enable you to check these patients on an individual basis.

6,4

81 You can print off a report of how many participants each screening nurse as seen, but the figures are incorrect because they include all the participants that DNA'd on their first appointment and so their name is shown twice. You also have to count the names up manually instead of a figure being given.

10,4

106 no Cantonese, Mandarin or other Chinese language listed as language option despite having reported this lack in Jan 2009, was given the change request 469

18

161 Any person can change the supporting notes even though it has been saved 6

164 If you make a mistake on a pathway you cant correct it without speaking to CFH 7

176 Information in fields changing when you scroll with the mouse 6

Ranked second in third slot:

19 It is not very easy to rectify errors and needs the help of CFH helpline 7

148 Certain individuals unhelpful on the help desk, would help if they had a clinical back ground. 12

Ranked second in fourth slot:

58 Can't identify any errors on QA reports etc unless go through connecting for health. Would be useful if there was a way to get the NHS numbers of any entries which need checking.

4,10

Ranked second in fifth slot: [no records]


of 84

Case Number

Negative feature of current system- ranked 2ndt by SSPs code

9 Need sub-pedunculated option in polyp type. 10

10 Need sub pedunculated on polyps 10

28 Anonymised data downloads 4

39 amount of times password needs changing 23

70 There is nowhere to record biopsies taken during colonoscopy or the histology result. 10

84 unsure sometimes on ceasing of patients 14

105 the list of duplicate diagnoses test. It is no use as the patients on the list are normally corrections or have had 2 tests, so we wouldn't change them. 10

109 Patients details at the top of the screen disappear when you move the screen down, this could lead to error 6

115 Collecting data is difficult, few options and often not exactly what the Dr's are looking for. 4

116 Alerts that say a first appointment is more than 14 days from positive FOB when it is patient choice - annoying to waste time checking when the first offered appointment was within time scales

4

120 Dataset complete field on Investigation dataset in the top third of datafields rather than being at the bottom -reported 6

174 Cancer audit data 15

Ranked second in second slot:

8 can get complicated when pt`s have complicated histories that do not neccersarly follow the usual path 7

12 clunky, often counter-intuitive layout. 6

14 No reports available from the questionaire datasets 4

15 BCSS is extremely rigid and not all patient pathways are straight forward 6,7

17 Unable to record CT with faecal - tagging 10

36 can't record if patient smokes anything other than cigarettes and must specify date and not just year they stopped 10

42 Terminology often ambiguous therefore not sure what you are asking/requiring in some of the fields. 10

50 Alerts for positive FOB's do not always appear on my screen. 6

53 The logging out system is too quick, I have to constantly log back in and often lose entered data. 6

56 Notes made on individual patients are often not chronological and could be changed by other users 6,10

62 Patients with possible duplicate datasets alert(mildly irritating rather than actual problem) 4

73 intermittent slowness 1

77 dataset infomation required can be dificult to interpret 10

88 Option to check EMR site at a year instead of max time allowed of 6 months 10

93 scrolling up and down to 'add polyp' button 6

99 non linear sequence to data sets and patient journey 6

114 Not able to obtain the information that PCT's require from the system this results in hours of time on a spreadsheet entering data 4

117 cumbersome subject search 4

127 IT IS TOO BASED AROUND LETTERS 8

137 Obvious /common entries not top of list in data sets 6

143 Using a colon between time ie 10:20 6

150 difficult to pull reports 4

151 drop down menus do not have information you think should be there. 6

169 I find it difficult to write patient letters 6

171 Not being able to keep screen open when looking up results or other pages 6

177 laparoscopic options for surgery are unavailable 10

179 No alert for changes in nurse appts. 4

Ranked second in third slot:

1 We are unable to enter faecal tagging CT as an alternative investigation. 10

12 system not tailored to user's role (eg distracting, irrelevant alerts, and vital info buried too deep. 6

40 not able to identify true date of colonscopy prior to investigation taking place 10

54 The logging out system is too quick, I have to constantly log back in and often lose entered data. 6

61 Sometimes the system seem open to different interpretations, thus leading to errors. 10

113 HAVING DUPLICATE DATA 17

120 date patient completed QA questionnaire field is not printed on QA questionnaire.Therefore we have to add sticker on form to ensure we add sticker asking patient to put date QA completed to ensure data accuracy -reported

10

Ranked second in fourth slot:

61 Information needed for cancer audit datasets can be difficult to obtain and confusing. 4

92 not enough space allocated for the events box we use as a careplan 10,6

114 There is no section in input the patients medications that they are currently taking on the system therefore this needs to be kept in written form in the patients notes

10

120 An on screen function on Logging In would be useful when updates had occurred briefly summarizing what has been changed 19

Ranked second in fifth slot: [no records]


of 84

Case Number

Negative feature of current system- ranked 3rd by SSPs code

17 Unable to record biopsy taking and results 10

24 Very restrictive 6,7

46 Colonoscopy classed as a fail when the aim of procedure was to go as far as the likes of transverse colon. This obviously cannot be marked as a flexi sig.

10

47 Could all lists be alphabetical please? i.e. lists of drugs, lists of other diagnosis. They are long lists to scroll through. 6

54 When completing MDT screen for patients on our second site, we are unable to select local MDT team/site (actually we can select from drop down but when letter prints it reverts to our main site which confuses GP's) (already contacted support about this).

6,10

77 duplication of episode notes, limited space 6,10

114 Cancer dataset is lengthy and it is time consuming in obtaining this info from other hospitals when a patient goes elsewhere for treatment 15

136 The drop down boxes on the assessment dataset should be set as 'no' and not 'not known.' This would save so much time in completing them. 10

143 Not able to record telephone calls unless post investigation 10

149 WHEN PROGRESSING A PATIENT, YOU HAVE TO COME OUT OF THE PATIENT, AND GO INTO LETTER BATCH TO PRODUCE THEIR LETTER 6

Ranked third in second slot:

1 Cancer audit data set is comprehensive, but as SSP's we spend ages chasing all the information required to fill it in. Sometimes we are unable to access the information needed to complete it.

15

10 Need cold biopsy for polypectomy 10

78 No record of Caecal Intubation time - system requires start, finish and extubation time, but if the 'reached extent' was timed it woudl allow automatic calculation of the extubation time

10

83 cannot change if accidentally made an error 10

92 no alerts for cancer patients re dataset completed could do with an alert to remind us it is still open ? 4

113 EXPERIENTIAL LEARNING - NO REFERENCE POINT 14

115 Cancer dataset is lengthy and time consuming. Many hospitals do not use the same format as ours for their surgery patients. 15

116 The time out is set at 30 minutes - 45 minutes would be useful as that gives the right time for most appointments and procedures. 6

Ranked third in third slot:

9 No option for sending GP/specialists letters when using individual letters. 8

14 Can be very slow - possibly our IT at fault? 1

42 Alerts - often not useful those that are shown i.e. duplicate investigation when patient has had a colonoscopy followed by BE on the same day as this is what is supposed to happen if at all possible.

4

56 Individual letter writing can be difficult 8

99 cancer data set not clear 10,15

127 IT IS TOO DIFFICULT TO CORRECT SOMETHING IF YOU DO SOMETHING WRONG 6,10

150 does not allow for variation in pathway 7

169 Had patient where we found the cancer was an ovarian primary. Was not sure what to put 14

171 letters are confusing, thankfully our admin. person does this. 8

179 No alert for late cancellations 4

Ranked third in fourth slot:

Case Number

Negative feature of current system- ranked 3th by NON- SSPs In first slot code

19 Batch downloads; format of information provided not very good 4

110 Extraction of information - not utilised enough as can be tricky to undertake 4

153 Time out feature needs to be extended 6

Ranked 3rd in second slot – no records

Ranked 3rd in third slot:

44 screen collapses if data is deleted 6

64 Strategic reports - not very useful at all and many users dont understand them 4

76 Entry of episodes listed as date on which dataset completed & not necessarily date episode took place. 10

156 Navigation between parts of the system is not possible - multi screens are needed 6

161 Cancer audit 15

Ranked 3rd in fourth slot:

66 Patient waiting more than 14 days for a clinic appointment shows up on 'Alerts' even when the patient has rescheduled. 6

148 Audit data not up to date, eg: showing that this centre has carried out less procedures than what has actually been performed, when investigated discovered that another centre had been capturing our figures.

4,10

176 Alert re SSP appointment out of time relates to actual date not first offered date 10

Ranked 3rd in fifth slot:

58 'Patient's with Positive FOBT Results' report is not updated to delete those patient's who don't have cancer. Therefore this report is completely useless for this purpose.

4


of 84

12 it is impossible to supply histological info in the manner requested, as reports do not match the BCS criteria. Few SSPs (if any?) have the education and skills to safely interpret the data to render it BCS-friendly. Arguably, if this info is so viatl for audit, the BCS needs to have it entered by the histology departments, not SSPs

10

24 All letters merge onto one section 8

70 No place for free text on the individual data sets. 10

137 Some diagnoses not on data sets 10

Ranked third in fifth slot:

40 difficulty understanding and accessing of reports 4

78 Some of the colouring is 'pretty' but causes problems, especially in a darkened procedure room. the contrast between blocks isn't quite 'black & white'!

6

114 There is no HUB to HUB patient information eg a patient that wants to be seen at a SC outside the HUB in which the local SC that the patient belongs to

13

115 Change requests placed to have medications added to the colonoscopy dataset have never been updated and patients datasets are not being closed as we are waiting for this information.

10,19

Case Number

Negative feature of current system- ranked 4th by NON- SSPs code

In first slot – [no records]

Ranked fourth in second slot:

148 Histology reporting requirements not in a format that is familiar with the SSP therefore they have difficulty in inputting the data very time consuming. It should be mandatory that pathology input the data.

6

Ranked fourth in third slot:

58 Some datasets are inappropriate ie surveillance questionnaires and 30 day Response to surveillance patients. 10

66 Questionnaire is the same for surveillance patients. 10

164 Can be slow at times 1

Ranked fourth in fourth slot:

156 Drilling down individual patient episode is cumbersome 6

161 System is not very flexible when it is not a straight forward treatment. 7

Ranked fourth in fifth slot:

176 Cancer data sets not easy to use for patients who have chemo/rad prior to surgery 10,15

Case Number

Negative feature of current system- ranked 4th by SSPs code

1 The episode notes only allow up to 4000 characters. 10

36 can't record if biopsies are taken where IBD is suspected 10,7

Ranked fourth in second slot:

9 Need cold biopsy option for polypectomy. 10

24 Only BCSS users can access the information 23

40 inability to correct some mistakes without having to go to open Exeter help desk 7

46 Cannot alter surveillance from 3yr to 1yr if not high risk. This is often requested by consultant after performing EMR. 10

104 Unable to get out any data from feed back forms that we spend so long inputting to get nothing back is disapointing 4

Ranked fourth in third slot:

10 Individual letters does not do copy for GP or enable us to write to GP/specialist 8

36 when patient booked for flexi to inspect previous polypectomy site dataset asks reason for failure when this was the procedure they were booked for and not a failed colonoscopy

6,7

92 maybe an alert for your own case load still have alert for all the active patients but an alert for your own would be very useful to keep track easier 4

137 Can`t change patients pi appt. 4

Ranked fourth in fourth slot:

14 Would like to be able to type more in the comments box sometimes for patient contact. 10

42 It would be helpful if you had alerts that showed incomplete data sets due to look up not being completed or changing the format so that look ups appear as a box to be completed as they are easily missed

4

54 The most important reports are unavailable. The screening Centre wants to see numbers of High, Intermediate, Low risk patients. This appears to be unavailable.

4

99 Unable to get QA information out of the system. other than that provided 4

115 Unable to record all patients medical history i.e no room for medication 10

127 IT SOMETIMES LOGS YOU OFF WITHOUT WARNING AND DOES NOT SAVE ANY OF YOUR WORK 6

171 Cancer data set lengthy 15

Ranked fourth in fifth slot: [no records]


of 84

Case Number

Negative feature of current system- ranked 5th by NON- SSPs code

148 Training was not balanced for the group weighted heavily on the admin side & not clinical. There should be separate training for Admin, clinical, path.

14

Ranked fifth in second slot:

58 Doesn't record histology turnaround (which is a target) 10

Ranked fifth in third slot:

153 Fixed nature of patient pathways 7

176 Inability to link with other systems for recording MDT and cancer data sets 17

Ranked fifth in fourth slot – no records

Ranked fifth in fifth slot:

156 When searching for patients it would be useful if there could be a feature to limit the search to those patients registered within the PCT catchment area

4

161 Unable to remove patients from alert system 10

Case Number

Negative feature of current system- ranked 5th by SSPs code

40 having to scroll back to top of page in investigation data set to add polyps becomes tedious after the 10th polyp! 6

104 as a nurse i can not get out endoscopic data re consultants. I.e. there performance when they are me for it 4

Ranked fifth in second slot – no records

Ranked fifth in third slot:

24 Episode notes are not secure 10,23

53 I find the patient's episode disjointed and unclear. I feel that the episode log should be on their front screen, it is never very easy to see exactly what has happened to the patient and when.

6

Ranked fifth in fourth slot

36 can't have more than one dataset open as a window at any one time 6

78 Patients who have 'ceased' from screening because of a cancer diagnosis still have datasets that require information - could that information be placed into BCSS by the pathologists/radioraphers/oncologists?

10

Ranked fifth in fifth slot:

42 If you put a note on the system patient away not back until ... hub ignore message and book patient into a clinic that they cannot attened 7

54 I find the patient's episode disjointed and unclear. I feel that the episode log should be on their front screen, it is never very easy to see exactly what has happened to the patient and when.

6

137 Could was scope inserted be on a default-as very rarely no 6

Case Number

Negative feature of current system- unranked t by NON- SSPs code

4 sometimes slow 1

82 Too fixed. Not able to undo problems very easily 7

100 To hard to get down loads 4

Unranked in second slot:

27 More flexibility in terms of free text to be able to explain an outcome more specifically 10

82 Not very easy to pull information out of system, ? if it is correct. 4

Unranked in third slot: [no records]

Unranked in fourth slot: [no records]

Unranked in fifth slot:

138 Letters sometimes inappropriately worded i.e. not personal enough and ability to amend is just too cumbersome 8


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Case Number

Negative feature of current system- unranked by SSPs code

30 THE QUESTIONAIRES ARE POOR AND THE SOFTWARE BRINGS UP THE FULL ASSESSMENT DATASET (NO ONE KNOWS HOW MUCH TO FILL IN WE JUST GUESS)

14,15

60 Poor linkage between some screens 6

85 Lack of ability to retrieve information put into BCSS such as number of adenomas found in a certain period 4

102 patient pathway is so fixed-there is no deviation from it (even though occasionally it doesn't make sense. 7

111 It takes time to thoroughly understand and remember all aspects of the BCSS database. I believe the training does not instill much confidence. I learnt by navigating myself and then printing a step by step instruction until I now know it off by heart.

14

133 Could do with a recent subject list 6

183 always freezes 1

Unranked in second slot:

30 INVESTIGATION DATASET HAS NOWHERE TO INPUT BIOPSIES TAKEN FROM ANYTHING OTHER THAN A POLYP 10

60 Inappropriate responsibility for closing episodes 7

133 Logs out too soon 6

183 short notice for logging off 6

Unranked in third slot:

15 Word restriction on episode notes, especially if we are trying to become a paper less process. 10

60 Unable to add GP details to main screen - letters addressed to practice 10,18

77 drop down menus in data sets do not cover everything 6

109 alert for possible duplicate tests- if patients have had incomplete colon and then have further tests this comes up as an alert, but this is obviously not a duplicate as the 1st test was incomplete. Unable to remove this alert

4

133 Too many patient contact pages when referring patients for further tests 6

183 no space for additional info @ investigation dataset 10

Unranked in fourth slot:

15 No spell check on episode notes 10

77 inability to extract usefull data easily 4

133 If you write an individual patient letter and confirm it as printed you cannot print another letter 6

183 need to contact helpdesk first before someone from BCSS would contact 12

Unranked in fifth slot:

120 Not able to drill down on reports to individual NHS numbers should a report show a variance to expected range 4

133 The cancer dataset takes forever to complete we have patients who we saw 2 years ago with an incomplete dataset. 15

183 info typed in lost once log in session expired 6

7.4 Additional information After the above question respondents were offered the opportunity to provide any additional information they felt would be useful, concerning the previous questions.

Case Number NOT ssp

58 BCSS is very good for following an individual patient through the screening pathway etc but needs improvement on gathering retrospective information such as activity, and identifying possible errors etc. In particular, if there is a duplicate entry on QA reports (or just a query) it is impossible to look into yourself and the helpdesk need to be contacted.

80 Rather than being alerted that a patient has had a positive FOB, i feel it will be beneficial (for screening clerks especially) to be able to have an alert of when their SSP clinic is going to be in a similar fashion to the alert of the positive FOB is returned. I am finding it takes up a lot of time then searching for the patients clinic date, especially when the system can run very slow.

106 it has sometimes been the case that a subject has requested an interpreter via the Hub but this information has not been passed on to us (the Screening Centre) and as there are many Chinese speaking subjects in our area it would have been helpful if the Hub had been able to annotate the subject's demographics with the required language

138 Is there a way to bring up a full summary of the complete patient dataset once everything completed??? Could scope inserted be on a default rather than typing in each time???

148 The trainers were excellent my above comment is not a reflection on them, however it was not curtailed to the mix of the delegates, very 'top heavy'


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SSP

12 At every 'advance' menu, there should be a 'record event or patient contact' option, allowing us to enter info that is timed, dated, printable and permanent, and is then labelled and appears in chronological order in the episode list - this can be ignored by BCS, but provides a complete record for health care professionals, avoiding the need for cumbersome, largely avoidable paper records

35 we have problems getting hold of providers GMC codes for pathology, radiology and surgeons at other hospital and our own! which means some cancer datasets are incomplete awaiting codes - which means these have to be re-visited.

40 Dummy data sets and learning scenarios please 61 Training could be useful on pathology/ radiological data required for the cancer audit dataset.

78 Although there is the facility to request a change, sometimes it seems that the difficulty it causes isn't seen as a priority? Eg smokers.

93 It becomes rather tedious when we have to keep scrolling back to the top to add polyps and sometimes there are lots of therapeutic events to add on to one polyp.

117 databases not logical or clear cut

120

Minutes of IT user group SSP QA and data and Admin QA and National Evaluation Group should be available on BCSP website to ensure cascade of information to all BCSP staff,who would have a personal responsibility to regularly look at this information to keep updated as well as hopefully getting feedback from their local representatives at these meetings. When inputting a post procedure complication could there be an alert to remind the SSP to fill in and submit Adverse incident form.

133 The cancer dataset to too comprhensive - most of the fields are not applicable but there is not an N/A button 137 Letters could also be worded better. 171 Not sure of how or when to advance cancer detected participants no training was provided for this scenario


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8. BCSS Support/Training

Respondents were asked to rate six aspects of support provided for the BCSS.

initial training

screening centre

Total NOT ssp ssp

none given Count 0 0 0

% .0% .0% .0%

very poor Count 0 3 3

% .0% 2.6% 1.7%

poor Count 6 17 23

% 9.0% 14.9% 12.7%


% 32.8% 50.0% 43.6%

good Count 28 26 54

% 41.8% 22.8% 29.8%


% 16.4% 9.6% 12.2%


% 100.0% 100.0% 100.0%

ongoing training

screening centre

Total NOT ssp ssp


% 49.3% 40.4% 43.6%


% 1.5% 7.0% 5.0%

poor Count 14 18 32

% 20.9% 15.8% 17.7%


% 19.4% 23.7% 22.1%

good Count 6 11 17

% 9.0% 9.6% 9.4%


% .0% 3.5% 2.2%


% 100.0% 100.0% 100.0%

user groups

screening centre

Total NOT ssp ssp


% 44.6% 54.1% 50.6%


% 1.5% 3.6% 2.8%

poor Count 5 10 15

% 7.7% 9.0% 8.5%


% 27.7% 18.0% 21.6%

good Count 11 12 23

% 16.9% 10.8% 13.1%


% 1.5% 4.5% 3.4%


% 100.0% 100.0% 100.0%

CFH help desk

screening centre - nurse

Total NOT ssp ssp


% 7.6% 1.8% 3.9%


% .0% .9% .6%

poor Count 2 3 5

% 3.0% 2.6% 2.8%


% 22.7% 22.8% 22.8%

good Count 34 51 85

% 51.5% 44.7% 47.2%


% 15.2% 27.2% 22.8%


% 100.0% 100.0% 100.0%


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documentation

screening centre

Total NOT ssp ssp


% 13.8% 6.3% 9.1%


% 1.5% 2.7% 2.3%

poor Count 6 16 22

% 9.2% 14.4% 12.5%


% 38.5% 48.6% 44.9%

good Count 24 24 48

% 36.9% 21.6% 27.3%


% .0% 6.3% 4.0%


% 100.0% 100.0% 100.0%

BCSP web site

screening centre

Total NOT ssp ssp


% 11.9% 2.6% 6.1%

very poor Count 0 2 2 % .0% 1.8% 1.1%

poor Count 8 12 20 % 11.9% 10.5% 11.0%

adequate Count 23 50 73 % 34.3% 43.9% 40.3%

good Count 28 39 67 % 41.8% 34.2% 37.0%

excellent Count 0 8 8 % .0% 7.0% 4.4%


% 100.0% 100.0% 100.0%

The above provides some interesting results. Just over two thirds of respondents considered the help line to be good or excellent (n=180) in contrast just under a third only placed the BCSS documentation in the same categories. Approximately half of screening centre staff have not have any ongoing training or involvement in user groups.

There was a significant difference in responses between adequacy of initial training between non ssp and ssp respondents (n= Mann-Whitney U=2788.5, 2-tailed p=0.001), SSPs providing a median score of adequate compared to non SSPs of good. However this may partly be due to outliers, see the boxplot below.

Initial training Statistic Std. Error

Mean non SSP: 4.66 .105



Variance .744 Std. Deviation .863

Minimum 3 Maximum 6

Range 3 Interquartile Range 1

Skewness -.139 .293 Kurtosis -.578 .578

Mean SSP: 4.22 .085



Variance .828 Std. Deviation .910

Minimum 2 Maximum 6


Skewness .123 .226 Kurtosis .063 .449


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9. Knowledge

Respondents were asked about their current computer knowledge/skills, both general and those related to their current role, and also their desire for both general and BCSS specific training.

Rate own computer knowledge/skills

screening centre

Total NOT ssp ssp

non-existent Count 0 0 0

% .0% .0% .0%

beginner Count 0 7 7

% .0% 6.0% 3.8%

intermediate Count 31 74 105

% 46.3% 63.8% 57.4%

advanced Count 29 32 61

% 43.3% 27.6% 33.3%

professional Count 7 3 10

% 10.4% 2.6% 5.5%


% 100.0% 100.0% 100.0%

current role computer knowledge/skills

screening centre

Total NOT ssp ssp

very inadequate

Count 2 0 2 % 3.0% .0% 1.1%


adequate Count 43 83 126 % 65.2% 71.6% 69.2%

above that required

Count 20 28 48 % 30.3% 24.1% 26.4%


% 100.0% 100.0% 100.0%

additional training outside of BCSS

screening centre

Total NOT ssp ssp

yes Count 17 42 59

% 26.2% 36.2% 32.6%

no Count 48 74 122 % 73.8% 63.8% 67.4%


% 100.0% 100.0% 100.0%

additional training for BCSS

screening centre

Total NOT ssp ssp

yes

Count 22 57 79 % 32.8% 50.0% 43.6%

no Count 45 57 102

% 67.2% 50.0% 56.4%


% 100.0% 100.0% 100.0%


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10. Documentation

In addition to the general adequacy of the BCSS documentation, mentioned in the previous section, those who had access to it (around three quarters of respondents) were asked in depth questions. The most frequent category selected was ‘useful’ for the majority of questions. Interestingly the most common SSP response was ‘little use’ concerning the use of the documentation as a how to do it guide.

Two questions concerning the language and format/layout of the documentation indicated that most respondents found these aspects ‘manageable’, whereas non SSP responses for the language of the documentation indicated a significant difference from non SSPs (n=148, M.W.U=1851, 2-tailed p=.012) considering it clear.

