OECI accreditation process ‘robust and independent’, hears conference

While some perceive peer review systems as “a soft touch”, the processes of the Organisation of European Cancer Institutes (OECI) are “very robust”, a senior OECI representative told the Gathering Around Cancer 2023 meeting in Croke Park, Dublin. 

“I really do believe in peer review systems,” the OECI’s Director of Quality and Accreditation Mr Simon Oberst told the session on accreditation on 17 November. 

“Some people think peer review is a ‘soft touch’, as you know, ‘I scratch your back and you scratch mine’, I assure you it is not,” he remarked. “Although we know you as friends and we have worked with you in helping to develop your processes and standards, when it actually comes to the peer review and the report, we are very robust and we are very independent, and then we work with you for the improvement process.”

The OECI, which is a non-governmental organisation, aims to ensure patients have equal access to a high quality of cancer care in multidisciplinary teams; cancer research and innovation are fully integrated into patient care pathways; and patients are at the centre of their care.

It has 123 member institutions and over 70 centres and networks are participating in its accreditation and designation (A&D) programme, including most of the top centres in Europe. The programme is designed to enable a complete quality system for cancer diagnosis, care, education, and research by using OECI standards and indicators and peer review.

The OECI accords three designations through this programme (cancer centre, comprehensive cancer centre, and comprehensive cancer network).

Currently, two Irish centres are accredited as OECI cancer centres – the Trinity St James’s Cancer Institute and the Beaumont RCSI Cancer Centre. Four Irish centres are seeking OECI accreditation.

The domains of the A&D programme include governance, organisational quality, patient involvement and empowerment, multi-disciplinarity, prevention and early detection, all modalities of diagnosis, treatment and care, translational and clinical research, and education and training.

Strengths and weaknesses

During his presentation, Mr Oberst outlined that the OECI sees many strengths in the European cancer care community, such as the “world-class research” being conducted in some centres.

However, there are also “massive inequalities in Europe” across the patient pathway. “We see in some of those central and eastern European countries the late detection of cancer and a reactive approach. We see delayed innovation… often due to a siloed approach and unfortunately a lack of core funding for research.”

Areas of opportunity included the need for more outcomes research, strengthening the patient voice, investment in omics, and a “massive push” on prevention and early detection.

He observed that a common threat to cancer care and research in Europe was the “massive workforce crisis”.

Structures

Mr Oberst spoke about forming cancer centres within university hospitals and the networks around them.

“That [process] requires new organisational structures, new agreements with universities, with freestanding research institutes…. Our emphasis is not on the separate legal entity – we do not say that a comprehensive cancer centre needs to be a separate legal entity with directors and all that jazz; the emphasis should be on practical workability and integration.”

He observed that a common threat to cancer care and research in Europe was the ‘massive workforce crisis’

He outlined: “The main steps of formation really are, number one, to form that cancer centre board bringing together the clinical, management, and research and education. Secondly, you absolutely need to have an integrated strategy for five or even 10 years which covers care, research and education.”

Other important elements included strong clinical governance, clear patient pathways, a high-performing clinical trials unit, and a “rational and achievable” research strategy.

Some of the challenges in establishing cancer centres may include lack of centralised funding; resistance or scepticism; and difficulties recruiting to senior academic posts.

The OECI has also developed a new set of standards for cancer networks, covering areas such as governance, patient pathways, MDT structures, and research collaborations. “And the big one of course – the difficult one – IT inter-operability, which is a huge issue as you all know here in Ireland,” he added.

Mr Oberst noted that Ireland’s national cancer strategy reflected largely the same criteria.

Earlier, Dr Jean-Benoit Burrion, Chair of the OECI’s A&D board, spoke at the conference on comprehensive cancer care and research in the broader EU context.  