Approximately one fifth of respondents indicated that they had produced additional local BCSS documentation to help with the use of BCSS.

access to the BCSS user guide

screening centre

Total NOT ssp ssp

yes

Count 49 98 147 % 74.2% 86.0% 81.7%

no Count 17 16 33

% 25.8% 14.0% 18.3%


% 100.0% 100.0% 100.0%

documentation as a intro. to BCSS

screening centre

Total NOT ssp ssp

not appro. in role

Count 1 1 2 % 2.1% 1.0% 1.3%

not at all Count 0 3 3 % .0% 3.0% 2.0%

little use Count 9 33 42 % 18.8% 32.7% 28.2%

useful Count 37 59 96 % 77.1% 58.4% 64.4%

extremely useful

Count 1 5 6 % 2.1% 5.0% 4.0%


% 100.0% 100.0% 100.0%

documentation as a definitive ref.

screening centre

Total NOT ssp ssp

not appro. in role

Count 1 1 2 % 2.1% 1.0% 1.4%

not at all Count 2 1 3

% 4.2% 1.0% 2.1%

little use Count 17 45 62

% 35.4% 46.4% 42.8%

useful Count 28 46 74

% 58.3% 47.4% 51.0% extremely

useful Count 0 4 4

% .0% 4.1% 2.8%


% 100.0% 100.0% 100.0%

documentation as a 'how to do it'

screening centre

Total NOT ssp ssp

not appro. in role

Count 0 0 0 % .0% .0% .0%

not at all Count 3 7 10

% 6.4% 7.1% 6.9%


% 31.9% 44.9% 40.7%


% 61.7% 44.9% 50.3% extremely

useful Count 0 3 3

% .0% 3.1% 2.1%


% 100.0% 100.0% 100.0%


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documentation as a guide for additional help

screening centre

Total NOT ssp ssp

not appro. in role

Count 1 0 1 % 2.1% .0% .7%

not at all Count 2 4 6 % 4.3% 4.1% 4.2%

little use Count 16 32 48 % 34.0% 33.0% 33.3%

useful Count 28 58 86 % 59.6% 59.8% 59.7%

extremely useful Count 0 3 3 % .0% 3.1% 2.1%


% 100.0% 100.0% 100.0%

How did you find the language of documentation?

screening centre

Total NOT ssp ssp

incomprehensible Count 0 0 0

% .0% .0% .0%

extremely difficult Count 1 2 3 % 2.1% 2.0% 2.0%

difficult Count 2 10 12 % 4.2% 10.0% 8.1%

manageable Count 21 61 82 % 43.8% 61.0% 55.4%

clear Count 23 23 46 % 47.9% 23.0% 31.1%

excellent Count 1 4 5 % 2.1% 4.0% 3.4%


% 100.0% 100.0% 100.0%

How did you find the format/layout of documentation?

screening centre

Total NOT ssp ssp

incomprehensible Count 0 0 0

% .0% .0% .0%

extremely difficult Count 2 3 5 % 4.3% 3.0% 3.4%

difficult Count 4 19 23 % 8.5% 19.0% 15.6%

manageable Count 24 55 79 % 51.1% 55.0% 53.7%

clear Count 17 19 36 % 36.2% 19.0% 24.5%

excellent Count 0 4 4 % .0% 4.0% 2.7%


% 100.0% 100.0% 100.0%

Local documentation?

screening centre

Total NOT ssp ssp

yes Count 11 22 33

% 17.5% 19.6% 18.9%

no Count 52 90 142 % 82.5% 80.4% 81.1%


% 100.0% 100.0% 100.0%


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11. Ongoing Support for the BCSS

Respondents were asked a series of questions concerning ongoing support for the BCSS. A validity question was included at the start (no respondents should have paid for BCSS training) indicating that the responses were valid.

The questions focused on the CFH help desk, interestingly more SSP’s have used it (97% approximately) compared to non SSPs (85% approximately). Over two thirds of respondents who had used the facility rated it overall as good/excellent a similar percentage rated similarly specific aspects such as returning the call and resolution of problem.

have you paid for training

screening centre

Total NOT ssp ssp

yes Count 1 0 1

% 1.5% .0% .5%

no Count 65 116 181 % 98.5% 100.0% 99.5%


% 100.0% 100.0% 100.0%

rate help desk excluding those who have not used it

screening centre

Total NOT ssp ssp

grossly inadequate Count 0 0 0

% .0% .0% .0%


adequate Count 16 27 43 % 28.1% 23.9% 25.3%

good Count 25 44 69 % 43.9% 38.9% 40.6%

excellent Count 14 38 52 % 24.6% 33.6% 30.6%

Total (chi square .681)

Count 57 113 170 % 100.0% 100.0% 100.0%

rate help desk

screening centre

Total NOT ssp ssp

not used it Count 10 3 13

% 14.9% 2.6% 7.1% grossly


% .0% .0% .0%


adequate Count 16 27 43 % 23.9% 23.3% 23.5%

good Count 25 44 69 % 37.3% 37.9% 37.7%

excellent Count 14 38 52 % 20.9% 32.8% 28.4%


% 100.0% 100.0% 100.0%

always provided named individual

screening centre

Total NOT ssp ssp

yes

n 52 103 155 % 91.2% 92.0% 91.7%

no n 5 9 14 % 8.8% 8.0% 8.3%

Total n 57 112 169 % 100.0% 100.0% 100.0%

always provided log call number

screening centre

Total NOT ssp ssp

yes n 54 102 156

% 96.4%

94.4%

95.1%

no n 2 6 8 % 3.6% 5.6% 4.9%

Total n 56 108 164

% 100.0%

100.0%

100.0%


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always get back

screening centre

Total NOT ssp ssp

extremely unreliable

Count 5 14 19 % 8.9% 12.5% 11.3%

unreliable Count 3 0 3 % 5.4% .0% 1.8%

adequate Count 10 19 29 % 17.9% 17.0% 17.3%

good Count 16 42 58 % 28.6% 37.5% 34.5%

excellent Count 22 37 59 % 39.3% 33.0% 35.1%


% 100.0% 100.0% 100.0%

asked to prioritise

screening centre

Total NOT ssp ssp

yes n 23 45 68 % 41.8% 40.2% 40.7%

no n 32 67 99 % 58.2% 59.8% 59.3%

Total n 55 112 167 % 100.0% 100.0% 100.0%

prioritisation appropriate

screening centre

Total NOT ssp ssp

yes n 24 57 81

% 42.9% 52.8% 49.4%

no n 9 13 22

% 16.1% 12.0% 13.4%

don't know

n 23 38 61

% 41.1% 35.2% 37.2%

Total n 56 108 164

% 100.0% 100.0% 100.0%

how helpful was the resolution

screening centre

Total NOT ssp ssp


% .0% .0% .0% extremely

limited Count 0 0 0

% .0% .0% .0%

limited Count 8 11 19

% 14.8% 9.8% 11.4%


% 25.9% 21.4% 22.9%

good Count 19 47 66

% 35.2% 42.0% 39.8%


% 24.1% 26.8% 25.9%


% 100.0% 100.0% 100.0%

would you like help desk enhancements

screening centre

Total NOT ssp ssp

yes Count 19 45 64

% 39.6% 41.7% 41.0%

no Count 29 63 92 % 60.4% 58.3% 59.0%


% 100.0% 100.0% 100.0%


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11.1 CFH helpdesk suggested enhancements Approximately two thirds of respondents offered suggestions for enhancing the CFH help desk facility which are provided below. As elsewhere in this report the responses have been divided into those from non SSPs and SSPs.

11.1.1 Non SSP responses

Case

Number Not SSP - suggested help desk enhancements

5 Knowledgeable first line support would definitely be helpful and time-saving.

6 The people who answer the phone should at least be trained to answer basic enquiries - there may as well be a recorded message and voice mail system instead of employing people to copy out what you say.

7 When I was in the Home Office I used to take turns manning an "on-line" help facility and this is really, really helpful.

23 I feel that the support should be handled as an online request. By selecting the category your query/problem falls under, specify the problem then allocate a number (1-5?) for the priority of the query/problem. Would be more efficient than waiting on the phone?

27 update reports sound good, but what is being reported?

33 Step-by-step guides for common issues/problems. The user guide is excellent but it is not easy to identify a certain section of the guide you may be interested - basically requires flicking through until you find it.

37 Find it useful to email an issue through ... only started doing this recently. Very prompt response to this as well and you can clearly express your problem rather than person on helpdesk struggling to undertand what you are trying to report.

64 on line access to see the progress of your call would be useful. 80 I feel it may be beneficial to have online help and support as the hub can sometimes be hard to get hold of. 86 TIMESCALE OF REPORTS ON BCSP WEBSITE ARE 4 WEEKS BEHIND. 94 Time scale of reports on BCS programme website, 4 weeks behind. 97 Knowledgable first line support would be an asset instead of call logging service. 110 I feel that email / telephone support line is adequate support as regular feedback is given as to the progress of the query.

138

Not everyone understands the problem when you call or are called. The problem appears to be resolved more around ticking the right box rather than being accurate in the data inputted i.e. we had a patient who came earlier than the booked PI date. The options are "Cancel appointment" or "Amend" but Amend does not allow you to bring the date forward without at first cancelling - we don't want to appear to have "cancelled" anything when all we have done is amend???

159 Update reports would be useful, as well as a FAQ relating to questions that the help desk often deal with, but individual screening centres may encounter rarely- i.e. how to rectify information that has been entered into a patients episode.

160 adequate reports 176 Reporting is difficult and the training for managers virtually non-existant


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11.1.1 SSP responses

Case Number SSP - suggested help desk enhancements

12 I do not think 'support' is the problem; it's a basically unfriendly system that uses terminology not used anywhere else, and support often have to 'make do' - because they have no way to fix anything, except via a committee that does not reply to emailed suggestions, and - apparently - takes several months to consider a suggestion before declining it.

14 To be able to see changes, information and advice all in one place would be useful. It would also be good to be able to access a summery of other peoples queries and responses as many are probably asking the same questions.

15 I have no problems with the way the current help desk is operated.

28 I would like to be able to phone up and get a resolution to the problem there and then. Callbacks are of limited use if I am out of office!!

30 BOTH OF THOSE WOULD BE VERY GOOD 35 excellent support, can not fault it ! George is brilliant, Nick and Claire. 42 Be able to call directly to an adviser (also see my first note) 49 Knowledgeable first line support would be good as sometimes just want to say I am going to do this is that right.

50 Would be useful if the person taking the call had some knowledge of the BCSS so they know what you were talking about when you rang.

52 Sometimes when you ring with what you think is a simple query it would be nice to get an answer straight away instead of having to wait for the team to get back to you

63 I sometimes feel that the staff do not understand what you are trying to explain to them and they give you an answer that you know is not correct and close the log, I feel that they need more training with issues that we raise.

70 As above 73 on line access to update reports. 75 Yes, 78 be useful to be able to access a log showing progress 79 Knowledgeable regarding how to advance a patient that doesn't fit in to the box. 83 person who can fix the problem not any receptionist 88 Support if queiry is medical in origin for required relevant data option 92 as above access to updates reports being emailed out would be useful in advance 105 SSP's have limited access to certain information. It would be nice to have the same access as the managers.

109 More help on clinical matters those that don't fit the boxes so to speak, sometimes feel they are unable to answer my questions

117 it is frustrating to speak to an agent in the first instance who does not understand what you are asking for

119 Maybe have an online support system as sometimes time it takes for problems to be resolved can be a few days and this delays the advancing of patients episodes in some situations.

120 update reports 124 Add a polyp grey box to move with the adding of polyps 127 WOULD LIKE TO BE ABLE TO EMAIL THE PROBLEM 137 This would hopefully speed the movement of patients through the system. 142 Think the service works ok as it is, they were unable to resolve my query though. 145 ONLINE ASSISTANCE,PROBLEMS TO BE RESOLVED IMMEDIATELY 149 CLINICAL EXPERTISE IS SOMETIMES REQUIRED TO NAVIGATE SPECIFIC FIELDS ON BCSS 150 easier to rectify mistakesable to down load report 154 Would be helpful occasionally to speak to a person with medical knowledge when resolving dataset problems 158 to speak to someone who can help directly rather than waiting

171 I have been passed from IT to OE and neither accepts its their area to assist. Clearer pathways of who helps with what please..


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12. Suggested BCSS enhancements

Respondents were asked, what improvements/changes would they make to the BCSS if they had a magic wand. They were allowed up to five wishes and asked to rank their wishes from the most important to the least. As elsewhere in this report the responses have been divided into those from non SSPs and SSPs, furthermore the relative ranking of each is provided along with the position it was entered in the questionnaire. The two tables below provide an overview of the comments using the thematic coding scheme discussed earlier.

Considering the relative frequency of various suggested enhancements it would appear that SSPs have a greater concern with the various datasets compared to the non SSPs.

12.1 Non ssp Case

Number Non SSP suggested enhancement ranked first code

5 Alerts when changes are made to appointments 4

6 I would like an additional calendar which would just be a free text thing that the screening centre could share. We run across 3 different sites so it would be hugely useful to us to be able to access something like this everywhere.

26

7 Much better user friendly manual 14

18 figures for reports to correspond with our own figures 10

19 The ability to go back and undo certain actions; eg when a patient has been advanced on the wrong pathway 7

23 Navigation Improvements 6

27 Better integrated reports that I can get at a click of a button. 4,6

37 User friendly data retrieval with no need whatsoever to manipulate data in access 4

44 improved access to statistical data 4

58 Able to obtain activity information which is clear and specific ie by PCT, nurse, or colonoscopist, which can be broken down to number of referrals, patients seen, number of colonoscopies, no of Virtual Colonoscopies & number of other tests & be able to obtain further information accordingly ie diagnosis etc.

4

64 In all QA reports the ability to link to patients details. ie, in colonoscopy details where completion has not be successful allow the report to identify those patients so a thorough investigation can take place.

4

65 Relevant reports on cancer patients 4

69 I would like the system to be a electronic diary, in which it tells you what patients and when they are attending Colonoscopy. 26

76 Reports !! Real time or as near to as possible 4

81 Accessing reports to be made easier and reports to show more information. 4

97 When a person changes appointment, their name to be highlighted (bold or another colour) so they can be tracked more easily. 6

106 NO FREEZING OF SCREEN HAVING GIVEN THE COMMAND 'BACK' 1,6

110 Easier process for downloading and extraction of information that is fed into the system. 4

138 Re-Evaluate all datasets and the information requested 10

152 More useful strategic reports 4

156 Access to information I want, the ability to construct my own reports and interrogate the system. Much information s put in to the system and little is available in return

4

enhancements non SSP Frequency Percent


38 44.2



11 12.8


4 4.7


3 3.5

Duplicate data entry excluding Spreadsheets 3 3.5

System enhancements (see codes in report) 3 3.5


Patient Minority Group (PMG) Issues 2 2.3





Total 86 100.0

enhancements SSP Frequency Percent


54 23.8




26 11.5


25 11.0


17 7.5


System enhancements (see codes in report) 7 3.1




Duplicate data entry excluding Spreadsheets 2 .9

Desire for dummy/training datasets 1 .4

Patient Minority Group (PMG) Issues 1 .4

other + security + management 1 .4

Total 227 100.0


of 84

159 Better reporting with ability to drill down to individual patients/colonoscopists/SSPs etc. so that when anomalies arise they can be investigated. 4

160 to be able to pull adequate reports with up to date data more effectively 4

164 On the subjects page i would like the PCT code and FOBT date aswell as Subjects NHS number and GP details 8

176 PID to remain on screen at all times (I have made a change request about this) 6

182 Ability to locally extract data to write reports. 4

slot 2

18 Training for printing off reports, not covered in-depth in training 14

65 Target dates for cancer patients with alerts 10

76 Patient Questionnaires - enable an evaluation report to be taken from the system as the responses are all inputted into a dataset. 4

82 For system to be more flexible if wrong information accidently entered. 10

97 Be able to collect ethnicity within the dataset as collected within screening assessment anyway - for health promotion targeting 10

138 Set up capability for statistical reporting of numbers, treatments, histology etc. etc. 4

slot 3 code

33 Be able to download any data which has been inputted onto the system and be assured that this information is as correct as humanly possible (these are wishes :-)) and be able to discard the numerous local kept spreadsheets!

10

76 Reports - generally improve the download system - seems to be hit & miss whether it works or not. 4

91 To be able to extract patient 30 day questionnaire result data and produce a report. I currently sit and input each questionnaire data onto a spreadsheet to report on this!

4

138 Allow for complete dataset printing for addition to casenotes rather than us having to resort to paper AND the system 4,17

slot 4

76 Reports - PCT's want non responder information and it seems to be a lottery as to whether this is accessible depending on who you are & who you ask for it.

4

138 Add the date of the First Appointment onto the Demographics or have a summary of appointment dates rather than having to go in and find via several layers of screens and events.

6

slot 5 [ no records]

Case Number

Non SSP suggested enhancement ranked second code

82 Have option to print letters in other languages for patients who do not understand English. 18

86 IF INTERIM REPORTS COULD BE MORE UP TO DATE RATHER THAN 4 WEEKS BEHIND SO AS THE STATISTICS WE GATHER COULD BE KEPT IN TIMELY FASHION.

4

91 To have the BCSS produce graphs showing the uptake rate by GP practice for each individual PCT area covered. 4

94 Would be nice if interim report on website could be sent monthly for each individually Screening Centre instead of having to trawl through to collect figures.

4

Slot 2

5 Alerts of new FOBts to not disappear from my alert menu until I have clicked on them. It does not help me that one of the SSPs have clicked on it, if I have not seen it, as I need to book new SSP appointments on our PAS system.

4,6

6 When I run a QA report for endoscopy or nursing, I would like to be able to get a list of those patients which have breached targets etc. This would be valuable for us to learn why and when the breaches happened.

4

7 Clearer definitions of all the different pathways 7

19 Reports / data in a more user friendly format 4

23 More reports to be obtainable 4

64 Allow evaluation of all 30 day questionnaires from the system - ability to produce these figures on a monthly,quarterly and yearly basis. 4

91 To be able to produce graphs/uptake data directly from the BCSS. 4

106 ADD CHINESE LANGUAGES TO LANGUAGE OPTIONS IN DEMOGRAPHICS 18

156 That there would be flow of information between information systems, duplication of data recording wastes time 17

176 Link to hospital MDT and cancer data sets to avoid double data entry 17

Slot 3

58 Be able to see the number of planned surveillances due (by month) in a set period in order to aid capacity planning. 4

97 In report modules - to be able to go back one screen when report compiled instead of having to go out and re request form. 6

159 Ability to organise layout of information according to your preferred method of use- a bit like setting your home page and choosing the tools you want to appear on it so that when you log on you have instant access to frequently used areas of the system.

6

Slot 4 [no records]

Slot 5

27 Training on downloads 14

138

Allow free text letters using word or similar rather than the complex and time-consuming method set up. Plus the questionnaire for patients does not follow the entire pathway and should be re-evaluated plus should allow for some local additional questions around clinic locations, ease of access to clinics etc...

10,26


of 84

Suggested enhancements NON ssp ranked third slot 1 Code

80 To have an alert on the main screen stating the patients SSP clinic date 4

Slot 2

27 More flexibility - free text 10

33 Be able to identify which information on list of events in an episode are incorrect. To correct a problem it usually requires the user to re-enter details again. It is not very easy to identify which information is accurate.

10

58 Be able to see all SSP appointments for the week at a glance - with the patient names included., (at the moment this report can only be done one SSP at a time).

4,6

159 Specific BCSS training 'modules' rather than the entire training course- some staff only use a specific section and it is expensive and time consuming to attend the full course.

14

Slot 3

5 Improvement of User group access, basically more access for the various user groups. 19

7 Needs to be much more user friendly 6

64 remove the dataset completion button - this is causing datasets to be incomplete as poeple aren't pressing it! Create mandatory fields instead to support this application and ensure the correct data fields are completed.

6,15

65 Reports on patients who have ben referred for surgery (non cancer) 4

82 To have an alert or notification if a patient has cancelled or changed appointment instead of having to go through diary daily checking all patients remain the same.

4

156 Ability to amend / edit free text entries 10

Slot 4 [no records]

Slot 5 [no records]

Suggested enhancements NON ssp ranked fourth slot 1 code

33 Ability to print 'patient assessment document' used at SSP positive assessment clinics with demographic details completed. 4

Slot 2

148 To meet the needs of the user as well as the BCSS

Slot 3 [no records]

Slot 4

5 Knowledgeable first line support 12

27 Easier system for getting replies from issue notifications 19

64 In downloads allow screening centres to see NHS numbers and patients surname - this would make the report more useful as some subjects have more than one procedure but you can't tell who they are as you don't have their details.

4

Slot 5 [no records]

Suggested enhancements NON ssp ranked fifth slot 1 code

41 For the system generate a separate row for each patient letter rather than grouping into batches. 8

148 To use a more 'user friendly' terminology 10,6

Slot 2

69 (Surveillance) I would like the system to tell me the names and sites that the surveillance patients are attending to forward plan more than 6 weeks in advance colonoscopy list, a bit like a PTL. The system at the moment only gives you a number of patients that are attending for that month and it doesn't tell you from which site.

6,4

Slot 3

27 More flexibility - being able to enter patient contact at any stage of the journey 7

Slot 4 [no records]

Slot 5

64 Ability to remove contacts when they have been inputted correctly. Also why do you need a start and end date for contacts can you not just add and remove when necessary?

6


of 84

12.2 SSP

Suggested enhancements ssp ranked first slot 1 code

1 That the system covered all eventualities in the patients care pathway. 7

9 Unable to record all contact with pt, has to be put in episode notes. 7,10

10 Unable to record each patient contact have to write all in episode notes 7,10

28 Instant resolution to problem 19

29 SIMPLIFY CANCER AUDIT DATASET 15

39 to be able to correct incorrect input i.e low risk polyps to intermediate risk if it is accidentally put in incorrectly. At present this is impossible to do and one needs to interrupt and start again.

7

40 dummy data sets 16

43 one button to complete a ' No to all' on the assessment dataset. 15

47 Access to more reports at my level. i.e. I would like to be able to look at a list of all my patients. Usually so I can check I have completed all the datasets. 4

50 Ensure all users receive all alerts. 4

53 Easier access to required information. See a list of clinic/colonoscopy dates for the month/year. Polyp categories High, intermediate, low risk, cancers and then be able to see those patients.

4

54 Easier access to required information. See a list of clinic/colonoscopy dates for the month/year. Polyp categories High, intermediate, low risk, cancers and then be able to see those patients.

4

55 When you compile a report for adverse events is would be good to cross reference the patients name so you know who you have accounted for. 4

56 Updates on notes are automatically saved chronologically and cannot be altered by other users. 10,6

61 Unlimited space for episode notes, this is needed for complicated patient to ensure adequate documentation. 10

62 Individual GP letters to be produced through BCSS 8

70 Either simplify the cancer data set or have the histopathologists enter the data. 15

73 faster 1

74 to be able to correct colonoscopy test outcome after data for another test performed has been entered without ringing open exeter to do it. on going learning process thus sometimes make mistakes.

7

75 online handbooks, idiots guides, newsletters with have you tried etc. 19

78 Speed - I'm not sure whether it's BCSS or the local network that causes problems, but there are times when it's excruciatingly slow. 1

79 Support regarding cancer Datasets 15

83 more options 6,7

84 would like training on ceasing of patients, 13 week rule, then who ceases them me or the Hub 7,14

88 Shorter initial training to be up and running at get log in details. But real training needs are when actually start to use system, which may be some time after training and no colleague advice available if are a new centre. Training should include main pathway scenarios.

14

92 stop having to go back all the time advance from the page you were on 6

93 Cancer audit dataset - needs more clarity 15

103 Would like to be able to book patients in myself directly for a second assessment appointment e.g. if they have been referred for clinician review we often need to see the patient again before booking for colonoscopy

7

104 patient pathways much simpler. 7

113 IMPROVE INITIAL TRAINING 14

116 Screen would always display identifying information 6

117 logical listings on datasets i.e. alphabetical or anatomical 6

119 Less information on cancer audit as we don't have access to most of this information therefore to access this takes time meaning delays in completion of these datasets

15

124 When adding polyps at the moment we need to keep going back to the top to add other polyps. The grey box needs to move with the most recent polyp added.

6

127 QUICKER 1

128 It has the screening practitioner appointment calendar but it would be extremely useful to have another calendar where you can book the Colonoscopy slots on as sometimes we have difficulty accessing our colonoscopy calendar off site

26

137 Reavaluate the datasets and the information requested and the options available in the drop down menus 6,10,15

142 give me more freedom to make changes to test results/outcomes. 7,10

143 I would like to be able to log all telephone calls made to patient and not just the post investigation offer 10

145 IMMEDIATE RESOLUTION OF PROBLEMS 19

149 CLINICAL EXPERTISE TO ASSIST WITH COMPLEX PATIENTS 12

166 Medications to be included 10

171 give realistic examples of how to work through situations 14

177 the cancer data set details was linked to Somerset or NBOCAP to prevent repetition of information 15,17

183 Less monitor freezing 1

Slot 2

52 Easier progression through the patient pathways - sometimes it is hard to navigate through more complex cases 6,7

95 It can be very frustrating when there is no relevant drop down box so that you have to write in events. This takes more time so i wish there were more options for certain things. It is difficult to specify details here.

10

104 ability to correct incorrect entries ourselves. 10

116 Reminders if episodes are complete but datasets have not been completed 4

150 more flexibility 6,7


of 84

183 longer log in session time 6

Slot 3

12 Have a system of recording events that do not intersest the BCS, but may be vital to patient's pathway, to enable all the info to be kept in one (online) place, accessible from all bases. This would satisfy the needs of FOI Act, patient privacy, and a safer, smoother system

26

14 That we should not have to complete cancer audit data. 15

17 Access to more information on patients history ,including barriers to communication, prior to nurse positive clinic 26

75 clear pathways to stop SSP's all doing something different 7

90 would be good to merge cancer data sets with hospital infloflex system so when colorectal nurses add cancer data and histology we can complete datasets

15,17

104 Option to print patient letters in specific languages for patients as English not always 1st language 18

114 Ability to put medications on the dataset 10

117 post investigation dataset complete overhall 15

133 A simpler or no cancer dataset 15

146 Abandon cancer data sets as too complicated for SSP's both to get information for and understand how to do 15

158 for assessments that 'no' was the default setting 6,10

169 It would be nice if the cancer data required was more simple to understand 15

175 more training on the reports element for BCSP managers 14

183 Automatically save data when untimely log off 6

Slot 4

75 Cancer data set margins - option to say n/a or not recorded rather than leaving as 0 implying incomplete removal of cancer. 10

104 Get rid of cancer audit data sets 15

109 More standard template letters as have had to make alot ourselves. This would help in ensuring all centres are doing the asme 8

114 Ability to record baseline observations on the dataset 10

146 Enable SSP's to navigate back to correct pathway if the wrong pathway has been chosen in error. 7

Slot 5

55 add in an option to write a letter to the GP or other consultants that relate to the patient. This would complete the record. 8

63 When a patient is seen in clinic and needs a second positive appointment to see a screening practitioner there is no way of putting this on the system and therefore is not representative of the work that we do and the patient journey

7

75 access for SSP's to colo QA options for endoscopy GRS and endoscopists use 10

114 Having different appropriate questionaires for patients The health check for states renal/kidney problems rather that kidney/liver problems

10

115 Having appropriate questionnaires for surveillance patients. Adjusting the health check form to ask if patients have any liver problems. 10


of 84

Case Number

SSP suggested enhancement ranked second code

12 Have it reviewed from a user persective, as opposed to a 'BCS needs' perspective.

17 Provision of blank boxes on most pages to document any issues etc. 10

52 A website for FAQ's to save time and resources ringing the helpdesk 26

90 the screen would scroll down with you as you fill in the investigation datasets 6

95 I feel i am quite good with computers but i found the BCSS system difficult to navigate at first so i wish it was an easier system to use. However, i am aware that a lot of complicated information needs to be inputted.

6

133 Be able to print off a paper copy of the nursing assessment in a user friendly form. 4

146 Extend time out 6

175 remove the cancer database - this is very complicated for the SSPs to complete - the SSP hands over care of the cancer patient at or before MDT - to expect them to complete the cancer pathway element is in my opinion not appropriate

15

Slot 2

9 Need sub-pedunculated option in polyp type. 10

10 Need sub pedunculated on polyps 10

12 Make every section printer friendly (including textboxes) 4

14 That useful information, instructions (from Exeter or national office) is kept on a national system all in one place so that we can refer back to it easily and don't have to keep all the separate emails etc.

26

40 easier way of correcting mistakes / back tracking 10

50 Enable the retrieval of data, what's the point of putting all the data in if there is no way of getting it out? 4

53 More user friendly screens with natural progression through those screens. 6

54 More user friendly screens with natural progression through those screens. 6

55 patients who do not attend the initial clinic, that there could be a button for not attended clinic and discharged from the round of screening so they no longer appear on the incomplete dataset list. Similar thing for the 30 day questionnaire.

10

61 More training on completing the cancer audit dataset 14,15

62 Individual SSP/screening centre ability to prioritise alerts 4

73 option to correct own errors without having to go through to the help desk 7

74 Cancer data sets appear repetative i.e is distance to nearest cut bowel margin not the same as tumour resection margin? if so why are both measurement needed?

10,15

83 guidelines what should be enter as: e.g. if these are and so on 10

90 it would be possible to pull off data about results from each patient 4

109 Vast improvements in the training this was poor and not always appropriate to my needs. Contacts for who to call for answers concerning clinical matters as connecting for health never able to help on these issues

14

113 IMPROVE DATA EXTRACTION FOR LOCAL USE 4

114 Less info required on the cancer datatset 15

117 tips and hints along the way 14

127 ALLOWED ME TO CORRECT MISTAKES EASIER 10

137 Summary of appointment dates would be useful without having to go through events 4

143 Individual section on assessment dataset for patient drugs. At present I have to document within the dataset in comments next to appropriate condition. 10,15

145 DEALING WITH 1 PERSON 19

149 ON GOING TRAINING & UPDATES 14

158 that the different pathways were clearer to follow 7

166 Social history ie : recent bereavement etc. 10

169 Would like to more knowledgeable about changing pathways if mistakes are made. 7,14

177 report showing numbers and recall dates of all surveillance patients in our programme 4

Slot 3

55 some way of recording conversations with the patient along their pathway, if you need to change colon date due to illness or patient wants to think about it etc.. as well as after the colonoscopy, more space for comments.

10

56 There is more flexibilty to pathways to allow for clinical judgement and patient need 7

92 more space on the events box to enable all information required to be put in 10

116 Cancel the cancer datasets or simplify them to diagnosis only - there is already a national database that is supposed to gather all the information 15

119 All letters to be available on system so that manual ones do not have to be done. Also are all letters from Bcss not supposed to be standardised? 8

128 it asks for a change of password too frequently 6

149 ACCESS TO LETTER PRODUCTION WHEN COMPLETING DATA ON A PARTICULAR PATIENT 6

150 able to undo mistakes 10

171 would like more detailed information put onto each page to guide you through. Especially if notes were not made during training as not aware at that stage what is relevant

6

Slot 4

63 Being able to add biopsies taken at colonoscopy from an abnormal area i.e colitis, inflamation, only have ability to do it for polyps/cancers at present, therefore not representive of the work that we do

10

183 Should have a sound alarm if session nearly to log off 6

Slot 5

1 That letters are still receiving complaints from patients about wording, they should all be looked at by patients and staff to discuss an appropriate way to tell people they have an abnormal result.

8


of 84

Suggested enhancements ssp ranked third slot 1 code

114 Access to patients outside the local HUB [different from case 115 – editor] 10

115 Access to patients outside our local HUB [different from case 114 – editor] 10

136 as mentioned previously, the drop down boxes on the assessment dataset need to be set as 'no' and not 'not known'. This would save so much time when filling them out.

10

158 that from the alerts you could directly access whatever it is that needs doing 6

165 The BCSS screen freezes out frequently, adds to the stress level 1

169 I would like to be able to write letters on the BCSS but not sure how 8,14

Slot 2

1 That change requests are considered and not downgraded in importance, and then forgotten about. 19

17 Provision to record biopsies and results of findings 10

36 you should not be able to complete the investigation dataset if the assessment dataset has not been completed 10

56 Thee would be a facility where amendments to templated letters could be made as one shoe does not fit all 8

63 Not needing to ring help desk for simple interupts 7

75 How about a watchdog who occasionally logs on to see what we are doing and gives advice etc to make it easier. 26

92 alerts for your own case load from endoscopy the you were currently working on would help to keep track on caseload 4

115 Is the cancer dataset really necessary and could it be shortened 15

119 system could be quicker 1

128 in the datasets for the actual investigation there are drop down boxes for the polyp information and there is complete/successful which is quite similar- maybe only need one option?

10

133 Easier downloads 4

146 Make navigation between screens more user friendly 6

171 would like some on the job training in real situations 14

175 add more free text 10

Slot 3

9 No option for sending GP/specialists letters when using individual letters. 8

10 Individual letters does not do copy for GP or enable us to write to GP/specialist 8

50 Reduction of the amount of data needed for the cancer datasets, the information is difficult to obtain and is also stored on other national databases. 15

54 More help with reporting. I have never been able to use data retrieval screens despite being programme Manager! 4

73 Better data downloads - considering the amount of data put in, the options to get that data out in a usable format is very limited 4

109 Continuing training i.e what to do with surveillance patients documentation etc - no guidance given 14

113 REPRINT LETTERS 8

115 Being able to record medications in patient pre-assessment datasets 10

127 WAS NOT SO LETTER ORIENTATED 8

137 Letters could be in word format and easier to change 8

145 ONLINE ASSISTANCE 12

166 To include tel nos 10

Slot 4

14 That we could easily produce a report from the information in the questionnaire datasets. 4

40 to access reports in an easier format 4

55 that you could add in chemotherapy or radiation therapy as a first treatment for cancer. Most rectal cancers have radiation therapy before surgery. 7,10

115 Recording pre-assessment observations 10

150 easier to navigate 6

Slot 5 [no records]


of 84

Suggested enhancements ssp ranked fourth slot 1 code

14 A helpline dedicated to completion of datasets and advancing patients on the system. 12

24 For the reports to be clearer and to be able to see each SSP records and completion for each stage 4

63 increase in episode note characters 10

109 more guidance on completing datasets particularly cancer datasets that are very complex 14,15

Slot 2

24 To be able to put in letters from GP/Consultants as records electronically 26

Slot 3

1 That feedback is given for each change request, especially to those that have raised the issue. 19

24 For all episode notes to be secure 10,23

36 the system should not allow you to move on via an interrupt if a letter was going to be produced confirming the latest event 6

40 Documentation of patients medication 10

Slot 4

9 Need cold biopsy option for polypectomy. 10

10 Need cold biopsy for polypectomy 10

54 Access to patient satisfaction questionnaire data to enable service improvement. 4

128 the log out time needs to be extended 6

166 To make the cancer data set easier to use. 15

169 I would like to print out individual letters 8

Slot 5 [no records]

Suggested enhancements ssp ranked fifth slot 1 code

36 ability to have open more than one dataset at the same time 6

150 able to down load reports 4

151 improving the cancer dataset can be quite confusing when entering data 15

Slot 2 [no records]

Slot 3

63 To be able to enter faecal tagging CT as a "other diagnostic test" and laparoscopic surgery as a treatment option 10

Slot 4

1 That letters were prepared automatically rather than having to go in and prepare a batch for the patient then a different one for the GP. 8

Slot 5

14 It would be useful if patients telephone numbers are always put on the system - they could be asked to provide this information when they send their kit back. So that for instance if a clinic has to be cancelled there would then be a means of contacting them at short notice.

10

109

How to manage letters for those patients who are suspected cancer but not confirmed as at present unable to write to GP until after surgery and have confirmation of diagnosis, system very limited perhaps an additional letter to be added which states suspected cancer as at least this will keep the GP's informed

7

166 Ability to view other hubs. 10

169 I would like to visualise who is in the batch of letters without having to prepare the letters first 6


of 84

Suggested enhancements ssp unranked code

15 Easier ways to download reports on specific data 4

30 SIMPLIFIED CANCER DATASETS OR BETTER STILL NONE AT ALL 15

42 Terminology often inadequate, exactly what are you asking on some field 10

60 Clear logical progression through system whichever pathway is taken 6,7

105 An easy way to get information ourselves without having to request information. For eg... list of NHS numbers of patients that may have had complications. We put in a request and it took nearly 4 weeks to get it back.

4

131 2 = a little more logical in advancing screens 6

Slot 2

15 More flexibility for the patient pathway (for example we had a pt who had a failed colonoscopy the procedrue was then repeated on the same day by the pt's requested by another screening consultant and the system did not have the flexability to advance and re-invite for the same day.

7

30 IF CANCER DATASETS HAVE TO STAY WE NEED MORE DETAILED INSTRUCTION IE:APPROPRIATE OPTIONS TO PUT IN SOME BOXES ESPECIALLY WHEN REPORTING CANCERS IN POLYPS.

14,15

42 Be able to call directly to an adviser not have to explain things twice 12

60 Letters appropriate to situation 8

84 some guidance when we arrive at the surveillance time in our centre 14

105 An easy way to get numbers of cancers or polyp cancers and Dukes staging 4

131 1 = To have a copy of the the screens in paper form when learning so we practice before going live 14

Slot 3

30

WHEN FINISHED DATA SET THE IT IS NOT ALWAYS CLEAR WHAT THE SYSTEM OUTCOME IS-WHEN IT SAYS "LETTER" IT SHOULD ALSO GIVE US THE STATUS EG: 36MONTH SURVIELLANCE AT PRESENT WE HAVE TO WAIT UNTIL LETTER IS PRINTED BEFORE WE KNOW WETHER IT IS SAYING WHAT WE WANT IT TO SAY. (YOU CAN GO INTO ACTIVE BATCH TO LOOK AT LETTER BUT IT IS DIFFICULT TO FIND THE LETTER YOU WANT, THIS ALSO CAUSES CONFUSION FOR ADMIN BECAUSE YOU HAVE LOOKED AT THE LETTER BUT NOT PRINTED IT).

6,10

105 A quick way to bring up individuals episodes & make episode notes easily on screening subject without having to go back though the List Episode & then Events

6

131 3 = Not to need such a complicated password & to change it so often 6

Slot 4

105 Sometimes the subject episode can be closed without completing the investigation or the post investigation datasets. It would be helpful that if these were incomplete the episode shouldn't be able to close until they are. This would ensure all datasets were completed.

7,10

Slot 5

183 Should have space for additional info on investigation data set 10


of 84

13. Enquiries/Reports/Alerts

Respondents were asked if they had ever user enquires/reports or alerts produced by the BCSS. Those who indicated they had done so were then asked a series of additional questions. The majority of questions produced a most frequent response as neutral or happy.

use of enquires/reports/alerts

Total NOT ssp ssp

yes Count 36 64 100

% 55.4% 58.7% 57.5%

no Count 29 45 74 % 44.6% 41.3% 42.5%


% 100.0% 100.0% 100.0%

information completeness

screening centre

Total NOT ssp ssp

do not understand

question

Count 3 0 3

% 8.1% .0% 2.9%

very unhappy

Count 6 4 10 % 16.2% 6.0% 9.6%

unhappy Count 1 6 7 % 2.7% 9.0% 6.7%

neutral Count 10 18 28 % 27.0% 26.9% 26.9%

happy Count 10 20 30 % 27.0% 29.9% 28.8%

very happy Count 7 19 26 % 18.9% 28.4% 25.0%


% 100.0% 100.0% 100.0%

information relevancy

screening centre

Total NOT ssp ssp

do not understand

question

Count 2 0 2

% 5.6% .0% 2.0%

very unhappy

Count 1 4 5 % 2.8% 6.1% 4.9%

unhappy Count 4 5 9 % 11.1% 7.6% 8.8%

neutral Count 13 23 36 % 36.1% 34.8% 35.3%

happy Count 9 20 29 % 25.0% 30.3% 28.4%

very happy Count 7 14 21 % 19.4% 21.2% 20.6%


% 100.0% 100.0% 100.0%


of 84

information accuracy

screening centre

Total NOT ssp ssp

do not understand

question

Count 3 1 4

% 8.3% 1.4% 3.8%

very unhappy

Count 4 7 11 % 11.1% 10.1% 10.5%

unhappy Count 5 10 15 % 13.9% 14.5% 14.3%

neutral Count 9 15 24 % 25.0% 21.7% 22.9%

happy Count 8 23 31 % 22.2% 33.3% 29.5%

very happy Count 7 13 20 % 19.4% 18.8% 19.0%


% 100.0% 100.0% 100.0%

How up to date is the information?

screening centre

Total NOT ssp ssp

do not understand

question

Count 2 0 2

% 5.7% .0% 1.9%

very unhappy

Count 3 3 6 % 8.6% 4.4% 5.8%

unhappy Count 1 2 3 % 2.9% 2.9% 2.9%

neutral Count 14 21 35 % 40.0% 30.9% 34.0%

happy Count 6 21 27 % 17.1% 30.9% 26.2%

very happy Count 9 21 30 % 25.7% 30.9% 29.1%


% 100.0% 100.0% 100.0%

Level of aggregation

screening centre

Total NOT ssp ssp

do not understand

question

Count 5 3 8

% 15.2% 4.5% 8.1%

very unhappy

Count 3 5 8 % 9.1% 7.6% 8.1%

unhappy Count 4 9 13 % 12.1% 13.6% 13.1%

neutral Count 10 19 29 % 30.3% 28.8% 29.3%

happy Count 8 19 27 % 24.2% 28.8% 27.3%

very happy Count 3 11 14 % 9.1% 16.7% 14.1%


% 100.0% 100.0% 100.0%

clarity

screening centre

Total NOT ssp ssp

do not understand

question

Count 2 0 2

% 5.9% .0% 2.0%

very unhappy

Count 3 6 9 % 8.8% 8.8% 8.8%

unhappy Count 4 4 8

% 11.8% 5.9% 7.8%


% 17.6% 39.7% 32.4%

happy Count 11 18 29

% 32.4% 26.5% 28.4%

very happy Count 8 13 21

% 23.5% 19.1% 20.6%


% 100.0% 100.0% 100.0%


of 84

Volume of information – too much

screening centre

Total NOT ssp ssp

do not understand

question

Count 4 0 4

% 11.8% .0% 4.0%

very unhappy

Count 1 5 6 % 2.9% 7.6% 6.0%

unhappy Count 3 1 4

% 8.8% 1.5% 4.0%


% 29.4% 43.9% 39.0%

happy Count 9 19 28

% 26.5% 28.8% 28.0%

very happy Count 7 12 19

% 20.6% 18.2% 19.0%


% 100.0% 100.0% 100.0%

Volume of information - too little

screening centre

Total NOT ssp ssp

do not understand

question

Count 2 0 2

% 5.6% .0% 2.0%

very unhappy

Count 5 5 10 % 13.9% 7.8% 10.0%

unhappy Count 3 2 5 % 8.3% 3.1% 5.0%

neutral Count 7 31 38 % 19.4% 48.4% 38.0%

happy Count 12 14 26 % 33.3% 21.9% 26.0%

very happy Count 7 12 19 % 19.4% 18.8% 19.0%


% 100.0% 100.0% 100.0%

formatting

screening centre

Total NOT ssp ssp

do not understand

question

Count 3 1 4

% 8.3% 1.5% 3.9%

very unhappy

Count 4 6 10 % 11.1% 9.1% 9.8%

unhappy Count 5 5 10 % 13.9% 7.6% 9.8%

neutral Count 11 24 35 % 30.6% 36.4% 34.3%

happy Count 6 17 23 % 16.7% 25.8% 22.5%

very happy Count 7 13 20 % 19.4% 19.7% 19.6%


% 100.0% 100.0% 100.0%


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13.1 Specific comments on reports Respondents were invited to list up the 5 comments about current reports or suggestions for new ones. No respondent provided more than 4 comments.

Case

Number report name report quality Report 1 comments not SSP

6 Endoscopy QA bad As above, it would be helpful to identify where the breached targets have occurred so we can check and either correct or learn why/how this has happened. It's great to have an overall performance rating but not that much use if you can't learn from it.

7 bad Need alerts for letters

19 xml batch downloads bad impossible to understand and needs transferring to another database

23 Clinic DNA Rates . Erected to keep track of all patients who have DNA'd, showing the month, clinic, next clinic appointment IF there is one or if the patient has been discharged.

33 All QA reports bad If a problem or possible input error is highlighted in the report it is not possible at present to identify the individual patient - unable to investigate or correct the problem.

58 Possible Duplicate Diagnostic Tests bad Have had no communication about what to do with these alerts. Most of these are probably

duplicates due to initial problems with the system during our first year.

64 Strategic reports . Why cant these be more up to date - the latest report you can generate on a monthly basis is March09

76 Non responder infomation . PCT want this info down to GP Practice level & subject level in some cases.

91 Count of Letter Types Produced . Never used it - not sure if its useful for anyone else

97 . See above free text combined with enhancements.

138 Dataset Completion . Before finishing Episode have a flag to state tick the YES box if dataset complete as this usually

comes up on reports as dataset not completed 153 Alert . Patient moved first positive assessment appointment

156 Colonoscopy outcomes . I am often asked for the number of normal colonoscopies we have carried out / how many have

other colonic pathologies etc

176 possible duplicate tests bad No way of turning this alert off once the individual cases have been checked

Case Number report name report

quality Report 1 comments SSP

14 Questionnaires . It would be useful to be able to get a report from the patients responses on the questionaire.

42 . Alerts often come for patients far to early i.e. you move a patient on and then waiting for histology report, surgery dates ets we cant do anything any earlier untill various other people (pathologist) have made there reports etc.

50 positive FOB test alerts . Ensure all users receive alerts

55 adverse incidents bad patients nhs numbers. ratios are unhelpful and inaccurate

60 Incomplete datasets bad No point in list that says at the bottom that there are more datasets but doesn't elaborate. Should run to several pages instead - at least the number of incomplete reports would be apparent.

62 Endoscopy QA reports good Able to drill down further to provide individual endoscopist data - currently all endoscopists data

can be seen which has confidentiality issues (generally useful report though)

109 duplicate tests bad this is not always accurate as if a pt has had a failed colonoscopy and then goes on to have a further test it arises this as an alert when it is obviously not

114 Colonoscopy Quality Assurance reports bad colonoscopy complications-unable to access the individual patients attached to these

115 Quality assurance

Colonoscopy complications

bad Very little useful information. There is a section for complications this should be broken down, as 'withdrawn consent' is a complication but this is not necessarily a problem with the colonoscopist as such. Although when looking at the report that is the impression it gives.

120 Patientswith

abnormal FOBt with incomplete datasets

good very useful but new centres/SSP's need training regarding its existence

137 Data sets not complete . before completing episode could there be some `flag up` if the yes boxes for datasets has not

been ticked


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Case

Number report name 2 report 2 quality Report 2 comments not SSP

7 bad Incomplete datasets 19 cvs batch downloads bad options for data/information needed quite limited

23 Colonoscopy Refusals . Erected to track all patients who have refused colonoscopy with reasons to why.

58

Patients Whose First Assessment

Appointment Is Booked More Than 14 Days In Advance

bad Most appointments are booked by the Hub, therefore don't see the value of having this alert for Screening Centres as we are unable to do anything with this alert.

64 Cancer Waits reports bad Produce reports for patients whose first offered clonoscopy appointment is more than 14 days in advance and remove the elapsed time between SSP appointment and first offered colonoscopy.

91 Strategic Report

Request and Retrieval

. The drop down menu in choosing the time period for the report is unhelpful. It would be great if we were given the option of choosing our own time frame.

97 Commissioning reports .

A NEW report suitable for the requirements of forthcoming PCT Commissioning of the BCS service. Standardisation for every centre would be useful.

156 Drugs administered . On occasion drugs are recorded as having been used although these particular drugs are not used within the department. It would be extremely useful to be able to identify these patients myself and then investigate and amend as appropriate so that data recording is accurate.

Report 2 comments SSP

42 . Duplicate investigation alert when this is what is supposed to happen ie have colonoscopy plus Bariun Enema on the same day

50 duplicate diagnostic tests . There is no way of changing these

114 Patient health check questionaire bad wording incorrect should read kidney/liver problems rather than renal/kidney problems

115 Health check form bad Does not ask if patient has any liver problems.

Case Number report name 4 report 4

quality Report name 4 comments not ssp

23 Opt In Reports . This could either be a report or an extra piece of information listed on the events page of the patient to indicate and distinguish for reporting on how many patients have done a self referral

Report name 4 comments ssp [no records]

No comments for report 5


quality Report 3 comments not SSP

23 Anatomical Reports . Erected to keep track of cancerous polyps/tumour's and where they were found in the bowel.

58 Surveillance Planning . As previously stated, it would be good to have a report to look at the planned surveillances due

by month to aid capacity planning etc.

91 Endoscopy Quality Assurance Reports . Under this section it would be useful to be able to drill down to the data of each colonoscopist

regardless of what site they work on.


quality Report 3 comments SSP

42 . Reports on number of colonoscopys often inacurrate plus other users I.e. wakefield being placed on our reports

115 Patient questionnaires bad Incomplete you are unable to record all sections asked on the questionnaire sent out to patients.


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13.2 Additional general comments about enquires/reports/alerts

Case

Number General comments about enquires/reports/alerts Not SSP

6

The alert for when a new positive FOBt is added disappears for all users as soon as one person clicks it. This has caused us to miss them frequently because the admin team may not get the alert. As mentioned earlier, there is no alert for when the hub changes or cancels an appointment - this would be hugely useful for our screening centre as we are required to update this on both trust booking systems and the cancer register.

7 We seem to have alerts for less important matters and dont get alerts for what we really need to see.

18 i have not had any training on producing reports, this was not covered in my initial training as the role did not require it.. I would like to have some documentation you can refer to if you are asked to print out reports.

64 Qa reports are useful but they do need enchancement. Users don't take the reports serioulsy because there is no way of linking the data with the subjects. If you could prodcue the subject information when a report is produced it would allow investigation.

66 There should be the facility to generate a report from the Patient Questionnaire.

Case Number General comments about enquires/reports/alerts SSP

24 George on Helpdesk is a fantastic help and his manner is much appreciated within our screening centre 28 In general reports are sufficient and help me plan workload etc. They also give me access to QA info which I find helpful.

30 THE FORMAT IS POOR. FOR INSTANCE IF YOU ASK FOR NUMBER OF POLYPS IT IS A ONE BAR GRAPH. THE NUMBERS OF POLYPS DOES NOT CORRESPOND WITH OUR RECORDS. THE NUMBER OF CANCERS DO NOT CORRESPOND WITH OUR RECORDS IETHER.

40 generally found it very difficult to pull of reports. 47 (Relating to BCSS User guide - I will make myself familiar with this. Not aware of it until now)

113 I use alert cockpit on daily basis & reports on SSP clinics BCSS alert notices / changes are clear & timely

120

an alert would be useful reminding us to fill in A/E form to send to National Office/QA Lead when we fill in adverse event following colonoscopy eg bleed that requires admission on investigation dataset. An alert to show if someone has tried to booked an SSP clinic that has already been set up at the same location with another SSP at the same time. We are sent User Bulletins regarding messages advice from National Office.It would be very useful to have these on the BCSP website in a file as a source of reference for newer centres to look at and as a valuable reminder to mature screening centres.

131 Ask me again in 6 months time when have a bit more experience! 142 I find the nursing reports really interesting and helpful, especially when they flag up incomplete data sets etc.

175 I feel there should be additional training for BCSP managers on how to interpret the reports available - to date there has been no training on this subject. I do not feel the sub team communicate changes or developments within the wider field.


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14. Help Line function

It was assumed that screening centre staff would complete this section, however a few appear to have done so, this probably related to the amount of telephone consultations that SSPs take place – for details of which see the SSP activities section. The table below is provided for completeness.

Valid Cases Missing Percent Percent

How difficult is it to enter data while taking a call 26 14.1% 158 85.9% How often do you take unnecessary phone calls 24 13.0% 160 87.0% Does the BCSS cause unnecessary phone calls 23 12.5% 161 87.5% unnecessary phone calls - leaflets 2 1.1% 182 98.9% unnecessary phone calls - letters 2 1.1% 182 98.9% unnecessary phone calls -test kits 3 1.6% 181 98.4% unnecessary phone calls - appointments 3 1.6% 181 98.4% unnecessary phone calls - dropping out 3 1.6% 181 98.4% unnecessary phone calls - other 2 1.1% 182 98.9%


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15. The national office

This report is only concerned with responses from screening centres (n=184) also it should be noted that not all respondents provided answers to certain questions as can be seen from the total count values in the tables below.

15.1 Quality and amount of communication

Amount of information from the national office

screening centre

Total NOT ssp ssp

not appro. in role Count 9 3 12

% 15.0% 2.6% 6.9%

none given Count 1 1 2 % 1.7% .9% 1.1%

far too little Count 2 7 9 % 3.3% 6.1% 5.2%

too little Count 7 28 35 % 11.7% 24.6% 20.1%

adequate Count 28 47 75 % 46.7% 41.2% 43.1%

good Count 13 27 40 % 21.7% 23.7% 23.0%

more than required Count 0 1 1 % .0% .9% .6%

far too much Count 0 0 0 % .0% .0% .0%


% 100.0% 100.0% 100.0%

Approximately two thirds of respondents felt that amount and quality of information from the national office was adequate or good. Note the disparity in the percentage of whose who felt that it was inappropriate in their role to receive information from the national office, this is a common disparity in the responses to several questions in this section (see below).

Quality of information from national office

screening centre

Total NOT ssp ssp


% 16.4% 3.5% 8.0%

grossly inadequate Count 1 0 1 % 1.6% .0% .6%


adequate Count 27 66 93 % 44.3% 58.4% 53.4%

good Count 19 28 47 % 31.1% 24.8% 27.0%

excellent Count 0 2 2 % .0% 1.8% 1.1%


% 100.0% 100.0% 100.0%

15.2 Good practice guidelines

Ceasing subjects good practice guidelines usefulness

screening centre

Total NOT ssp ssp


% 32.1% 1.8% 11.5%

no use Count 0 1 1 % .0% .9% .6%

little use Count 2 8 10 % 3.8% 7.1% 6.1%

useful Count 24 56 80 % 45.3% 50.0% 48.5%

very useful Count 10 45 55 % 18.9% 40.2% 33.3%


% 100.0% 100.0% 100.0%


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Surveillance good practice guidelines usefulness

screening centre

Total NOT ssp ssp


% 28.3% .0% 9.1%

no use Count 0 0 0 % .0% .0% .0%

little use Count 1 4 5 % 1.9% 3.6% 3.0%

useful Count 24 60 84 % 45.3% 53.6% 50.9%



% 100.0% 100.0% 100.0%

Episode management good practice guidelines usefulness

screening centre

Total NOT ssp ssp

not appro. in role

Count 16 0 16 % 30.8% .0% 9.8%

no use Count 0 0 0

% .0% .0% .0%


% 1.9% 12.6% 9.2%


% 50.0% 48.6% 49.1%

very useful Count 9 43 52

% 17.3% 38.7% 31.9%


% 100.0% 100.0% 100.0%

Exceptions good practice guidelines usefulness

screening centre

Total NOT ssp ssp


% 40.4% .0% 12.9%

no use Count 0 2 2 % .0% 1.8% 1.2%

little use Count 1 18 19 % 1.9% 16.2% 11.7%

useful Count 23 48 71 % 44.2% 43.2% 43.6%



% 100.0% 100.0% 100.0%

"Other" good practice guidelines usefulness

screening centre

Total NOT ssp ssp


% 66.7% 10.3% 37.5%

no use Count 0 2 2

% .0% 6.9% 3.6%


% .0% 6.9% 3.6%


% 18.5% 48.3% 33.9%

very useful Count 4 8 12

% 14.8% 27.6% 21.4%


% 100.0% 100.0% 100.0%


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Case

Number Other good practice guidelines, details Not SSP

58 It would be useful to have regular updates/reminders on all issues 112 Not used 153 good practice guide

159

guidelines regarding who is responsible for assisting people take part in the programme-i.e. if a disabled person requests help is it the hub, the screening centre or someone else? Guidelines for interpreting data-currently i believe each centre/hub can calculate uptake figures/positivity/DNA rates etc. and it would be useful if we all did it the same way so that comparisons can be drawn.

176 what is regarded as normal, how to deal with surveillance requested by the clinicians which does not follow the BSG guidelines e.g. incompletely excised TVAs with severe dysplasia

Case Number Other good practice guidelines, details SSP

14 Bowel preparation generally (including adjustment of diet) and for specific types of patient. General good practice guidance re Diabetics, renal patients etc

35 recent e-mail 28/5/09 re ulcerative colitis including bowel cancer confusing and unmanageable and doesn't make sense against other advice and instruction already received. IBD cases ?symptomatic service or us also comes back to judgement rather than national guidance.

55 No response from relevant people when asking for guidance on issues relating to specific patient problems. No feedback from NO on adverse events. Communication that is sent is agressive and undermining.

111 other disease e.g crohnes, colitis 114 radiology guidelines in general as the guidelines are not clear eg does not state needs to be done within 14 days 115 radiology guidance for all radiological interventions, guidelines are vague as to timeliness etc 165 Mental health capacity Act

15.3 Planned developments for the BCSS

Planned developments for BCSS

screening centre

Total NOT ssp ssp

not appro. in role

Count 11 8 19 % 18.3% 7.2% 11.1%

grossly inadequate

Count 0 4 4 % .0% 3.6% 2.3%


adequate Count 23 59 82 % 38.3% 53.2% 48.0%

good Count 16 24 40 % 26.7% 21.6% 23.4%

excellent Count 1 5 6 % 1.7% 4.5% 3.5%


% 100.0% 100.0% 100.0%

15.4 Regular BCSS newsletter

Usefulness of national newsletter

screening centre

Total NOT ssp ssp

no use Count 3 2 5

% 4.9% 1.8% 2.9%

little use Count 12 11 23 % 19.7% 9.8% 13.3%

useful Count 28 61 89 % 45.9% 54.5% 51.4%



% 100.0% 100.0% 100.0%


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15.4.1 Topics for newsletter

Case

Number topics in newsletter not SSP

64 Changes in policy - update on activity - health promotion idea's. change requests agreed!!

81 Fundraising events that have been done by screening centres. 91 Recent developments/changes

97 Some ideas: Statistics on uptake regionally, no of cancers diagnosed etc Reports generally - what is new especially for commissioning purposes.

138 Problem Column i.e. a Dear George Column !!!!!!!!!!!!!!!!!!! 159 national performance so centres can benchmark. 176 Examples of problems other sites have had with data entry and how to solve them

Case Number topics in newsletter SSP

14 Commonly asked questions of the helpline. Useful tips. National statistics.

28 XXXX keeps us up to date with emails of developments. I see no use in printing a newsletter. Money best spent on other things.

30 HOW TO APPROPRIATELY FILL IN A CANCERDATASET FOR CANCERS IN POLYPS

35

Age extension how this effects patients currently closed-out due to age. How the age extension will be rolled out. how it will effect numbers. Clarity about XXXX e-mail 28/5/09, how exactly can a 'Bowel Cancer' patient be 'run in parallel' with 'symptomatic follow up services' if we are discharging them due to cancer (and they are being seen at 6 + different hospitals?

40 Trouble shooting scenarios 42 usefull conferences/updates relevant to SSP

47 Unusual real life scenarios and with management and outcomes. Latest updates to system - those live and those planned.

53

Roll out Information about other site successes Troubleshooting Unusual Patient pathways Update on current national office initiatives

54

Roll out Information about other site successes Troubleshooting Unusual Patient pathways Update on current national office initiatives

55

When commissioning is to be commenced. What are the developments with certain areas going live. When is roll out to be completed nationally. London wide publicity, what is the plan and latest development. We have been taken over by regional QA centres but we were not told about this before hand. We also would like an update on the progress of how screening is going generally in terms of number of cases, is there a decrease in bowel cancer incidence, are we doing a good job running our centres? Support on the health promotion front would also be greatly appreciated.

60 Planned updates to system including content Progress of change requests/issue notifications Planned developments to the BCSP

72 changes to the system /updates etc

75 idiots guide for SSP's. top 10 most common calls to help desk and how to avoid these

78 Progress towards a national programme, uptake rates and findings - the information IS available elsewhere if you've got time to look for it, but it would be nice to have it in one place

84 updates/changes proposed to the programme, useful tips on example managing surveillance, getting date for QA

92 how the programme is running on a whole? have we affected the statistic's to reduce cancer deaths as planned and how many undiagnosed cancers has the programme picked up to date?

109 opportunities for training updates or on line training. Lists of contacts to call for specific problems Updates on changes to the system and how to manage these changes

111 sharing of useful information 114 We get in the loop regularly 115 We already receive a regular newsletter 'in the loop'. 127 CLEARER GUIDANCE FOR EVERYONE TO FOLLOW AT THE SAME TIME 137 questions and answers for difficult situations


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142 any changes to the system. 147 Never seen it 151 like to hear about new and future improvements and develpements within the bcss and other screening centres 166 Already receiving 'The Loop'.

15.5 General comments

Case

Number Additional comments national office Not SSP

27

I think having to ask national office for details of NHS numbers to do any investigation of alerts is cumbersome Having to fax them is not 100% secure. It is just as easy to dial a wrong number as it is to get a wrong email. Incidentally the helpline will not use fax (opposite to the national office) they will use encrypted nhs mail. Can we have one system please.

33

We do not have a screening centre manager at our screening centre as such. Both myself (as Lead Administrator) and the Lead Practitioner log on as screening centre manager on the system. There is no Lead Administrator role (which requires more access than that of clerk which currently the only other option). Emails and updates are sent depending on your role on BCSS - I sometimes receive information which is important to my role and sometimes I don't (but others in the centre do).

37 It would be very helpful for screening centres to have a regular update of agreed changes circulated this would prevent duplicate INs being submitted.

65 It would be useful to have some feedback on Change Request / Issue Notifications submitted to national office

Case Number Additional comments national office SSP

12 Feedback following suggestions would be a simple, low cost courtesy 14 I would like to know what, if any, national advertising is being planned.

30 SORRY IT ALL SOUNDS NEGATIVE, OVERALL I LIKE THE SOFTWARE AND GRADUALLY OVER TIME IT IS GETTING BETTER. SSPS ARE HOWEVER STUCK TO THIER COMPUTERS FOR A LOT OF THE DAY WHEN THEY COULD BE GIVING MORE TIME TO HEALTH PROMOTION/CANCER PREVENTION/SYMPTOM AWAREWNESS.

40 please evaluate the Liverpool course. consider professional forums and in service development

47 I am not aware of receiving any notifications from National Office. I am not really sure if I have knowledge of all the sources of information that are available. An online handbook of sorts would be good - I am quite new to post and I don't know what I don't know.

55 see above 92 advice from national office for the future plan with moving into PCT land?

109 More contact or visits to discuss any issues / problems 111 Sharing of any different scenarios.

128 Would have valued at least one visit as we were a new screening centre just started out to highlight areas we are doing well and areas we could improve on or need advice on

144 Again as a new centre I have had v. little to do with the national office as yet and have found it difficult to offer an opinion.


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16. Information about respondents

Screening centre respondents indicated that they had one or more of the following roles:

Other role:

Case

Number SC - other role

26 Centre Director 65 Patient Pathway Co-ordinator

163 Received training on Open Exeter but do not

use daily - contact person for Screening Centre

16.1 Topics not covered in questionnaire

Case

Number Optional comments topics not covered - Not SSP

20

Our total of colonoscopies carried each month is always more than the Open Exeter has registered. I find this out when I print off the QA reports for the Consultants. I have been informed this is because the datasets are incomplete, usually awaiting histology results. It would be more accurate if the system could recognise a colonoscopy had been carried out without having to wait for histology to make the figure count.

31 As before I only use a small amount of this system so a lot of this doe not apply to me 37 BCSS is much improved from 3 years ago, changes happen very slowly (although I do understand why!), but this is frustrating. 38 In Patient questionnaires there is no box for 'no sedation', some patients do not have any.

81

I have never had any training on accessing the reports and what information can be retrieved. We are a new screening centre and I am learning as I go on, but I am sure that there are reports that I could use, but don't know how to find them or access them. I especially need a report that gives a percentage of participants with polyps (which we do have a report for) but which breaks the percentage down into 3 separate categories, high, medium and low risk polyps. I am always being asked for this information by surgeons.

132 i have not completed this form fully as i have only been in post a short time and have not had the oportunity to use the system fully. when i have attempted to retrieve data for a report i find this very difficult, especially in respect to the numbers expected for surveillance when capacity planning.

138 Initial Training should include some background to the datasets ideally with Clinical input to the sessions as these are critical to accurate reporting and avoiding ambiguity

176 I think that the BCSP has a large advantage over other cancer screening services in having such a good computer system behind it - it makes life a lot easier for the team

Case Number Optional comments topics not covered - SSP

30 the initial training spent too much time on basics when i needed more time for finding out what was in the datasets. the courses are not available often enough or in enough venues. I missed the last update course and no other day was available in my area.

47

Could we add "Hyperplastic polyp" to the list rather than using "other" and "other". A comment box to add additional information in the investigation data set would be useful. I find the free text box for episode notes difficult. I have noticed that some people add free text to the top of the list and others to the bottom, meaning there is no proper sequence in the end. I have had to export to cut and paste into sequence. We add all information to a data base and reports are generated from that for local site meetings. There must be a way of pulling reports from OE for this purpose. We are a 2 site centre. We each print our own letters. It gets very difficult to know whose letter is in which batch without preparing the batch first. When looking (at the alerts for example) I have to go right into the event list to find out which site the patient was connected with - perhaps the site could be added to the top page i.e. "Screening centre name + site name” Why does the password have to change so often to access OE? None of the other systems in the hospital have such a frequent change. Twice yearly would be great.

55 It is a good system that needs a few adjustments made to it. Since the more recent changes I have found it much more user friendly and helpful in my role.


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77

training was poor, regular updates would be advantageous when a centre first starts. Helpline staff at times appear to have little understanding of the problem you are trying to explain, often better therefore to email the problem. over the past two years options have been available when advancing patients through the system which we have then found out we should not have used, ie patient under alternative screebing programme.

102

I would like to see amendments changed to the current cancer datasets. collating this information is extremely time consuming and often gets left until last. we are expected to gather intricate histological details none of which we have had any formal training in. it is largely left down to how helpful the histologist at your site is in order for you to get some assistance on this. Patients who are treated at our screening centre may be referred to up to five different sites thus making the job of collating the information far more challenging.

125 When you think of the complexity of bowel cancer screening and the number of potential pathways the BCSS system is an amazing achievement that works consistently well.

137 Initial training should have covered the datasets as this is the majority of the input for the SSP`s

16.2 General comments concerning information management

16.3 Length of time worked for BS and Liverpool course undertaken For SSPs:

number of years working for BS

Liverpool course N Mean Std. Deviation Std. Error Mean not undertaken 14 .3571 .49725 .13289

undertaken 90 1.3689 .90127 .09500

There was a significant difference of time in post (t=4.093, df=102, two-tailed p>.0005 ci -1.502, -.521) for those who have and have not undertaken the Liverpool course, indicating that it is targeted appropriately at the new SSPs.

Case Number Optional comments concerning information management - Not SSP

58 Unfortunately, it is difficult to remember all the issues (both positive and negative) unless you are using it at the time so I apologize but there are probably issues not included.

65 It would be useful if we could produce the reports that we require for our particular role.

Optional comments concerning information management - SSP

125

I wish the data reports were a bit more accurate, but this is all work in progress I believe. I am deeply concerned about the number of people working on data mining projects at national, local, hub, screening centre level etc. It all seems like a lot of duplication and wasted expense, there should be a dedicated group at national level who develop a common set of reports that can be run and used by various groups (in a useful data format). At the moment there a multiple groups all developing their own little interfaces a great expense, typical NHS IT strategy!!


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17. Screening Practitioner activities

Screening practitioners where asked on average how many patients do you see a week for +ve fob assessments?

How many patients do you see a week for +ve fob assessments Statistic Std. Error

Mean 8.74 .449 95% Confidence Interval for Mean Lower Bound

Upper Bound 7.85 9.63



Minimum 1 Maximum 24


Skewness 1.188 .226 Kurtosis 1.156 .449

17.1 Pre investigation SSP’s were also asked to indicate what proportion of patients provided them with a adequate medical history, as well as the frequency they used other sources of information to help assess suitability of any subsequent investigation.


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What proportion of patients provide you with a adequate medical history

Medical notes before colonoscopy

GP before colonoscopy

Screening colonoscopist before colonoscopy

gastroenterologist before colonoscopy

non BCSS computer systems before

colonoscopy

other before colonoscopy

Valid 113 111 111 111 109 109 34

Missing 4 6 6 6 8 8 83 Mean 4.88 4.93 2.66 2.61 1.97 2.99 2.12

Median 5.00 (more than half to 3/4) 6.00(< three quarters

but > than half) 2.00 (< ¼) 2.00 (< ¼) 2.00 (< ¼) 2.00 (< ¼) 2.00 (< ¼)

Std. Deviation 1.402 2.048 1.311 .965 .897 1.908 1.200


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17.1.1 Other sources of information

Other sources of information in preparation for their investigation resulted in 28 comments (while grammar has not been edited, incorrect spelling have been.)

id Information source 1 Google 2 other consultants treating the patients 3 Cardiologist,Nephrologist,Diabetic Support Team 4 CARDIOLOGISTS, HAEMOTOLOGISTS,RENAL PHYSICANS 5 hospital specialist the patient is under. 6 renal consultants or cardiologist if patients are currently under their care 7 contacting other health professionals and other hospitals 8 other consultants that may be treating patients elsewhere. 9 other consultants 10 Other specialists e.g. haemotology, neurology, cardiology 11 Cardiologist, Hematologist, Nephrologist 12 other health practitioneers/specialist nurses 13 other specialists from other trusts, if pt outside our home trust. 14 other consultants or specialist nurses 15 advice from other disciplines ie Consultant during active episode of care 16 I ask my manager & colleagues for opinion too 17 diabetic clinic, anticoagulation clinic, haemodialysis unit 18 other hospital specialists such as cardiologists or renal physicians 19 cardiologist, transplant unit, renal unit, specialist hospital 20 we check bloods for EGFR if possible and EMR records 21 Cardiologists 22 specialist consultants i.e. cardiologist , renal 23 Other medical/ surgical consultants / specialist nurses / technicians if they have relevant disease or problems which need further

information or advice sought. 24 occasionally need to write to other Consultants re patients medical conditions, also need to liaise with anti-coag nurses/specialist

diabetic nurses/practice nurses for more info on patients care & management pre colonoscopy 25 Write to Specialist Clinician pending the clinical issue; cardiologist, Renal Physician 26 Specialists, Cardiologists, Haematologists, Nephrologists 27 consultants regarding other medical problems 28 Contacting other hospitals and other health professionals.

17.1.2 Creation of separate records for +ve fob assessment

SSP’s were asked if they created a separate record of the +ve fob assessment in addition to that in the BCSS and if this was in the medical notes.

Create separate record in medical notes of +ve fob assessment Frequency Percent Valid Percent

Valid yes 82 70.1 72.6 no 31 26.5 27.4


Total 117 100.0

Create separate record NOT in medical notes of +ve fob assessment Frequency Percent Valid Percent

Valid yes 77 65.8 68.1 no 36 30.8 31.9


Total 117 100.0

They were also asked how useful would they or did they find the paper medical notes at the +ve fob assessments?

How useful do or would you find paper medical notes at +ve fob

Frequency Percent Valid Percent Cumulative Percent

Valid

little use 5 4.3 4.4 4.4

useful 42 35.9 37.2 41.6

extremely useful 66 56.4 58.4 100.0

Total 113 96.6 100.0

Missing System 4 3.4

Total 117 100.0

Create separate record in medical notes of +ve fob assessment Create separate record NOT in medical notes

Total yes no

yes

Count 54 28 82 % 65.9% 34.1% 100.0%

no Count 23 8 31

% 74.2% 25.8% 100.0%


% 68.1% 31.9% 100.0%


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Respondents were asked if they recorded the reason(s) for colonoscopy cancellation and if so how they recorded it.

The high number of responses for “Recording in BCSS” needs to be investigated as it is the authors belief that the BCSS does not allow the recording of reason for appointment cancellation. Possibly respondents are referring to the use of optional free text comments.

17.2 Communication within hospital Respondents were asked to indicate how adequate they found the local clinical support from the histology/pathology departments colonoscopists as well as their ability to interpret histology/pathology reports.

How adequate local support from histology/pathology Frequency Percent Valid Percent Cumulative Percent

Valid inadequate 7 6.0 6.2 6.2 adequate 23 19.7 20.4 26.5

good 44 37.6 38.9 65.5 excellent 39 33.3 34.5 100.0


Total 117 100.0

How adequate local support from local screening colonoscopists Frequency Percent Valid Percent Cumulative Percent

Valid

inadequate 1 .9 .9 .9 adequate 10 8.5 8.8 9.7

good 35 29.9 31.0 40.7 excellent 67 57.3 59.3 100.0


Total 117 100.0

What proportion of histology/pathology reports can you adequately interpret Frequency Percent Valid Percent Cumulative Percent

Valid

none of them 1 .9 .9 .9 <1/4 2 1.7 1.8 2.7 1/2 11 9.4 9.7 12.4

<3/4 11 9.4 9.7 22.1 >3/4 75 64.1 66.4 88.5 all 13 11.1 11.5 100.0


Total 117 100.0

There was a Significant correlation between adequacy of local histology/pathology and adequacy of local screening colonoscopy support (rs=.267, n=113, p 2-tailed =.004).


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17.3 Use of BCSS during activities SSPs were asked if they entered data directly into the BCSS during various activities and if they had ever shadowed a GP using the computer during the consultation.

shadowed GP using computer in consultation Frequency Percent Valid Percent Cumulative Percent

Valid yes 4 3.4 3.6 3.6 no 108 92.3 96.4 100.0


Total 117 100.0

enter data directly into BCSS during +fob assess. Frequency Percent Valid Percent Cumulative Percent

Valid

none 83 70.9 73.5 73.5 <1/4 3 2.6 2.7 76.1 1/2 1 .9 .9 77.0

>3/4 2 1.7 1.8 78.8 all 24 20.5 21.2 100.0


Total 117 100.0

enter data directly into BCSS during colonoscopy Frequency Percent Valid Percent Cumulative Percent

Valid

none 46 39.3 40.7 40.7 <1/4 1 .9 .9 41.6 <1/2 1 .9 .9 42.5 1/2 4 3.4 3.5 46.0

<3/4 1 .9 .9 46.9 >3/4 10 8.5 8.8 55.8 all 50 42.7 44.2 100.0


Total 117 100.0

enter data directly into BCSS during post invest. consultation. Frequency Percent Valid Percent Cumulative Percent

Valid

none 57 48.7 50.4 50.4 <1/4 3 2.6 2.7 53.1 <1/2 1 .9 .9 54.0 1/2 5 4.3 4.4 58.4

<3/4 4 3.4 3.5 61.9 >3/4 6 5.1 5.3 67.3 all 37 31.6 32.7 100.0


Total 117 100.0

While there is a significant correlation between the level of direct data entry for all activities, possibly the more interesting fact is the clear separation between those who do not use the computer during the activities at all and those that use it most of the time for most activities.

Correlations - Spearman's rho

enter data directly into BCSS during +fob assess.

enter data directly into BCSS during

colonoscopy enter data directly into BCSS during post invest. consultation.


+fob assess.

Correlation Coefficient 1.000 .437** .521**

Sig. (2-tailed) . .000 .000


colonoscopy

Correlation Coefficient .437** 1.000 .418**

Sig. (2-tailed) .000 . .000 N 113 113 113

**. Correlation is significant at the 0.01 level (2-tailed).


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17.4 Post investigation consultations Respondents were asked to indicate how many post investigation consultations they carried out per week, and if there were seen or unseen (such as telephone) consultations.

Average number of patients SEEN for post investigation consultation per week

Average number of patients for post investigation consultation NOT face to face per week

Average number of patients SEEN for post invest. consults.

weekly

Statistic

Std. Error

Mean 2.25 .329 95% Confidence

Interval for Mean Lower 1.60 Upper 2.91

5% Trimmed Mean 1.78 Median 1.00 Variance 10.521

Std. Deviation 3.244 Minimum 0 Maximum 17



Average number of patients not FtF for post invest.

consults. weekly Statistic

Std. Error

Mean 7.49 .503 95% Confidence

Interval for Mean Lower 6.50 Upper 8.49

5% Trimmed Mean 7.08 Median 6.00 Variance 24.497

Std. Deviation 4.949 Minimum 1 Maximum 23



17.4.1 Creation of separate records for post investigation consultations

Respondents were asked if they kept additional paper notes for the post investigation consultations and if they recorded the patient reactions.

what proportion of post invest. consults keep additional paper notes Frequency Percent Valid Percent Cumulative Percent

Valid

none 14 12.0 12.8 12.8 <1/4 2 1.7 1.8 14.7 <1/2 2 1.7 1.8 16.5 1/2 2 1.7 1.8 18.3

<3/4 1 .9 .9 19.3 >3/4 4 3.4 3.7 22.9

all 84 71.8 77.1 100.0 Total 109 93.2 100.0

Missing System 8 6.8 Total 117 100.0

record patients reaction to good/bad news Frequency Percent Valid Percent Cumulative Percent

Valid yes 52 44.4 46.8 46.8 no 59 50.4 53.2 100.0


Total 117 100.0


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17.5 Follow up of patients Respondents were asked if they had further contact with patients after the post investigation consultation, interestingly of those who responded over 50% stated they did have some contact.

Further contact after post invest consult.


Valid yes 60 51.3 54.5 54.5 no 50 42.7 45.5 100.0


Total 117 100.0

17.5.1 Nature of followup

If the respondent indicated that they did have further contact they were offered the opportunity to provide details of the nature of the contact.

Patients diagnosed with cancer - phone the patient the following day. telephone calls Patients are advised to call if they have any queries telephone calls phone calls telephone calls. Telephone call regarding scan dates etc telephone call - visit to ward if for surgery telephone call if patient wants one telephone calls PHONE NUMBER GIVEN IF REQUIRED they are offered the oppurtunity to phone if they think of any other questions Telephone calls some telephone calls if necessary offer our telephone number for them to call, sometimes ring the pt at home to check they are OK, talk to relatives at the pts request either a follow up phonecall or patient telephones especially if it is an unusual diagnosis or cancer To give appointment times of scans etc. telephone calls if patient phones to ask anything NORMALLY VISIT THEM ON THE WARD IF THEY GO FOR SURGERY We offer a post staging results clinic for cancer patients and as the patients get to feel comfortable with you many will contact me post surgery or if the colorectal CNS has not met the patient when having surgery the MDT might ask me to contact the patient will their definitive treatments results if patients are referred to surgeon for further investigation/surgery for non-cancer polyps continue to offer support to some cancer patients and those that go on for further treatment We advise patients to call us for any further problems or queries and we can advise them what to do 30 day telephone call to check that no complications post procedure where experienced During histology report minimal further contact instigated by us as the patients with cancer are refered to a colorectal nurse who arranges CT MRI & MDT information re cancer pathway also some patients like to phone and have the contact with an SSP after hand over Follow-up post CNS at patient request, Point of contact if they're experiencing difficulty Available on phone to those diagnosed with cancer, will contact them with information regarding scans, appointments etc. offered telephone support if they want us to call them. yes depending on results and further treatment or investigations required Are always invited to call back with any questions all patients given given contact number sometimes they require additional support. I would like to be able to call them though


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mostly diagnosed cancer patients They are encouraged to call if they need any advice. to ensure they have recieved scan dates and appointments, and pre and post op if needing surgery as courtesy as we have usually formed a nurse-patient therapeutic relationship. contact details are given if needed but generally no I keep in touch with all MDT patients, usually by phone, but face-to-face is offered if the patient appears confused about detail, upset, or requests it. Patients who receive a result which requires MDT referral are usually called post MDT meeting. Only when needed, we are a point of contact if the patients feel they need to discuss anything further ring patients awaiting surgery to maintain contact patients and relatives are being offered to contact the KCH screening site whenever they have any concerns and further questions (if things are not happening fast enough etc, mainly through telephone calls) Support Group, telephone calls Support Group, telephone calls from cancer patients in particular. occasional phone calls from patients we have handed over in a joint clinic with colorectal CNS teams to answer questions if they have been unable to obtain contact with team .We explain we are available to them even though we have handed over care. Patients occasionally calling us to let them know how they are post surgery. Visit when have surgery if possible and receive some phone calls Tell them can call if any questions or queries after consultation CNS involved at PI if cancer care handed over to nurse specialist Not usually but there have been the odd occasion If significant news broken at PI appt we will often phone patient the following day to enquire how they are, if they have any questions or with information re follow up care. Pts are always informed they can contact us should they wish to do so. SOMETIMES IF IT IS A CANCER DIAGNOSIS, HELP WITH SORTING SCANS ETC.. occasionally if patient has been anxious may follow up with further call, or they may telephone in on helpline Sometimes patients need some sort of follow-up just for advice. But only if patient asks a question which involves me contacting another health care professional Pt's have contact no. and occasionally call with questions. patient focus group for those diagnosed with cancer via screening occasionally if patients want to contact the department I always call patients to reassure and make sure that all is well with them (especially the very anxious patients)


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17.6 Support and training Respondents were asked to indicate the adequacy of the ongoing support for their professional development and communication within the SSP bowel screening community. They were also requested to indicate how well they felt the Liverpool course had prepared them for their role as SSP’s

support for professional development Frequency Percent Valid Percent Cumulative Percent

Valid

none given 3 2.6 2.7 2.7 extremely limited 6 5.1 5.3 8.0

inadequate 9 7.7 8.0 15.9 adequate 34 29.1 30.1 46.0

good 41 35.0 36.3 82.3 excellent 20 17.1 17.7 100.0


Total 117 100.0

Those who selected none (n=16) were removed from the table below. Liverpool course


Valid

extremely limited 7 8.8 8.8 8.8 inadequate 9 11.3 11.3 20.0 adequate 27 33.8 33.8 53.8

good 28 35.0 35.0 88.8 excellent 9 11.3 11.3 100.0

Total 80 100.0 100.0

communication within SSP community Frequency Percent Valid Percent Cumulative Percent

Valid

extremely limited 8 6.8 7.2 7.2 inadequate 13 11.1 11.7 18.9 adequate 29 24.8 26.1 45.0

good 48 41.0 43.2 88.3 excellent 13 11.1 11.7 100.0


Total 117 100.0


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17.7 Other comments The informal comments have been separated into those directly relating to the Liverpool course, those concerning communication, Screening process and a final miscellaneous category.

17.7.1 Liverpool course

I HAVE NOT DONE THE LIVERPOOL COURSE YET I WILL BE STARTING IT NEXT YEAR Liverpool course,although useful,created a lot of stress due to the extent of work needed to submit. More national guidelines on bowel prep and diabetic management would be useful as there appears to be lots of discrepancies when liaising with other Screening Centres. have only been doing SSP since XXX 2009 and have not yet undertaken Liverpool course. Have felt I have had excellent support from SSP's in other areas, particularly XXX. HAVE JUST COMPLETED THE LIVERPOOL COURSE WHICH WAS EXTREMELY INFORMATIVE, BUT I NOW APPEAR TO HAVE LIMITED CAREER OPPORTUNITIES WITHIN BOWEL SCREENING.

have not done liverpool course as on secondment only I have not attended Liverpool course yet. Lead Nurse to SSP for our division is slow in replying to emails and as yet none of us here have met her.

I haven't done the Liverpool course yet as I am only on secondment.

I've indicated NONE for the JMU course - I've yet to be able to take part. Parts of the course were very useful i.e. histology interpretation and development of cancers. However it is very difficult to pitch the course to everyone as some have nursing background yet others may not. Generally i thought the course was basic and i didnt really gain a great deal on new knowledge. I don't feel that the SSP course in Liverpool was particularly helpful, mainly because I had been in post for 18 months prior to being able to start it. I also had previously had 6 years experience working within 2 endoscopy departments and a lots of the course content was endoscopy related, making a lot of the content irrelevant. I also felt that the course was overloaded with paper work and competencies, which I don't feel can prove you are able to do the job properly. I believe the money spent on sending an SSP to the Liverpool course would be better spent sending an assessor to observe and question an SSP in clinical practice. I have only been in post 8 months so relatively new to the programme, and i am due to start the John Moores course in September this year

I am about to start the Liverpool course in September 09 as there was no availability when I should have taken it in March 09

Have not yet done screening course as had to cancel due to illness.

have not been on liverpool course so cant comment on above question The Liverpool course offers the opportunity for SSPs to exchange ideas and build a support network. However, the content of the course was of limited use to me and the required assignments both very time consuming and academically unstimulating. I think the more junior SSPs may find it more useful but maybe there should be alternate routes through the course dependent on prior qualifications and level of experience. I have been given advice on the Liverpool course from those who have attended, and apart from pathology, other lectures are not helpful to those SSP's who have worked in Endoscopy for over two years and who have already attained Degree level. I found the John Moore SSP Course interesting and useful. The over riding benefit being the interaction with other SSPs and learning about the way they work and realise they have similar problems. HOWEVER, the amount of work it entailed had a huge impact on my life. It is difficult enough to keep on top of the day to day work as an SSP within my contracted hours and I and my colleagues regularly work unpaid overtime. On top of that the extra work for the course became almost unbearable. It was very stressful and all consuming, in particular I found the portfolio a huge waste of time and a'tick box' exercise that caused me a lot of hassle. The case studies were fine and in fact I found great benefit from critically looking at care given. Whilst it is recommended that staff are given study time I think this is just lip service because in practice this does not take place (and I think JMU and National are probably fully aware of this). Even if managers are in agreement that time can be taken, the workload means that time is just not available so basically the whole thing is done at weekends and late into the evening. This impacted on my home life, I lacked sleep and I felt as though my social life was completely 'on hold' Would be motivating to have the Liverpool course have option on masters or degree level. essential for some of us who have degrees already I met other SSPs at the Liverpool course and developed a good relationship and network since then. We have kept in touch via phone and e-mails and helped sort out various queries about situations that arise within our various screening centres. Standardize the amount of study time to be given when undertaking the BCSP course as some students got lots and others got none, very unfair. Maybe more regional meetings for SSP's to get together as this is an excellent learning opportunity to share ideas.

I have been in post as an SSP for 1 year but the next available space for me on the Liverpool course is not until January 2010.


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17.7.2 Communication

we have had no lead nurse for a long time in this area, info is often not disseminated other than from regional QA meetings, I personally dont see the minutes from the user group meetings so often feel out of touch with what is going on preferably a lead nurse should have been in place before the screening centre went 'live' and the lead nurse therefore should have completed the liverpool course in order to facilitate/support the rest of SSPs to a high standard It is a national programme but the role of the SSP across the country does not appear to be standardised? More hub centred focus groups would help with "networking" between all the different groups SSPs admin etc. more opportunity to lesion with other groups on an informal/formal basis. SSPs I feel as a group are very isolated with little in the way of mutual support or career development. If I need information I do have SSP's I can contact for advice via e-mail but I feel there should be at least annual meetings so we can ensure all SSP's are working towards the same outcome/goals. It is always good to network and get feedback from other centres to see how they are working.

Regular meetings with other local SSPs would be a useful forum

There needs be to a formal system of networking at relatively local level. Patients with malignant polyps completely excised get very little if any support. If they don't go on to need surgery colo-rectal nurses dont always get involved as they have large number of patients who are to have surgery to concentrate on. When these patients come back on symptomatic service for check colonoscopy in a years time it can be done by any doctor thus continuity for patient is non existent. Also when they are approaching their follow up colo they often ring SSP to find out when it will be as ours is the only contact number they have. I feel we should keep these type of patients within screening as it does feel rather like they have been abandoned because of cancer diagnosis discharged from screening but no further treatment other than colo followup is required. Once we diagnosed cancer, we pass the care to the surgical team. this is the time we do not have contact with the patient and it is hard to have no further communication with patient.

We are very fortunate in the XXX hub because we regularly have regional SSP meetings. Would be useful to meet up with other SSPs, to discuss on going role, we have organised a local group meeting of SSPs as a support mechanism for ourselves We currently have no Regional Nurse lead for our area, and I feel this limits our communication & updates re BCS Our Nurse Lead has a dual role (nurse endoscopist) and does not do the day to day role of an SSP ie. clinics,screening lists, admin, her role is very much supervisory, she is not based in our office, again this makes things very difficult... I would have thought a Nurse Lead should be based with the SSPs to appreciate the role and demands of the service, and to fill in for clinics and lists as required More guidance as to the completion of the datasets-particularly as we are new to the programme .The questions asked are sometimes ambiguous and sometimes there is not an obvious entry in the drop down box

Regional SSP support groups would be very useful

I receive good support from SSP's within our screening centre and occasionally ask advice from other centres. we are isolated and not involved in the larger community due to the lack of a regional lead, we are not kept informed/or the information is not being filtered down, the only communication is the newsletter. Ongoing educational needs have to be met by the SSP themselves at there own cost, such as BSc and MSc and oncology courses. I have instigated regular meetings for SSP and admin staff to try to alleviate the sense of isolation that can be felt in some centres. The feedback has been very positive. This helps feedback issues from Nat Office but also feedback issues from the ground up.I have provide training on histology related to cancer audit datasets and Investigation datasets by using QA Lead histopathologist due to demand I facilitate 3 monthly meetings in various locations around the SHA to allow equal access. With other senior SSP's I have supported staff undergoing the LJMU viva. I try to visit 2 centres a month. web based SSP forum formal post evaluation of SSP Liverpool course An SSP website as sub division of the BCSS websitewould be useful with a forum, exemplar cases, knowledge base with where user load up paper work, care plans, good practice guides etc. Also some e-learning packages for BCSS, histopathology etc. Calender for events, contact details, liverpool information etc.


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17.7.3 Screening process

I think it would be useful to have some of the open exeter training after being in post for a few months or so, as there are a lot of questions that get raised when having to move patients along pathways. Not every patient is straight forward. We do not always have access to a computer whilst in clinic - this would be useful for some things, however I couldn't enter data at the same time as talking to the patient.

more options for different languages post procedure/letter to patient when episode closed Health promotion ideas that are put to the publishers to be approved should all be on the BCSP site so everyone can access them rather than everyone creating there own. We can learn from each other and share ideas and resources, this would save a lot of time and effort

more letters aloud in the events, and stop anyone from deleting someone else's entry For a national programme, it is surprising that screening centres are not more standardised. It has taken us this first year to realize that other centres have been using other data collection systems for audit and data retrieval because the BCSS doesn't allow for it. We did not know we would need to do this and have ended up doing vast trawls through notes etc to get info for meetings etc. It has been frustrating to try and produce publicity material only to discover that another centre has a raft of material which has not been put onto the BCSP web site - since everything has to go through national office, it would be helpful if more was shared. As a national programme and a process in it's own entity, a universal bowel preparation would be helpful for SSP's as well as patients who may move around different screening centres throughout their screening time. As autonomous practitioners running a service, there should be more uniformity throughout the BCSP as this would make sure that standards and expectations were the same nationwide and SSP's would be able to provide a more seamless service to patients. Regarding paper based assessments in clinic I personally feel are vital with the level of anxiety we experience from the patients who attend. I would feel uncomfortable inputting directly onto the BCSS . Our communication and bond is unique and based on eye contact and running the SSP session is entirely different from patient to patient addressing their needs from the consultation as well as our need for information .My personal experience of sitting with a GP /Practice nurse is one of computer focus rather than patient focus.


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17.8 Length of time working for BC, satisfaction and workload The possible relationship between the number of years a SSP was employed with the Bowel Screening program and various other measures was investigated. Those who have not undertaken the Liverpool course were excluded from the analysis below.

Firstly, considering the length of time with the Bowel screening program and aspects of satisfaction.

Spearman's rho correlations number of years working for BS

support for professional development

Liverpool course satisfaction

communication within SSP community

Overall satisfaction


Correlation Coefficient .037 -.143 -.004 -.136

Sig. (2-tailed) .753 .223 .976 .249 N 74 74 73 74

support for professional development

Correlation Coefficient .407** .493** .492**

Sig. (2-tailed) .000 .000 .000 N 80 79 79

Liverpool course satisfaction

Correlation Coefficient .304** .394**

Sig. (2-tailed) .006 .000 N 79 79

communication within SSP community

Correlation Coefficient .367**

Sig. (2-tailed) .001 N 78

While the length of time working for the BCSS for SSPs does not correlate with any of the above satisfaction aspects it is interesting the note that satisfaction with both the Liverpool course, communication within the SSP community and overall BCSS system satisfaction are significantly correlated.

Secondly, the possible relationship between the length of time working for the bowel screening program and workload was considered. Workload was measured as the average number of patients seen per week for +ve fob assessments, post investigation consultations face to face and also not face to face. While there was no correlation between length of time working for the bowel screening program and any workload measure, there was a highly significant positive correlation between number of patients seen for +ve fob assessments and number of non face to face post investigation consultations, but only slightly for face to face (FtF) consultations, however controlling for post investigation non FtF consultations this increased.

Correlations

how many patients do you see a week for +ve fob assessments

average number of patients SEEN for post invest. consults. weekly

average number of patients not FtF for post invest. consults. weekly


Pearson Correlation .254* .170 .187 Sig. (2-tailed) .030 .167 .130

N 73 68 67 how many patients do

you see a week for +ve fob assessments

Pearson Correlation .264* .683** Sig. (2-tailed) .025 .000

N 72 71 average number of patients SEEN for

post invest. consults. weekly

Pearson Correlation -.022 Sig. (2-tailed) .855

N 70

*. Correlation is significant at the 0.05 level (2-tailed). **. Correlation is significant at the 0.01 level (2-tailed).

Partial Correlation Control Variable: average number of patients not FtF for post invest.

consults. weekly how many patients do you see a week for +ve fob

assessments average number of patients SEEN for post invest.

consults. weekly

how many patients do you see a week for +ve fob assessments

Correlation 1.000 .386 Significance (2-

tailed) . .001

df 0 66

average number of patients SEEN for post invest. consults. weekly

Correlation .386 1.000 Significance (2-

tailed) .001 .

df 66 0


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18. Variability within and between screening centres

While much of the analysis in this document has assumed that each respondent’s response is independent this may not necessarily be the case as screening practitioners and administrators work closely together within screening centres. To take this into account a statistical technique called multilevel modelling has considered.

A cursory analysis of the overall satisfaction scores for each centre demonstrated a statistically significant difference between them (Kruskal Wallis, chi square 84.035 df=46, p<.001) when the possible correlation between responses within screening centres was ignored. However it should be noted that 12 out of the 47 screening centres contributed 3 or less valid overall satisfaction scores (table opposite). Considering this constrained model that is where 𝛿𝛿𝑢𝑢0

2 = 0 which is the equivalent to the above single level model with only an intercept term the resulting −2𝑙𝑙𝑙𝑙𝑙𝑙𝐿𝐿2=543.519 (158 cases) value can be used to compare it with the value obtained from the model which considers screening centre to be a random level 2 parameter, and allows for correlated responses. This yields the likelihood ratio test value of 543.519 -527.255=16.264 which has a chi squared distribution with 1 degree of freedom (p<.0001) which is highly significant. Given this result we can conclude that there is a statistically significant difference between overall satisfaction scores between screening centres. Details are provided in the box below.

The mean of overall satisfaction (i.e. tohappy2) across all screening centres is estimated as �̂�𝛽0 = 6.087 with a standard error of 0.152. The means for the different screening centres are distributed about their overall mean with an estimated variance of 𝜎𝜎�𝑢𝑢2 = 0.504 this is the variance across screening centres. In contrast the variance between respondents within screening centres is estimated as 𝜎𝜎�𝑒𝑒2 = 1.324

N overall satisfaction

Mean Std. Deviation Std. Error 95% Confidence Interval for Mean

Minimum Maximum Lower Bound Upper Bound

1 6 4.6032 .53593 .21879 4.0407 5.1656 4.05 5.48

2 5 7.0476 1.03236 .46168 5.7658 8.3295 5.95 8.33

3 2 7.0238 2.18866 1.54762 -12.6406 26.6882 5.48 8.57

4 5 6.6190 1.02961 .46045 5.3406 7.8975 5.24 7.86

5 3 5.8730 .54986 .31746 4.5071 7.2389 5.24 6.19

6 5 7.3810 1.57035 .70228 5.4311 9.3308 5.95 9.76

7 6 5.5952 1.13439 .46311 4.4048 6.7857 4.76 7.38

8 3 6.5873 1.54914 .89440 2.7390 10.4356 5.00 8.10

9 6 4.6825 1.16318 .47487 3.4619 5.9032 3.57 6.90

10 4 5.4167 1.15625 .57813 3.5768 7.2565 4.29 6.90

11 2 6.7857 1.17851 .83333 -3.8028 17.3742 5.95 7.62

12 7 6.6327 .82968 .31359 5.8653 7.4000 5.48 7.62

13 2 7.5000 .50508 .35714 2.9621 12.0379 7.14 7.86

14 1 7.1429 . . . . 7.14 7.14

15 3 5.0000 .85846 .49563 2.8675 7.1325 4.29 5.95

16 2 4.7619 .00000 .00000 4.7619 4.7619 4.76 4.76

17 1 4.0476 . . . . 4.05 4.05

18 6 7.5000 .99602 .40663 6.4547 8.5453 6.19 8.57

19 4 6.9643 1.15625 .57813 5.1244 8.8041 5.24 7.62

20 2 3.9286 1.51523 1.07143 -9.6852 17.5424 2.86 5.00

21 4 7.3810 .43470 .21735 6.6892 8.0727 6.90 7.86

22 6 5.6349 1.61951 .66116 3.9353 7.3345 2.62 6.90

23 3 6.7460 .54986 .31746 5.3801 8.1120 6.43 7.38

24 3 6.6667 2.14286 1.23718 1.3435 11.9898 4.52 8.81

25 5 6.5714 1.12435 .50283 5.1754 7.9675 5.24 7.62

26 4 6.3095 1.31133 .65566 4.2229 8.3961 5.00 7.86

27 4 5.3571 1.23718 .61859 3.3885 7.3258 4.05 6.90

28 3 5.3968 .68732 .39683 3.6894 7.1042 5.00 6.19

29 4 5.7738 .91957 .45979 4.3106 7.2371 4.76 6.67

30 1 4.5238 . . . . 4.52 4.52

31 5 6.5238 1.66326 .74383 4.4586 8.5890 3.81 8.10

32 3 5.2381 .41239 .23810 4.2137 6.2625 5.00 5.71

33 4 6.2500 1.26549 .63275 4.2363 8.2637 4.76 7.86

34 4 6.4286 .58321 .29161 5.5006 7.3566 5.71 7.14

35 3 7.2222 2.40857 1.39059 1.2390 13.2054 5.71 10.00

36 5 6.8095 1.22104 .54606 5.2934 8.3256 4.76 7.86

37 6 5.8333 1.23947 .50601 4.5326 7.1341 4.52 7.38

38 4 4.9405 1.08892 .54446 3.2078 6.6732 3.81 6.19

39 3 4.2063 .49563 .28615 2.9751 5.4376 3.81 4.76

40 2 6.0714 .50508 .35714 1.5335 10.6094 5.71 6.43

41 5 7.0476 .94641 .42325 5.8725 8.2227 5.48 7.86

42 2 5.1190 .16836 .11905 3.6064 6.6317 5.00 5.24

43 2 4.7619 .33672 .23810 1.7366 7.7872 4.52 5.00

44 2 6.7857 2.18866 1.54762 -12.8787 26.4501 5.24 8.33

45 8 6.1310 1.07048 .37847 5.2360 7.0259 4.76 7.86

46 4 4.1667 .74027 .37013 2.9887 5.3446 3.33 5.00

47 5 6.0952 1.04599 .46778 4.7965 7.3940 4.76 7.62

Total 179 6.0615 1.37384 .10269 5.8588 6.2641 2.62 10.00


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To investigate the proportion of variance between and within screening centres we will use the variance partition coefficient.

The variance partition coefficient (VPC) also known as the intra-class correlation gives an indication of the similarity between respondents in the same screening centre. It can also be interpreted as the proportion of the total residual variation that is due to differences between groups i.e. screening centres. (Goldstein 2003)

𝜎𝜎𝑢𝑢02

𝜎𝜎𝑢𝑢02 + 𝜎𝜎𝑒𝑒2

= 0.504

0.504 + 1.324 = .2757

In other words about a quarter of the total variance in overall satisfaction with the BCSS can be attributed to differences between screening centres, indicating that three quarters of it is at the individual response level.

The above multilevel analysis was carried out using the MLwiN software version 2.10.

References

Goldstein H 2003 Multilevel statistical models. London: Arnold, 3rd edition.


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19. Appendix A – Questionnaire

Bowel Cancer Screening System (BCSS) and Information Management

How often do you have problems logging onto the BCSS? (Please fill in one bubble)

General Performance

<-- more frequent less frequent -->

More than daily daily weekly monthly 3 monthly yearly never

far too slow too slow adequate good excellent

grossly inadequate inadequate adequate good excellent


strongly disagree disagree neutral agree strongly agree





very unhappy unhappy neutral happy very happy

Please provide below any additional information you feel would be useful, concerning the above questions.

How would you rate overall response time (screen refresh) for viewing subject/patient information? (Please fill in one bubble)

How would you rate the adequacy of the menu system in the BCSS? (Please fill in one bubble)

How would you rate the ease of navigation between screens in the BCSS? (Please fill in one bubble)

The BCSS contributes to my job satisfaction . . (Please fill in one bubble)

The BCSS reduces my productivity . . (Please fill in one bubble)

The BCSS is easy to use . . (Please fill in one bubble)

The BCSS is a source of stress in my job . . (Please fill in one bubble)

How adequate is the BCSS in supporting the tasks you undertake in your job? (Please fill in one bubble)

How happy are you with the BCSS? (Please fill in one bubble)

Confidentiality All information in this questionnaire will be treated in strict confidence. You, the respondent, will not be named in any results produced internally or published, nor will un-anonymised information be provided to any NHS employee/ department or any other organisation. Your anonymity is assured. The accompanying email/letter provides further details. This questionnaire should be completed online and returned by email, using the button on the last page. Only as a last resort should it be printed out and posted back to Claire Nickerson at the National office. Many thanks for your continued support in this project Robin Beaumont [email protected]

If you selected one of these four options please answer the questions in the shaded area below



If you answered `3 monthly to never' please ignore the shaded area

Are the systems: Please fill in all boxes that apply)

Computer based paper based other (please specify):

How often do you get asked for information/data from the BCSS? (Please fill in one bubble)



Who requests this information/data from the BCSS? (Please fill in all boxes that apply)

If you selected one of these four options please answer the questions in the shaded area below

Any additional information:

Colorectal surgeons + MDT PCT Screening endoscopists SSP's Hub The national office

other (please specify):

How often do you find it is necessary to manually copy i.e. onto paper or by 'cut and paste', information in the BCSS? (Please fill in one bubble)

What proportion of requests are considered to be appropriate, that is an attempt is made to provide the data? (Please fill in one bubble)

If you answered `3 monthly to never' please ignore the shaded area

extremely easyeasymanageabledifficultextremely difficultimpossible

none of them about a quarter about half about three quarters about all of them

How easy is it to provide the data for appropriate requests? (Please fill in one bubble)

Optionally please list below up to five positive and negative (e.g. problems) aspects of the BCSS you feel we should know about:

Negative feature (problem) RankCurrent useful feature Rank

Please provide below any additional information you feel would be useful, concerning the above questions. Please rank the above features/problems from 1=greatest to 5=smallest

BCSS Support/Training How would you rate the following support aspects of the BCSS? (Please fill in one bubble)

support aspectnone given or not

usedvery poor poor adequate good excellent

initial training

ongoing training

user groups

CfH help desk

documentation

BCSP web site

non-existent beginner intermediate advanced professional

very inadequate inadequate adequate above that required

yes no

yes no

KnowledgeHow would you rate your own computer knowledge/skills? (Please fill in one bubble)

Considering your current role, do you feel your level of computer knowledge and skills are: (Please fill in one bubble)

Would you like additional IT training outside of the BCSS system (e.g Microsoft office or general IT)? (Please fill in one bubble)

Would you like additional IT training for the BCSS system? (Please fill in one bubble)

DocumentationDo you have access to the BCSS user guide. (Please fill in one bubble)

yes no - please ignore the shaded area below

If you selected 'yes' please answer the questions in the shaded area

below

How useful do you find the documentation as a . . (Please fill in one bubble for each row)

not appropriate in my role

not at all

little use useful extremely

useful

General introduction to the BCSS

Definitive reference to the BCSS

'How to do it' for a specific task in the BCSS

Guide as to where to get any additional sources of help

How do you find the LANGUAGE of the documentation? (Please fill in one bubble)

incomprehensible extremely difficult difficult manageable clear excellent

How do you find the FORMAT / LAYOUT of the documentation? (Please fill in one bubble)

incomprehensible extremely difficult difficult manageable clear excellent

Have you used any locally produced documentation to help you use the BCSS. (Please fill in one bubble)

yes no

Ongoing Support for the BCSS

Have you personally paid for any training for the BCSS? (Please fill in one bubble)

yes no

not used it grossly inadequate inadequate adequate good excellent

yes no

yes no

extremely unreliable unreliable adequate good excellent

yes no

yes no don't know

none given extremely limited limited adequate good excellent

yes (please specify below) no

Overall how would you rate the CFH Help desk with regard to the BCSS? (Please fill in one bubble)

If you selected any of these options please answer the questions in the shaded area below

Are you ALWAYS provided with a named individual? (Please fill in one bubble)

Are you ALWAYS provided with a call log number? (Please fill in one bubble)

How reliable is the help desk in getting back to you? (Please fill in one bubble)

Would you like to see any enhancements/changes to the current service such as online access to update reports and knowledgeable first line support? (Please fill in one bubble)

Are you asked to prioritise the problem? (Please fill in one bubble)

Do you feel that the prioritisation is appropriate? (Please fill in one bubble)

How helpful is the resolution? (Please fill in one bubble)

Suggested EnhancementsIf you could wave a magic wand what improvements/changes would you make to the BCSS? You have up to five wishes.

Please rank the above from 1=most important to 5=least important

Wish Rank

Enquiries/Reports/AlertsHave you ever used either on screen, or paper based (pdf's), enquires/reports and alerts produced by the BCSS? (Please fill in one bubble)

no - please ignore the shaded area below yes

If you selected 'yes' please answer the questions below

The Information presented in the BCSS enquiry/report/alert generally is . . .? (Please fill in one bubble for each row)

Information aspect Don't understand

question

Incomplete

Irrelevant

Out of date

Far too fragmented/aggregated

Unclear

Inaccurate

Far too much

Far too little

Poorly formatted

complete

relevant

accurate

up to date

correct level of aggregation

clear

correct amount

correct amount

correctly formatted

If you have any comments about specific reports/alerts or suggestions for new ones, please add them below?

report name comments qualitybad good

Please add any additional general comments about the enquiries/reports/alerts below:

Hub Help Line StaffOnly if you personally work as a helpline advisor/manager please answer the questions on this page

How difficult do you find it to enter data while taking a call? (Please fill in one bubble)

extremely difficult difficult manageable easy extremely easy

How often do you feel you receive avoidable phone calls from subjects/patients? (Please fill in one bubble)



Are there any features of the BCSS that causes the generation of unnecessary phone calls? (Please fill in one bubble)

Do you personally MANAGE helpline staff? (Please fill in one bubble)

yes no

If you selected 'yes' please answer the questions in the shaded area

below

Please add any positive or negative comments you may have concerning the BCSS and how it relates to your management of the help line staff?

no - please ignore the shaded area below yes

negative comments: positive comments:

In your role as a help line MANAGER, please make any additional comments below:

leaflets

letters

test kits

other: (please specify)

If you selected 'yes' please answer the questions in this green shaded area

the phone calls relate to . . .? (Please fill in one bubble for each row

appointments

dropping out of the program

none of them about a quarter about half about three quarters about all of them proportion of avoidable calls:

The National Office

How would you rate the AMOUNT of communication you have received from the National office? (Please fill in one bubble)

Not appropriate in my role

none given

far too little too little adequate good more than

required far too much

How would you rate the QUALITY of communication you have received from the National office? (Please fill in one bubble)

Not appropriate in my role grossly inadequate inadequate adequate good excellent

Not appropriate in my role grossly inadequate inadequate adequate good excellent

no use little use useful extremely useful

How useful would you find national guidance (including good practice guidelines) concerning: (Please fill in one bubble per row)

Optionally, please list below any topics or titles you would particularly like to see in such a newsletter:

Optionally, please add below any additional comments you feel would be useful to the National Office:


usefulness: no use useful very usefullittle usenot appropriate in my role

ceasing subjects

surveillance

episode management

exceptions (e.g. constipation etc)

How would you rate the communication from the National office concerning planned developments/timetable for the BCSS? (Please fill in one bubble)

How useful would you find a regular BCSS newsletter: (Please fill in one bubble per row)

Please type in the number of years you have worked for the Bowel Screening program (enter zero '0' if it is less than one year)

All the information in this questionnaire will be treated in strict confidence. You, the respondent, will not be named in any results produced internally or published, nor will un-anonymised information be provided to any NHS employee/ department or any other organisation. The accompanying email/letter provides further details. Your anonymity is assured. Why collect your name and email address? This is to prevent you from receiving duplicate questionnaires and additional emails requesting you to complete the questionnaire. At the end of the data collection period, all personal details including names and email addresses will be destroyed before data analysis begins.

The following, final two pages of this questionnaire has been developed in collaboration with a number of SSP's to help understand more fully how you use the BCSS

My current role involves? (Please fill in all bubbles that apply)

Working at a Hub . . .

Working at a Screening centre . . .

reading test kits managing test kits Help line staff Help line manager

hub manager Hub data management/analysis Hub administration


Screening practitioner performing colonoscopies Screening nurse managment

Screening centre manager

Screening centre data management/analysis

Screening centre administration


Working at the national office


Information about you

Please add any additional general comments about the BCSS that you feel have not been covered in the questionnaire:

Please add any additional general comments about INFORMATION MANAGEMENT that you feel has not been covered below:

Optional additional comments

Last Name

First NameYour work email:

Screening Practitioners (SSP's)

Do you record reason(s) for colonoscopy cancellation? (Please fill in all boxes that apply)

Because the BCSS provides information about the number of patients not progressing to colonoscopy (unfit, refusal and dissented) it is not necessary to ask questions about this aspect.

On average how many patients do you see a week for +ve fob assessments?

none of them less than a quarter

quarter to less than half about half more than half

to three quartersmore than three quarters but not all

all of them

yes no

yes no

no use little use useful extremely useful

No- I do not record it Yes - I record it in:

BCSS paper notes Excel spreadsheet

local database other (please specify):

Do you create a separate record, in the medical notes of the +ve fob assessment? (Please fill in one bubble)

Do you create a separate record, other than in the medical notes or the BCSS, of the +ve fob assessment? (Please fill in one bubble)

How useful do you, or would you find the paper medical notes at the +ve fob assessments? (Please fill in one bubble)

What proportion of patients provide you with an adequate medical history, i.e. one that means you do not need to obtain additional information? (Please fill in one bubble)


How adequate do you find the support from the local screening colonoscopists? (Please fill in one bubble)


<-- low high -->

Information source: none all

GP

screening colonoscopist

gastroenterologist


Computer systems (not BCSS)

quarter to less than half

about half

more than half to three quarters

more than three quarters but not all

less than a quarter

For what proportion of patients do you use the following sources of information in preparation for their investigation? That is associated with the +ve fob assessment appointment but before the colonoscopy (Please fill in one bubble for each row)

medical notes

How adequate do you find the local clinical support from the histology/pathology department? (Please fill in one bubble)

What proportion of histology/pathology reports can you adequately interpret? (Please fill in one bubble)




all of them

<-- low high -->

OR

Screening Practitioners (continued)

yes no

Have you ever shadowed a GP using a computer in consultations? (Please fill in one bubble)

During an average week how many patients do you SEE, for post investigation consultations?

During an average a week how many post investigation consultations are NOT face to face (e.g phone, email etc)?

activity: none all

colonoscopy/ investigation

post investigation consultatation

quarter to less than half

about half

more than half to three quarters

more than three quarters but not all

less than a quarter

DURING the following activities, for what proportion, do you enter data directly into the BCSS? (Please fill in one bubble for each row)

+ve fob assessment

For what proportion of POST investigation consultations do you keep additional paper notes? (Please fill in one bubble)




all of them

<-- low high -->

Do you routinely record the patients reactions to receiving bad/good news in the post investigation consultation? (Please fill in one bubble)

yes no

yes (please specify): no

none given extremely limited inadequate adequate good excellent



Do you have any further contact (e.g. telephone calls, support groups, counselling etc.) with patients after the post investigation consultation? (Please fill in one bubble)

How well do you feel you are being supported in your ongoing professional development as a SSP? (Please fill in one bubble)

How well do you feel the Liverpool course prepared you for your role as a SSP? (Please fill in one bubble)

How good would you say the communication is within the bowel screening practitioner (SSP) community? (Please fill in one bubble)

Optionally In your role as a SSP, please make any other additional comments you feel would be helpful below:

Many thanks for taking the time and effort to complete this questionnaire

Now please return the completed questionnaire by clicking on the 'e-mail back' button e-mail back

BCSS + information management questionnaireScreening centre analysis – Appendix B

Appendix B Page 1 of 17

Miscellaneous SPSS Syntax variable labels v1 "filename" /q1 "How often do you have problems logging onto the BCSS" /q2 "overall response time" /q3 "menu system" /q4 "Ease of navigation between screens" /q5 "Contributes to job satisfaction?" /q6 "reduces productivity" /q7 "easy to use" /q8 "source of stress" /q10 "Supporting tasks in job" /q11 "happy with BCSS" . VALUE LABELS q1 01 "more than daily" 02 "daily" 03 "weekly" 04 "monthly" 05 "3 monthly" 06 "yearly" 07 "never" / q2 01 "far too slow" 02 "too slow" 03 "adequate" 04 "good" 05 "excellent" / q3 01 "grossly inadequate" 02 "inadequete" 03 "adequate" 04 "good" 05 "excellent" / q4 01 "grossly inadequate" 02 "inadequete" 03 " adequate" 04 "good" 05 "excellent" / q5 01 "strongly disagree" 02 "disagree" 03 "neutral" 04 "agree" 05 " strongly agree" / q6 01 "strongly disagree" 02 "disagree" 03 " neutral" 04 "agree" 05 "strongly agree" / q7 01 "strongly disagree" 02 "disagree" 03 "neutral" 04 "agree" 05 " strongly agree" / q8 01 "strongly disagree" 02 "disagree" 03 "neutral" 04 "agree" 05 " strongly agree" / q10 01 "grossly inadequate" 02 "inadequete" 03 " adequate" 04 "good" 05 " excellent" / q11 01 "very unhappy" 02 "unhappy" 03 "neutral" 04 "happy" 05 "very happy" . COMMENT ** Page 2 below variable labels q13 "how often copy data" /q14_a "computer based system" /q14_b "paper based system" /q14_c "other type of system" /Txt_q14c "other type of system details:" /q15 "How often asked for information" /q16a "Colorectal surgeons + MDT requests for data" /q16b "PCT requests for data" /q16c "Screening endoscopists requests for data" /q16d "SSP's requests for data" /q16e "Hub requests for data" /q16f "National office requests for data" /q16g "Other requests for data" /txt_q16 "other people that request data:" /q17 "What percentage considered appropriate?" /q18 "How easy t provide data for appropriate requests?" /q19u1 "Current useful feature 1" /q19u1r "Rank of current useful feature 1" /q19n1 "Current negative feature 1" /q19n1r "Rank of current negative feature 1" /q19u2 "Current useful feature 2" /q19u2r "Rank of current useful feature 2" /q19n2 "Current negative feature 2" /q19n2r "Rank of current negative feature 2" /q19u3 "Current useful feature 3" /q19u3r "Rank of current useful feature 3" /q19n3 "Current negative feature 3" /q19n3r "Rank of current negative feature 3" /q16u4 "Current useful feature 4" /q19u4r "Rank of current useful feature 4" /q19n4 "Current negative feature 4" /q19n4r "Rank of current negative feature 4" /q19u5 "Current useful feature 5" /q19u5r "Rank of current useful feature 5"

/q19n5 "Current negative feature 5" /q19n5r "Rank of current negative feature 5" /Txt_q20 "Additional information". COMMENT ** Now the value labels VALUE LABELS q13 01 "more than daily" 02 "daily" 03 "weekly" 04 "monthly" 05 "3 monthly" 06 "yearly" 07 "never" / q14_a 01 "computer based system" / q14_b 01 "paper based system" / q14_c 01 "other type of system" / q15 01 "more than daily" 02 "daily" 03 "weekly" 04 "monthly" 05 "3 monthly" 06 "yearly" 07 "never" / q16a 01 "Colorectal surgeons + MDT requests for data" / q16b 01 "PCT requests for data" / q16c 01 "Screening endoscopists requests for data" / q16d 01 "SSP's requests for data" / q16e 01 "Hub requests for data" / q16f 01 "National office requests for data" / q16g 01 "Other requests for data" / q17 01 "none of them" 02 "about a quarter" 03 "about half" 04 "about all of them" / q18 01 "extremely difficult" 02 "difficult" 03 "manageable" 04 "easy" 05 "extremely easy" 06 "impossible" . COMMENT *** above variable was coded incorrectly in adobe form COMMENT *** Page 3 below variable labels t1 "initial training" /t2 "ongoing training" /t3 "user groups" /t4 "CFH help desk" /t5 "documentation:" /t6 "BCSP web site" /k1 "Rate own computer knowledge/skills" /k2 "current role computer knowledge/skills" /k3 "additional training outside of BCSS" /k4 "additional training for BCSS" /d1 "access to BCSS user guide" /d2 "documentation as a intro. to BCSS" /d3 "documentation as definitive ref." /d4 "documentation as how to do it " /d5 "documentation guide for additional help" /d6 "How did you find the language of documentation?" /d7 "How did you find the format/layout of documentation?" /d8 "Local documentation?". COMMENT ** Now the value labels VALUE LABELS t1 01 "none given" 02 "very poor" 03 "poor" 04 "adequate" 05 "good" 06 "excellent" / t2 01 "none given" 02 "very poor" 03 "poor" 04 "adequate" 05 "good" 06 "excellent" / t3 01 "none given" 02 "very poor" 03 "poor" 04 "adequate" 05 "good" 06 "excellent" / t4 01 "none given" 02 "very poor" 03 "poor" 04 "adequate" 05 "good" 06 "excellent" / t5 01 "none given" 02 "very poor" 03 "poor" 04 "adequate" 05 "good" 06 "excellent" / t6 01 "none given" 02 "very poor" 03 "poor"



04 "adequate" 05 "good" 06 "excellent" / k1 01 "non‐existent" 02 "beginner" 03 "intermediate" 04 "addvanced" 05 "professional" / k2 01 "very inadequate" 02 "inadequate" 03 "adequate" 04 "above that required"/ k3 01 "yes" 02 "no"/ k4 01 "yes" 02 "no"/ d1 01 "yes" 02 "no"/ d2 01 "not appro. in role" 02 "not at all" 03 "little use" 04 "useful" 05 "extremely useful" / d3 01 "not appro. in role" 02 "not at all" 03 "little use" 04 "useful" 05 "extremely useful" / d4 01 "not appro. in role" 02 "not at all" 03 "little use" 04 "useful" 05 "extremely useful" / d5 01 "not appro. in role" 02 "not at all" 03 "little use" 04 "useful" 05 "extremely useful" / d6 01 "incomprehensible" 02 "extremely difficult" 03 "difficult" 04 "manageable" 05 "clear" 06 "excellent" / d7 01 "incomprehensible" 02 "extremely difficult" 03 "difficult" 04 "manageable" 05 "clear" 06 "excellent" / d8 01 "yes" 02 "no". COMMENT ** Page 4 below COMMENT ** ongoing support variable labels os1 "have you paid for training" /os2 "rate help desk" /os3 "always provided named individual" /os4 "always provided log call number" /os5 "always get back" /os6 "asked to prioritise" /os7 "prioritisation appropriate" /os8 "how helpful resolution" /os9 "would you like help desk enhancements" txt_os9 "suggested help desk enhancements" /qse1 "suggested enhancement 1" /qse2 "suggested enhancement 2" /qse3 "suggested enhancement 3" /qse4 "suggested enhancement 4" /qse5 "suggested enhancement 5" /qse1r "suggested enhancement rank 1" /qse2r "suggested enhancement rank 2" /qse3r "suggested enhancement rank 3" /qse4r "suggested enhancement rank 4" /qse5r "suggested enhancement rank 5". VALUE LABELS os1 01 "yes" 02 "no"/ os2 01 "not used it" 02 "grossly inadequate" 03 "inadequete" 04 " adequate" 05 "good" 06 " excellent" / os3 01 "yes" 02 "no"/ os4 01 "yes" 02 "no"/ os5 01 "extremely unreliable" 02 "unreliable" 03 " adequate" 04 "good" 05 "excellent" / os6 01 "yes" 02 "no"/ os7 01 "yes" 02 "no" 03 "don't know"/ os8 01 "none given" 02 "extremely limited" 03 "limited" 04 " adequate" 05 "good"

06 " excellent" / os9 01 "yes" 02 "no". COMMENT ** Page 5 below COMMENT ** enquires reprots alerts variable labels sr1 "have you used enquires/reports/alerts" /sr2 "information complete" /sr3 "information relevant" /sr4 "information accurate" /sr5 "information up to date" /sr6 "information aggregation" /sr7 "information clarity" /sr8 "information amount too much to correct" /sr9 "information amount too little to correct" /sr10 "information formatting" /sr11 "report name 1" /sr12 "report name 2" /sr13 "report name 3" /sr14 "report name 4" /sr15 "report name 5" /sr11b "report name 1 comments" /sr12b "report name 2 comments" /sr13b "report name 3 comments" /sr14b "report name 4 comments" /sr15b "report name 5 comments" /sr11c "report 1 quality" /sr12c "report 2 quality" /sr13c "report 3 quality" /sr14c "report 4 quality" /sr15c "report 5 quality" Txt_sr16 "general comments about enquires/reports/alerts". VALUE LABELS sr1 01 "yes" 02 "no" / sr2 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr3 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr4 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr5 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr6 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr7 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr8 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr9 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr10 01 "do not understand question" 02 "very unhappy" 03 "unhappy" 04 "neutral" 05 "happy" 06 "very happy"/ sr11c 01 "bad" 02 "good"/ sr12c 01 "bad" 02 "good"/ sr13c 01 "bad" 02 "good"/ sr14c 01 "bad" 02 "good"/ sr15c 01 "bad" 02 "good". COMMENT ** Page 6 below COMMENT ** Help line advisors/managers



variable labels HL1 "How difficult to enter data while calling" /HL2 "How often unnecessary phone calls" /HL3 "Does the BCSS cause unnecessary phone calls" /hl4a " unnecessary phone calls ‐ leaflets" /hl4b " unnecessary phone calls ‐ letters" /hl4c " unnecessary phone calls ‐test kits" /hl4d " unnecessary phone calls ‐ appointments" /hl4e " unnecessary phone calls ‐ dropping out" /hl4f " unnecessary phone calls ‐ other" /Txt_HL4 " unnecessary phone calls ‐ other details" /HL8 "Do you personally manage helpline advisors" /Txt_HL9 "HL managers negative comments" /Txt_HL10 "HL managers positive comments" /Txt_HL11 "HL managers additional comments". VALUE LABELS HL1 01 "extremely difficult" 02 "difficult" 03 "manageable" 04 "easy" 05 "extremely easy"/ HL2 01 "more than daily" 02 "daily" 03 "weekly" 04 "monthly" 05 "3 monthly" 06 "yearly" 07 "never" / HL3 01 "yes" 02 "no" / hl4a 01 "none of them" 02 "about quarter" 03 "about half" 04 "about 3/4" 05 "about all" / hl4b 01 "none of them" 02 "about quarter" 03 "about half" 04 "about 3/4" 05 "about all" / hl4c 01 "none of them" 02 "about quarter" 03 "about half" 04 "about 3/4" 05 "about all" / hl4d 01 "none of them" 02 "about quarter" 03 "about half" 04 "about 3/4" 05 "about all" / hl4e 01 "none of them" 02 "about quarter" 03 "about half" 04 "about 3/4" 05 "about all" / hl4f 01 "none of them" 02 "about quarter" 03 "about half" 04 "about 3/4" 05 "about all" / HL8 01 "yes" 02 "no" . COMMENT ** Page 7 below COMMENT ** National office variable labels n1 "Amount of info from national office" /n2 "Quality of info from national office" /n3 " ceasing subjects good practice guidelines usefulness" /n4 " surveillance good practice guidelines usefulness" /n5 " episode management good practice guidelines usefulness" /n6 " exceptions good practice guidelines usefulness" /n7 " other good practice guidelines usefulness" /txt_n7 "other good practice guidelines, details" /n8 "Planned developments for BCSS" /n9 "Usefulness of national newletter" /Txt_n10 "topics in newsletter" /Txt_n11 "Additional comments national office". VALUE LABELS n1 01 "not appro. in role" 02 "none given" 03 "far too little" 04 "too lttle" 05 "adequate" 06 "good" 07 "more than required" 08 "far too much"/ n2 01 "not appro. in role" 02 "grossly inadequate" 03 "inadequete" 04 " adequate" 05 "good" 06 " excellent" / n3 to n7 01 "not appro. in role" 02 "no use" 03 "little use" 04 "useful" 05 "very useful" / n8 01 "not appro. in role" 02 "grossly inadequate" 03 "inadequete"

04 " adequate" 05 "good" 06 " excellent" / n9 01 "not appro. in role" 02 "no use" 03 "little use" 04 "useful" 05 "very useful" . COMMENT ** Page 8 below COMMENT ** About you variable labels ie1 "hub ‐ test kit reader" /ei2 "hub ‐ managing test kit reading" /ie3 "hub ‐ help line advisor" /ie4 "hub ‐ help line manager" /ie5 "hub ‐ manager" /ie6 "hub ‐ data manager/analyst" /ie7 "hub ‐ administration" /ie8 "hub ‐ other role" /txt_ie8 "hub ‐ other role" /ie9 "screening centre ‐ nurse" /ie10 "screening centre ‐ colonoscopist" /ie11 "screening centre ‐ nurse management" /ie12 "screening centre ‐ manager" /ie13 "screening centre ‐ data manager/analyst" /ie14 "screening centre ‐ administration" /ie15 "screening centre ‐ other role" /txt_ie15 "SC ‐ other role" /ie16 "working at the national office" /ie17 "other place of work" /Txt_ie17 "other place of work ‐ details" /ie18 "number of years working for BS" /email "Work email" /FirstName "Firstname" /LastName "Lastname" /Txt_a1 "Optional comments 1" /Txt_a2 "Optional comments 2". VALUE LABELS ie1 01 "hub ‐ test kit reader" / ei2 01 "hub ‐ managing test kit reading" / ie3 01 "hub ‐ help line advisor" / ie4 01 "hub ‐ help line manager" / ie5 01 "hub ‐ manager" / ie6 01 "hub ‐ data manager/analyst" / ie7 01 "hub ‐ administration" / ie8 01 "hub ‐ other role" / ie9 01 "screening centre ‐ nurse" / ie10 01 "screening centre ‐ colonoscopist" / ie11 01 "screening centre ‐ nurse management" / ie12 01 "screening centre ‐ manager"/ ie13 01 "screening centre ‐ data manager/analyst" / ie14 01 "screening centre ‐ administration" / ie15 01 "screening centre ‐ other role" / ie16 01 "working at the national office" / ie17 01 "other place of work". COMMENT ** SSP section page 1 variable labels ie1 "hub ‐ test kit reader" /sp1 "how many patients do you see a week for +ve fob assessments" /sp2 "What proportion of patients provide you with a adequate medical history" /sp3 "Medical notes before colonoscopy" /sp4 "GP before colonoscopy" /sp5 "Screening colonoscopist before colonoscopy" /sp6 "gastroenterologist before colonoscopy" /sp7 "non BCSS computer systems before colonoscopy" /sp8 "other before colonoscopy" /Txt_sp8 "details other before colonoscopy" /sp9 "Create separate record in medical notes of +ve fob assessment" /sp10 "Create separate record NOT in medical notes of +ve fob assessment" /sp14 "How useful do or would you find paper medical notes at +ve fob" /sp15 "Do not record ‐ Reason for colonscopy cancellation " /sp16a "record in BCSS ‐ Reason for colonscopy cancellation " /sp16b "record in paper notes ‐ Reason for colonscopy cancellation " /sp16c "record in excel ‐ Reason for colonscopy cancellation " /sp16d "record in local database ‐ Reason for colonscopy cancellation" /sp16e "record in other ‐ Reason for colonscopy cancellation " /Txt_sp16e "record in other ‐ details" /sp17 "How adequate local support from histology/pathology" /sp18 "How adequate local support from local screening colonoscopists" /sp19 "What proportion of histology/pathology reports can you adequately interpret". VALUE LABELS sp2 01 "none of them" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp3 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2"



05 "<3/4" 06 ">3/4" 07 "all" / sp4 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp5 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp6 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp7 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp8 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp9 01 "yes" 02 "no" / sp10 01 "yes" 02 "no" / sp14 01 "no use" 02 "little use" 03 "useful" 04 "extremely useful"/ sp15 01 "do not record it"/ sp16a 01 "record in bcss"/ sp16b 01 "record in paper notes" / sp16c 01 "excel" / sp16d 01 "local DB" / sp16e 01 "other" / sp17 01 "grossly inadequate" 02 "inadequate" 03 "adequate" 04 "good" 05 "excellent"/ sp18 01 "grossly inadequate" 02 "inadequate" 03 "adequate" 04 "good" 05 "excellent"/ sp19 01 "none of them" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" . COMMENT ** Page 10 below COMMENT ** SSP section page 2 variable labels sp22 "shadowed GP using computer in consultation" /sp23 "enter data directly into BCSS during +fob assess." /sp24 "enter data directly into BCSS during colonoscopy" /sp25 "enter data directly into BCSS during post invest. consultation." /Txt_sp26 "average number of patients SEEN for post invest. consults. weekly" /Txt_sp27 "average number of patients not FtF for post invest. consults. weekly" /sp28 "what proportion of post invest. consults keep additional paper notes" /sp29 "record patients reaction to good/bad news" /sp30 "Further contact after post invest consult." /Txt_sp30 "Other contact details" /sp31 "support for professional development" /sp32 "Liverpool course" /sp33 "communication within SSP community" /Txt_sp34 "SSP additional optional comments" . VALUE LABELS sp22 01 "yes" 02 "no" / sp23 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp24 01 "none"

02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp25 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp28 01 "none" 02 "<1/4" 03 "<1/2" 04 "1/2" 05 "<3/4" 06 ">3/4" 07 "all" / sp29 01 "yes" 02 "no" / sp30 01 "yes" 02 "no" / sp31 01 "none given" 02 "extremely limited" 03 "inadequate" 04 " adequate" 05 "good" 06 " excellent" / sp32 01 "none given" 02 "extremely limited" 03 "inadequate" 04 " adequate" 05 "good" 06 " excellent" / sp33 01 "none given" 02 "extremely limited" 03 "inadequate" 04 " adequate" 05 "good" 06 " excellent" . COMMENT ** End of data definition file * Compute filters and summary variables * Compute binary variable t_site 1= hub 2= sc from the various role variables Compute #counter =0. Compute #counter2 =0. COMPUTE #counter = Sum(ie1 to ie8). COMPUTE #counter2 = Sum(ie9 to ie15). COMPUTE t_site = 3. DO If #counter GT 0. COMPUTE t_site = 1. END IF. DO If #counter2 GT 0. COMPUTE t_site = 2. END IF. EXECUTE VARIABLE LABELS t_site "hub Screening centre or other". VALUE LABELS t_site 01 "hub role" 02 "Screening centre role" 03 "other+national role"/. * Compute a overall satisfaction score from the first page of items q6 and q7 need to be reverse marked RECODE q6 (1 =5) (2=4) (3=3) (4=2) (5=1) into q6_invert. RECODE q8 (1 =5) (2=4) (3=3) (4=2) (5=1) into q8_invert. execute. Compute tothappy = sum(q1 to q5) + q7 + q10 + q11 + q6_invert + q8_invert. EXECUTE . * now have a variable that can range in values from 10 to 52, transform to min 0 max 10, Compute tothappy2 =( tothappy ‐10)/ 4.2 . execute. * now remove the 2 pains: the national office and other responses (that is use all site codes but 3) so can compare sc with hub USE ALL. COMPUTE filter_$=(t_site<> 3). VARIABLE LABEL filter_$ 't_site<> 3 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. * Run analyses for hub versus screening centres *now new filter to use only screening centre staff dividing into clerical and SSPs That is using site 2 codes only, can not use the questionnaire type as some hubs people filled in SSP questionnaire etc. then use ie9 to categorise.



USE ALL. COMPUTE filter_$=(t_site= 2). VARIABLE LABEL filter_$ 't_site= 2 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. GRAPH /BAR(GROUPED)=PCT BY n9 BY ie9. CROSSTABS /TABLES=q15 BY ie9 /FORMAT=AVALUE TABLES /STATISTICS=CHISQ BTAU /CELLS=COUNT COLUMN TOTAL /COUNT ROUND CELL /BARCHART=percent(100). DATASET ACTIVATE DataSet1. CROSSTABS /TABLES=ie9 BY q11 /FORMAT=AVALUE TABLES /CELLS=COUNT ROW COLUMN /COUNT ROUND CELL /BARCHART=percent(100). DATASET ACTIVATE DataSet1. DATASET COPY ssp_only_21_08_2009. DATASET ACTIVATE ssp_only_21_08_2009. FILTER OFF. USE ALL. SELECT IF (NOT(filter_$=0)). DATASET ACTIVATE DataSet1. EXECUTE. COMMENT ** Select only those SSPs who have done the Liverpool course. DATASET ACTIVATE DataSet1. USE ALL. COMPUTE filter_$=((ie9=1) and (sp32<>1)). VARIABLE LABEL filter_$ '(ie9=1) and (sp32<>1) (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** Create a new dicot. variable done liverpool course or not , 1= not done it, 2= yes RECODE sp32 (1=1) (ELSE=2) INTO liverpl. VARIABLE LABELS liverpl 'done liverpool couse'. VALUE LABELS liverpl 01 "not undertaken" 02 "undertaken" . EXECUTE. * End of syntax COMMENT ** Analysis for page 1 Necessary to use syntax to obtain catagories with zero counts in barcharts DATASET ACTIVATE DataSet1. CROSSTABS Variables q1 (1,7) q2 q3 q4 q5 q6 q7 q8 q10 q11 (1,5) ie9 (0,1) /TABLES = q1 to q11 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . COMMENT ** Now for the barcharts for the actual report GRAPH /BAR(GROUPED)=PCT BY q5 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'How happy are you with the BCSS?'. COMMENT ** Some stats on probably differences NPAR TESTS /M‐W= q5 q8 q10 q11 BY ie9(0 1) /MISSING ANALYSIS. COMMENT ** Now stuff about the overall satisfaction score XGRAPH CHART=[HISTOBAR] BY tothappy2[s] BY ie9[c] /COORDINATE SPLIT=YES /BIN START=AUTO SIZE=COUNT(40). EXAMINE VARIABLES=tothappy2 BY ie9 /PLOT BOXPLOT HISTOGRAM /COMPARE GROUPS /STATISTICS DESCRIPTIVES

/CINTERVAL 95 /MISSING LISTWISE /NOTOTAL. GRAPH /HISTOGRAM(NORMAL)=q2. GRAPH /HISTOGRAM=tothappy2. * comment end of syntax page 1 COMMENT ** Analysis for page 2 Necessary to use syntax to obtain catagories with zero counts in barcharts GRAPH /BAR(GROUPED)= PCT BY q13 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'How often is it necessary to copy information from the BCSS?'. CROSSTABS Variables q13 (1,7) ie9 (0,1) /TABLES = q13 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR . Comment ** Type of system? CROSSTABS Variables q14_a (0,1) ie9 (0,1) /TABLES =ie9 BY q14_a /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR . CROSSTABS Variables q14_b (0,1) ie9 (0,1) /TABLES =ie9 BY q14_b /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR . GRAPH /BAR(GROUPED)= PCT BY q14_a BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'computer based system'. CROSSTABS Variables q15 (1,7) ie9 (0,1) /TABLES = q15 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR . GRAPH /BAR(GROUPED)= PCT BY q15 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'How often do you get asked for information?'. CROSSTABS Variables q17 q18 (1,6) ie9 (0,1) /TABLES = q17 q18 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR . GRAPH /BAR(GROUPED)= PCT BY q18 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'How easy is it to provide the data?'. COMMENT ** Now the useful features, need to find those that were ranked 1st regardless of where they put them First filter out all cases that do not have a no 1 ranking for q19u1r, then q19u2r, then q19u3r, etc q19u4r and q19u5r USE ALL. COMPUTE filter_$=(q19u1r=1 ). VARIABLE LABEL filter_$ 'have a useful 1st ranking for 1st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank1 position1' /MISSING=VARIABLE /CELLS=COUNT. Comment * now at position 2 USE ALL. COMPUTE filter_$=(q19u2r=1 ). VARIABLE LABEL filter_$ 'have a useful 1st ranking for 2st (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries'



/MISSING=VARIABLE /CELLS=COUNT. COMMENT ** Now the useful feactures, need to find those that were ranked 1st regardless of where they put them First filter out all cases that do not have a no 1 ranking for then q19u3r, etc q19u4r and q19u5r USE ALL. COMPUTE filter_$=(q19u3r=1 ). VARIABLE LABEL filter_$ 'have a positive 1st ranking in 3rd slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(q19u4r=1 ). VARIABLE LABEL filter_$ 'have a positive 1st ranking for 4 slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q16u4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(q19u5r=1 ). VARIABLE LABEL filter_$ 'have a positive 1st ranking for 5th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries' /MISSING=VARIABLE /CELLS=COUNT. ******************************* Ranked 2 ****************************************************** COMMENT ** useful feactures, ranked 2nd st regardless of where they put them First filter out all cases that do not have a no 2 ranking for q19u1r, then q19u2r, then q19u3r, etc q19u4r and q19u5r USE ALL. COMPUTE filter_$=(q19u1r=2 ). VARIABLE LABEL filter_$ 'have a positive 2st ranking for 1st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank2 position1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 2 slot 2 USE ALL. COMPUTE filter_$=(q19u2r=2 ). VARIABLE LABEL filter_$ 'have a positive 2st ranking for 2st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank2 position2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 2 slot 3

USE ALL. COMPUTE filter_$=(q19u3r=2 ). VARIABLE LABEL filter_$ 'have a positive 2st ranking for 3rd slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank2 position3' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 2 slot 4 USE ALL. COMPUTE filter_$=(q19u4r=2 ). VARIABLE LABEL filter_$ 'have a positive 2st ranking for 4th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q16u4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank2 position4' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 2 slot 5 USE ALL. COMPUTE filter_$=(q19u5r=2 ). VARIABLE LABEL filter_$ 'have a positive 2st ranking for 5th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank2 position 5' /MISSING=VARIABLE /CELLS=COUNT. ******************************* Ranked 3 ****************************************************** COMMENT ** useful feactures, ranked 3nd st regardless of where they put them First filter out all cases that do not have a no 3 ranking for q19u1r, then q19u2r, then q19u3r, etc q19u4r and q19u5r USE ALL. COMPUTE filter_$=(q19u1r=3 ). VARIABLE LABEL filter_$ 'have a positive 3st ranking for 1st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 3 position1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 2 USE ALL. COMPUTE filter_$=(q19u2r=3 ). VARIABLE LABEL filter_$ 'have a positive 3st ranking for 2st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 3 position2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 3 USE ALL.



COMPUTE filter_$=(q19u3r=3 ). VARIABLE LABEL filter_$ 'have a 3rd ranking for 3rd slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 3 slot 3' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 4 USE ALL. COMPUTE filter_$=(q19u4r=3 ). VARIABLE LABEL filter_$ 'have a 3rd ranking for 4th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q16u4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 3 slot 4' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 5 USE ALL. COMPUTE filter_$=(q19u5r=3 ). VARIABLE LABEL filter_$ 'have a 3rd ranking for 5th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 3 slot 5' /MISSING=VARIABLE /CELLS=COUNT. ******************************* Ranked 4 ****************************************************** COMMENT ** useful feactures, ranked 4nd st regardless of where they put them First filter out all cases that do not have a no 4 ranking for q19u1r, then q19u2r, then q19u3r, etc q19u4r and q19u5r USE ALL. COMPUTE filter_$=(q19u1r=4 ). VARIABLE LABEL filter_$ 'have a positive 4st ranking for 1st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 4 position1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 2 USE ALL. COMPUTE filter_$=(q19u2r=4 ). VARIABLE LABEL filter_$ 'have a positive 4st ranking for 2st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 3 position2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 4 slot 3 USE ALL. COMPUTE filter_$=(q19u3r=4 ). VARIABLE LABEL filter_$ 'have a 4rd ranking for 3rd slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE.

SUMMARIZE /TABLES=q19u3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 4 slot 3' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 4 slot 4 USE ALL. COMPUTE filter_$=(q19u4r=4 ). VARIABLE LABEL filter_$ 'have a 4rd ranking for 4th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q16u4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 4 slot 4' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 5 USE ALL. COMPUTE filter_$=(q19u5r=4 ). VARIABLE LABEL filter_$ 'have a 5rd ranking for 5th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 5 slot 5' /MISSING=VARIABLE /CELLS=COUNT. ******************************* Ranked 5 ****************************************************** COMMENT ** useful feactures, ranked 5nd st regardless of where they put them First filter out all cases that do not have a no 5 ranking for q19u1r, then q19u2r, then q19u3r, etc q19u4r and q19u5r USE ALL. COMPUTE filter_$=(q19u1r=5 ). VARIABLE LABEL filter_$ 'have a positive 5st ranking for 1st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 5 position1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5 slot 2 USE ALL. COMPUTE filter_$=(q19u2r=5 ). VARIABLE LABEL filter_$ 'have a positive 5th ranking for 2st slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 5 position2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5 slot 3 USE ALL. COMPUTE filter_$=(q19u3r=5 ). VARIABLE LABEL filter_$ 'have a 5rd ranking for 3rd slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 5 slot 3'



/MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5 slot 4 USE ALL. COMPUTE filter_$=(q19u4r=5 ). VARIABLE LABEL filter_$ 'have a 5th ranking for 4th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q16u4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 5 slot 4' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5 slot 5 USE ALL. COMPUTE filter_$=(q19u5r=5). VARIABLE LABEL filter_$ 'have a 5rd ranking for 5th slot (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries rank 5 slot 5' /MISSING=VARIABLE /CELLS=COUNT. ******************************* unranked****************************************************** COMMENT ** useful feactures, uranked regardless of where they put them First filter out all cases that have any ranking for q19u1r, then q19u2r, then q19u3r, etc q19u4r and q19u5r USE ALL. COMPUTE filter_$=( SYSMIS(q19u1r) =1 ). VARIABLE LABEL filter_$ ' SYSMIS(q19u1r) (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position1' /MISSING=VARIABLE /CELLS=COUNT. Comment The above just filters on missing values, therefore you get all cases with sysmissing even if there is no test in the q19u1 field. The following filter gets rid of the empty string fields as well. USE ALL. COMPUTE filter_$=( SYSMIS(q19u1r) =1 and CHAR.LENGTH(q19u1)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19u1r) =1 and CHAR.LENGTH(q19u1)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position1' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19u2r) =1 and CHAR.LENGTH(q19u2)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19u2r) =1 and CHAR.LENGTH(q19u2)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position2' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19u3r) =1 and CHAR.LENGTH(q19u3)>1).

VARIABLE LABEL filter_$ ' SYSMIS(q19u3r) =1 and CHAR.LENGTH(q19u3)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19u3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position3' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19u4r) =1 and CHAR.LENGTH(q16u4)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19u4r) =1 and CHAR.LENGTH(q16u4)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q16u4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position 4' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19u5r) =1 and CHAR.LENGTH(q16u5)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19u5r) =1 and CHAR.LENGTH(q16u5)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q16u5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position 5' /MISSING=VARIABLE /CELLS=COUNT. * Comment end of page 2 syntax * COMMENT ** Sorts the negative features into the ranging suggested by respondents by non‐ssp and ssp for each of the 5 rankings including any possible unranked entries Considers the ranking regardless of where they put them First filter out all cases that do not have a no 1 ranking for q19n1r, then q19n2r, then q19n3r, etc q19n4r and q19n5r ****************************** Ranked 1 ****************************************************** USE ALL. COMPUTE filter_$=(q19n1r=1 ). VARIABLE LABEL filter_$ 'have 1 ranking for negative feature in 1st slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 1 slot 1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 1 slot 2 USE ALL. COMPUTE filter_$=(q19n2r=1). VARIABLE LABEL filter_$ 'have 1 ranking for negative feature in 2nd slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 1 slot 2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 1 slot 3 USE ALL. COMPUTE filter_$=(q19n3r=1 ). VARIABLE LABEL filter_$ 'have 1st ranking for negative feature in 3rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE.



SUMMARIZE /TABLES=q19n3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 1 slot 3' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 1 slot 4 USE ALL. COMPUTE filter_$=(q19n4r=1 ). VARIABLE LABEL filter_$ 'have 1st ranking for negative feature in 4rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 1 slot 4' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5 slot 5 USE ALL. COMPUTE filter_$=(q19n5r=1). VARIABLE LABEL filter_$ 'have 1st ranking for negative feature in 5rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg feature rank 1 slot 5 ' /MISSING=VARIABLE /CELLS=COUNT. ****************************** Ranked 2 ****************************************************** USE ALL. COMPUTE filter_$=(q19n1r=2). VARIABLE LABEL filter_$ 'have 2 ranking for negative feature in 1st slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 2 slot 1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 2 slot 2 USE ALL. COMPUTE filter_$=(q19n2r=2). VARIABLE LABEL filter_$ 'have 2 ranking for negative feature in 2nd slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 2 slot 2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 2 slot 3 USE ALL. COMPUTE filter_$=(q19n3r=2). VARIABLE LABEL filter_$ 'have 2st ranking for negative feature in 3rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 2 slot 3' /MISSING=VARIABLE /CELLS=COUNT.

Comment ranked 2 slot 4 USE ALL. COMPUTE filter_$=(q19n4r=2 ). VARIABLE LABEL filter_$ 'have 2st ranking for negative feature in 4rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 2 slot 4' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 2 slot 5 USE ALL. COMPUTE filter_$=(q19n5r=2). VARIABLE LABEL filter_$ 'have 2st ranking for negative feature in 5rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg feature rank 2 slot 5 ' /MISSING=VARIABLE /CELLS=COUNT. ****************************** Ranked 3 ****************************************************** USE ALL. COMPUTE filter_$=(q19n1r=3). VARIABLE LABEL filter_$ 'have 3 ranking for negative feature in 1st slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 3 slot 1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 2 USE ALL. COMPUTE filter_$=(q19n2r=3). VARIABLE LABEL filter_$ 'have 3 ranking for negative feature in 2nd slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 3 slot 2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 3 USE ALL. COMPUTE filter_$=(q19n3r=3). VARIABLE LABEL filter_$ 'have 3rd ranking for negative feature in 3rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 3 slot 3' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 4 USE ALL. COMPUTE filter_$=(q19n4r=3 ). VARIABLE LABEL filter_$ 'have 3rd ranking for negative feature in 4rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$.



EXECUTE. SUMMARIZE /TABLES=q19n4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 3 slot 4' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 3 slot 5 USE ALL. COMPUTE filter_$=(q19n5r=3). VARIABLE LABEL filter_$ 'have 3rd ranking for negative feature in 5rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg feature rank 3 slot 5 ' /MISSING=VARIABLE /CELLS=COUNT. ****************************** Ranked 4 ****************************************************** USE ALL. COMPUTE filter_$=(q19n1r=4). VARIABLE LABEL filter_$ 'have 4th ranking for negative feature in 1st slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 4 slot 1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 4 slot 2 USE ALL. COMPUTE filter_$=(q19n2r=4). VARIABLE LABEL filter_$ 'have 4th ranking for negative feature in 2nd slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 4 slot 2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 4 slot 3 USE ALL. COMPUTE filter_$=(q19n3r=4). VARIABLE LABEL filter_$ 'have 4th ranking for negative feature in 3rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 4th slot 3' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 4 slot 4 USE ALL. COMPUTE filter_$=(q19n4r=4 ). VARIABLE LABEL filter_$ 'have 4th ranking for negative feature in 4rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 4th slot 4'

/MISSING=VARIABLE /CELLS=COUNT. Comment ranked 4 slot 5 USE ALL. COMPUTE filter_$=(q19n5r=4). VARIABLE LABEL filter_$ 'have 4th ranking for negative feature in 5rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 4th slot 5 ' /MISSING=VARIABLE /CELLS=COUNT. ***************************** Ranked 5 ****************************************************** USE ALL. COMPUTE filter_$=(q19n1r=5). VARIABLE LABEL filter_$ 'have 5th ranking for negative feature in 1st slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 5th slot 1' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5 slot 2 USE ALL. COMPUTE filter_$=(q19n2r=5). VARIABLE LABEL filter_$ 'have 5th ranking for negative feature in 2nd slot '. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 5th slot 2' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5 slot 3 USE ALL. COMPUTE filter_$=(q19n3r=5). VARIABLE LABEL filter_$ 'have 5th ranking for negative feature in 3rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 5th slot 3' /MISSING=VARIABLE /CELLS=COUNT. Comment ranked 5th slot 4 USE ALL. COMPUTE filter_$=(q19n4r=5). VARIABLE LABEL filter_$ 'have 5th ranking for negative feature in 4rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 5th slot 4' /MISSING=VARIABLE /CELLS=COUNT. USe all. Comment ranked 5 slot 5 USE ALL.



COMPUTE filter_$=(q19n5r=5). VARIABLE LABEL filter_$ 'have 5th ranking for negative feature in 5rd slot'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='neg features rank 5th slot 5 ' /MISSING=VARIABLE /CELLS=COUNT. ******************************* unranked****************************************************** COMMENT ** useful feactures, uranked regardless of where they put them First filter out all cases that have any ranking for q19n1r, then q19n2r, then q19n3r, etc q19n4r and q19n5r USE ALL. COMPUTE filter_$=( SYSMIS(q19n1r) =1 ). VARIABLE LABEL filter_$ ' SYSMIS(q19n1r) (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position1' /MISSING=VARIABLE /CELLS=COUNT. Comment The above just filters on missing values, therefore you get all cases with sysmissing even if there is no test in the q19u1 field. The following filter gets rid of the empty string fields as well. USE ALL. COMPUTE filter_$=( SYSMIS(q19n1r) =1 and CHAR.LENGTH(q19n1)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19n1r) =1 and CHAR.LENGTH(q19n1)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position1' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19n2r) =1 and CHAR.LENGTH(q19n2)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19n2r) =1 and CHAR.LENGTH(q19n2)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position2' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19n3r) =1 and CHAR.LENGTH(q19n3)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19n3r) =1 and CHAR.LENGTH(q19n3)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position3' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19n4r) =1 and CHAR.LENGTH(q19n4)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19n4r) =1 and CHAR.LENGTH(q16n4)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE.

SUMMARIZE /TABLES=q19n4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position 4' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(q19n5r) =1 and CHAR.LENGTH(q19n5)>1). VARIABLE LABEL filter_$ ' SYSMIS(q19n5r) =1 and CHAR.LENGTH(q19n5)>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=q19n5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position 5' /MISSING=VARIABLE /CELLS=COUNT. * Comment end of page 2 neg features DATASET ACTIVATE DataSet1. CROSSTABS Variables t1 t2 t3 t4 t5 t6 (1,6) k1 (1,5) k2 (1,4) k3 k4 (1,2) d1 (1,2) d2 d3 d4 d5 (1,5) d6 d7 (1,6) d8 (1,2) ie9 (0,1) /TABLES = t1 to d8 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY t1 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Initial training'. GRAPH /BAR(GROUPED)=PCT BY t2 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Ongoing training'. GRAPH /BAR(GROUPED)=PCT BY t3 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'User groups'. GRAPH /BAR(GROUPED)=PCT BY t4 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'CFH help desk'. GRAPH /BAR(GROUPED)=PCT BY t5 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'documentation'. GRAPH /BAR(GROUPED)=PCT BY t6 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'BCSP web site'. COMMENT ** Knowledge section barcharts GRAPH /BAR(GROUPED)=PCT BY k1 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Own computer knowledge/skills'. GRAPH /BAR(GROUPED)=PCT BY k2 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'current role computer knowledge/skills'. GRAPH /BAR(GROUPED)=PCT BY k3 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Additional non BCSS training'. GRAPH /BAR(GROUPED)=PCT BY k4 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Additional BCSS training'. COMMENT ** Documentation section barcharts GRAPH /BAR(GROUPED)=PCT BY d1 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Do you have access to the BSCC user guide'.



GRAPH /BAR(GROUPED)=PCT BY d2 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'General introduction to BCSS ‐ usefulness'. GRAPH /BAR(GROUPED)=PCT BY d3 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Definitive reference to BCSS ‐ usefulness'. GRAPH /BAR(GROUPED)=PCT BY d4 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'How to do it guide to BCSS ‐usefulness'. GRAPH /BAR(GROUPED)=PCT BY d5 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'How to get additional help guide to BCSS ‐usefulness'. GRAPH /BAR(GROUPED)=PCT BY d6 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Language of BCSS documentation'. GRAPH /BAR(GROUPED)=PCT BY d7 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Format/layout of BCSS documentation'. GRAPH /BAR(GROUPED)=PCT BY d8 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'locally produced BCSS documentation'. Comment ** end of analysis below details of filter to remove 'non given category for questions concerning training USE ALL. COMPUTE filter_$=(t5<>1). VARIABLE LABEL filter_$ 't5<>1 (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. CROSSTABS Variables t5 (2,6) ie9 (0,1) /TABLES = t5 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR . GRAPH /BAR(GROUPED)=PCT BY t5 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'documentation'. use all. * Comment end of page 3 syntax * Comment page 4 ongoing support SPSS syntax CROSSTABS Variables os1 (1,2) os2 (1,6) os3 (1,2) os4 (1,2) os5 (1,5) os6 (1,2) os7 (1,3) os8 (1,6) os9 (1,2) ie9 (0,1) /TABLES = os1 to os9 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY os1 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Personally paid for training'. GRAPH /BAR(GROUPED)=PCT BY os2 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Rate CFH help desk'. GRAPH /BAR(GROUPED)=PCT BY os3 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Provided named individual'. GRAPH /BAR(GROUPED)=PCT BY os4 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Log call number'. GRAPH /BAR(GROUPED)=PCT BY os5 BY ie9

/TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Returning call'. GRAPH /BAR(GROUPED)=PCT BY os6 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Asked to prioritise'. GRAPH /BAR(GROUPED)=PCT BY os7 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Prioritisation appropriate'. GRAPH /BAR(GROUPED)=PCT BY os8 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Resolution'. GRAPH /BAR(GROUPED)=PCT BY os9 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Would like help desk enhancements'. Comment ** Textual possible improvements to help desk SUMMARIZE /TABLES=Txt_os9 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested help desk enhancements' /MISSING=VARIABLE /CELLS=COUNT. Comment ** Suggested enhancements There are 5 slots qse1 ‐ qse5 and 5 ranking qse1r to qse5r will need find all those ranks 1 regardless of which slot then2, then 3 then 4 then 5 then finally unranked entries *********** Ranked first ************************************* USE ALL. COMPUTE filter_$=(qse1r=1). VARIABLE LABEL filter_$ ' (qse1r=1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 1 ranked first' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse2r=1). VARIABLE LABEL filter_$ ' (qse2r=1)'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 2 ranked first' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse3r=1). VARIABLE LABEL filter_$ ' (qse3r=1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 3 ranked first' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse4r=1). VARIABLE LABEL filter_$ ' (qse4r=1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 4 ranked first' /MISSING=VARIABLE /CELLS=COUNT.



USE ALL. COMPUTE filter_$=(qse5r=1). VARIABLE LABEL filter_$ ' (qse5r=1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 5 ranked first' /MISSING=VARIABLE /CELLS=COUNT. Comment ** *********** Ranked second ************************************* USE ALL. COMPUTE filter_$=(qse1r=2). VARIABLE LABEL filter_$ ' (qse1r=2)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 1 ranked 2nd' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse2r=2). VARIABLE LABEL filter_$ ' (qse2r=2)'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 2 ranked 2nd' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse3r=2). VARIABLE LABEL filter_$ ' (qse3r=2)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 3 ranked 2nd' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse4r=2). VARIABLE LABEL filter_$ ' (qse4r=2)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 4 ranked second' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse5r=2). VARIABLE LABEL filter_$ ' (qse5r=2)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 5 ranked second' /MISSING=VARIABLE /CELLS=COUNT. Comment ** *********** Ranked third ************************************* USE ALL. COMPUTE filter_$=(qse1r=3). VARIABLE LABEL filter_$ ' (qse1r=3)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0).

FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 1 ranked 3rd' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse2r=3). VARIABLE LABEL filter_$ ' (qse2r=3)'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 2 ranked 3rd' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse3r=3). VARIABLE LABEL filter_$ ' (qse3r=3)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 3 ranked 3rdd' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse4r=3). VARIABLE LABEL filter_$ ' (qse4r=3)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 4 ranked third' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse5r=3). VARIABLE LABEL filter_$ ' (qse5r=3)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 5 ranked second' /MISSING=VARIABLE /CELLS=COUNT. Comment ** *********** Ranked fourth ************************************* USE ALL. COMPUTE filter_$=(qse1r=4). VARIABLE LABEL filter_$ ' (qse1r=4)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 1 ranked 4th' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse2r=4). VARIABLE LABEL filter_$ ' (qse2r=4)'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 2 ranked 4th' /MISSING=VARIABLE /CELLS=COUNT.



USE ALL. COMPUTE filter_$=(qse3r=4). VARIABLE LABEL filter_$ ' (qse3r=4)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 3 ranked 4th' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse4r=4). VARIABLE LABEL filter_$ ' (qse4r=4)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 4 ranked fourth' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse5r=4). VARIABLE LABEL filter_$ ' (qse5r=4)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 5 ranked fourth' /MISSING=VARIABLE /CELLS=COUNT. Comment ** *********** Ranked fifth ************************************* USE ALL. COMPUTE filter_$=(qse1r=5). VARIABLE LABEL filter_$ ' (qse1r=5)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 1 ranked 5th' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse2r=5). VARIABLE LABEL filter_$ ' (qse2r=5)'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 2 ranked 5th' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse3r=5). VARIABLE LABEL filter_$ ' (qse3r=5)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 3 ranked 5th' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse4r=5). VARIABLE LABEL filter_$ ' (qse4r=5)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse4 BY ie9

/FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 4 ranked fifth' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(qse5r=5). VARIABLE LABEL filter_$ ' (qse5r=5)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='suggested enhancements slot 5 ranked fifth' /MISSING=VARIABLE /CELLS=COUNT. COMMENT ** ******************************* unranked****************************************************** This filter also removes any fields that contain empty text or single charachers USE ALL. COMPUTE filter_$=( SYSMIS(qse1r) =1 and CHAR.LENGTH(qse1)>1). VARIABLE LABEL filter_$ ' ( SYSMIS(qse1r) =1 and CHAR.LENGTH(qse1)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position1' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(qse2r) =1 and CHAR.LENGTH(qse2)>1). VARIABLE LABEL filter_$ ' ( SYSMIS(qse2r) =1 and CHAR.LENGTH(qse2)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position2' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(qse3r) =1 and CHAR.LENGTH(qse3)>1). VARIABLE LABEL filter_$ ' ( SYSMIS(qse3r) =1 and CHAR.LENGTH(qse3)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse3 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position3' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(qse4r) =1 and CHAR.LENGTH(qse4)>1). VARIABLE LABEL filter_$ ' ( SYSMIS(qse4r) =1 and CHAR.LENGTH(qse4)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse4 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position 4' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=( SYSMIS(qse5r) =1 and CHAR.LENGTH(qse5)>1). VARIABLE LABEL filter_$ ' ( SYSMIS(qse5r) =1 and CHAR.LENGTH(qse5)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. SUMMARIZE /TABLES=qse5 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='Case Summaries unranked position 5' /MISSING=VARIABLE /CELLS=COUNT. COMMENT ** Ranking of help desk removing those who have not used it



CROSSTABS Variables os2 (2,6) ie9 (0,1) /TABLES = os2 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . * Comment end of page 4 spss syntax COMMENT ** page 5 Enquires comments and alerts section first basic crosstab number of those who have used them or not by ssp non ssp but first need to convert the sr1 variable as *no was saved as no please ignore the shaded area* RECODE sr1 (CONVERT) ('1'=1) (MISSING=SYSMIS) (ELSE=2) INTO sr1_rcd. VARIABLE LABELS sr1_rcd 'use of enquires/reports/alerts'. VALUE LABELS sr1_rcd 1 'yes' 2 'no'. EXECUTE. CROSSTABS Variables sr1_rcd (1,2) ie9 (0,1) /TABLES = sr1_rcd BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY sr1_rcd BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Have you used enquires/report or alerts produced by the BCSS?'. COMMENT ** now the specific aspects of the enquires/reports/alerts CROSSTABS Variables sr2 to sr10 (1,6) ie9 (0,1) /TABLES = sr2 to sr10 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY sr2 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Completeness'. GRAPH /BAR(GROUPED)=PCT BY sr3 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Relevancy'. GRAPH /BAR(GROUPED)=PCT BY sr4 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Accuracy'. GRAPH /BAR(GROUPED)=PCT BY sr5 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Up to date?'. GRAPH /BAR(GROUPED)=PCT BY sr6 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Degree of aggregation'. GRAPH /BAR(GROUPED)=PCT BY sr7 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Clarity'. GRAPH /BAR(GROUPED)=PCT BY sr8 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Volume of information ‐ too much'. GRAPH /BAR(GROUPED)=PCT BY sr9 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Volume of information ‐ too little'. GRAPH /BAR(GROUPED)=PCT BY sr10 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Formatting'. Comment ** Now for the comments about specific reports ignore entries with no text in comments comment 1 ‐ sr11b USE ALL. COMPUTE filter_$=(CHAR.LENGTH(sr11b)>1).

VARIABLE LABEL filter_$ ' (CHAR.LENGTH(sr11b)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= sr11 sr11c sr11b BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. Comment ** Now for the comments about specific 2 reports ignore entries with no text in comments comment 2 ‐ sr12b USE ALL. COMPUTE filter_$=(CHAR.LENGTH(sr12b)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(sr12b)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= sr12 sr12c sr12b BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. Comment ** Now for the comments about specific 3 reports ignore entries with no text in comments comment 3 ‐ sr13b USE ALL. COMPUTE filter_$=(CHAR.LENGTH(sr13b)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(sr13b)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= sr13 sr13c sr13b BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. Comment ** Now for the comments about specific 4 reports ignore entries with no text in comments comment 4 ‐ sr14b USE ALL. COMPUTE filter_$=(CHAR.LENGTH(sr14b)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(sr14b)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= sr14 sr14c sr14b BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. Comment ** Now for the comments about specific 5 reports ignore entries with no text in comments comment 5 ‐ sr15b USE ALL. COMPUTE filter_$=(CHAR.LENGTH(sr15b)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(sr15b)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= sr15 sr15c sr15b BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. Comment ** Finally on the page the optional general comments about reports USE ALL. COMPUTE filter_$=(CHAR.LENGTH(Txt_sr16)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(Txt_sr16)>1)'.



VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= Txt_sr16 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. COMMENT ** end of page 5 analysis * Comment help line advisors/managers It was not expected that screening staff would complete this section however several did! DATASET ACTIVATE DataSet1. CROSSTABS Variables HL1 (1,5) HL2 (1,7) HL3 (1,2) hl4a hl4b hl4c hl4d hl4e hl4f (1,5) HL8 (1,2) ie9 (0,1) /TABLES = HL1 to HL8 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . COMMENT ** Now for the barcharts for the actual report GRAPH /BAR(GROUPED)=PCT BY HL1 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Difficulty in entering data while taking a call?'. COMMENT ** Some stats on probably differences NPAR TESTS /M‐W= q5 q8 q10 q11 BY ie9(0 1) /MISSING ANALYSIS. * Comment end of page 6 analysis COMMENT ** National office section page 7 Make use of the t_site variable t_site= 1 t_site = 2 = hub 2 t_site = 3 other roles The t_site variable created in the filters_summary_vars.sps file from the various role options on page 8 of questionnaire COmment ** just a check to see we have the correct file and cases USE all. FREQUENCIES t_site /BARCHART PERCENT. Comment ** question 1 amount of info CROSSTABS Variables n1 (1,8) ie9 (0,1) /TABLES = n1 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY n1 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Amount of information from the national office'. Comment ** question 2 qualitity of info CROSSTABS Variables n2 (1,6) ie9 (0,1) /TABLES = n2 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY n1 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Quality of information from the national office'. Comment ** question 3 to 7 national guidennnce concerning . . . CROSSTABS Variables n3 to n7 (1,5) ie9 (0,1) /TABLES = n3 to n7 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY n3 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Ceasing subjects good practice guidelines usefulness'.

GRAPH /BAR(GROUPED)=PCT BY n4 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Surveillance good practice guidelines usefulness'. GRAPH /BAR(GROUPED)=PCT BY n5 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Episode management good practice guidelines usefulness'. GRAPH /BAR(GROUPED)=PCT BY n6 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Exceptions good practice guidelines usefulness'. GRAPH /BAR(GROUPED)=PCT BY n7 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= '"Other" subjects good practice guidelines usefulness'. Comment ** Now the text concerned with *other* guidelines USE ALL. COMPUTE filter_$=(CHAR.LENGTH(txt_n7)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(txt_n7)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= txt_n7 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. Use all. Comment ** Communication concerning planned BCSS developments CROSSTABS Variables n8 (1,6) ie9 (0,1) /TABLES = n8 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY n8 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Planned developments/timetable for the BCSS'. Comment ** Communication concerning planned newsletter CROSSTABS Variables n9 (1,4) ie9 (0,1) /TABLES = n9 BY ie9 /CELLS=COUNT COLUMN /STATISTICS=CHISQ CORR /BARCHART . GRAPH /BAR(GROUPED)=PCT BY n9 BY ie9 /TEMPLATE='C:\Program Files\SPSSInc\PASWStatistics17\Looks\robin_barchart1.sgt' /TITLE= 'Regular national Newsletter usefulness'. Comment ** Finally on the page the optional general comments first about newsletter then about anything and the national office USE ALL. COMPUTE filter_$=(CHAR.LENGTH(Txt_n10)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(Txt_n10)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= Txt_n10 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. USE ALL. COMPUTE filter_$=(CHAR.LENGTH(Txt_n11)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(Txt_n11)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report



SUMMARIZE /TABLES= Txt_n11 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. use all. COMMENT ** end of page 7 syntax COMMENT ** Information about you page 8 types of roles and optional additional comments GRAPH /BAR(SIMPLE)=SUM(ie9) SUM(ie10) SUM(ie11) SUM(ie12) SUM(ie13) SUM(ie14) SUM(ie15) /MISSING=LISTWISE /TITLE='Roles in the screening centre'. Comment ** other role USE ALL. COMPUTE filter_$=(CHAR.LENGTH(Txt_ie15)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(Txt_ie15)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= Txt_ie15 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments' /MISSING=VARIABLE /CELLS=COUNT. Use all. Comment ** Now for the general comment for topics not covered in the questionnaire USE ALL. COMPUTE filter_$=(CHAR.LENGTH(Txt_a1)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(Txt_a1)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= Txt_a1 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments topics not included in questionnaire' /MISSING=VARIABLE /CELLS=COUNT. Use all. Comment ** Now for the general comment for inormation management topics not covered in the questionnaire USE ALL. COMPUTE filter_$=(CHAR.LENGTH(Txt_a2)>1). VARIABLE LABEL filter_$ ' (CHAR.LENGTH(Txt_a2)>1)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. COMMENT ** now produce the report SUMMARIZE /TABLES= Txt_a2 BY ie9 /FORMAT=VALIDLIST CASENUM TOTAL /TITLE='report comments topics not included in questionnaire' /MISSING=VARIABLE /CELLS=COUNT. Use all. COMMENT ** end of page 8 analysis * Comment example of post coding syntax FREQUENCIES VARIABLES=enh_nssp /FORMAT=DFREQ /ORDER=ANALYSIS. VALUE LABELS enh_ssp 1 "slow performance" 2 "Other performance issues (negative)" 3 "Other performance issues (positive)" 4 "Reporting (output) issues –negative including: keeping additional spreadsheets" 5 "Reporting (output) issues –positive: Including alerts and QA reports" 6 "Screen design + navigation (negative)" 7 "Pathway management (problems) including: unable to change test results " 8 "Letter issues (negative)" 9 "Letter issues (positive)" 10 "Data quality (negative) excluding cancer datasets and dummy datasets but including: add new fields + clarify data"

11 "Data quality (positive)" 12 "Help desk (negative)" 13 "Help desk (positive)" 14 "Training excluding: Difficulty entering cancer datasets + dummy/training datasets" 15 "Difficulty with (Cancer) datasets" 16 "Desire for dummy/training datasets" 17 "Duplicate data entry excluding Spreadsheets" 18 "Patient Minority Group (PMG) Issues" 19 "Communications issues (negative)" 20 "Communications issues (positive)" 21 "Trust issues (positive)" 22 "Trust issues (negative) including Hardware and IT support" 23 "other + security + management" 24 "screen design + navigation (positive)" 25 "Pathway management (positive) excluding individ.field edits" 26 "System enhancements (see codes in report)". * Comment screening centres used for the multilevel analysis USE ALL. COMPUTE filter_$=( sc_no = 1 | sc_no = 2 | sc_no = 4 | sc_no = 5 | sc_no = 6 | sc_no = 7 | sc_no = 8 | sc_no = 9 | sc_no = 10 | sc_no = 12 | sc_no = 15 | sc_no = 18 | sc_no = 19 | sc_no = 21 | sc_no = 22 | sc_no = 23 | sc_no = 24 | sc_no = 25 | sc_no = 26 | sc_no = 27 | sc_no = 28 | sc_no = 29 | sc_no = 31 | sc_no = 32 | sc_no = 33 | sc_no = 34 | sc_no = 35 | sc_no = 36 | sc_no = 37 | sc_no = 38 | sc_no = 39 | sc_no = 41 | sc_no = 45 | sc_no = 46 | sc_no = 47 ). VARIABLE LABEL filter_$ '>3 replies per sc (FILTER)'. VALUE LABELS filter_$ 0 'Not Selected' 1 'Selected'. FORMAT filter_$ (f1.0). FILTER BY filter_$. EXECUTE. Mulitlevel analysis carried out using MLWin 2.14

BCSS + Information Management Questionnaire - Screening ...€¦ · BCSS + information management...

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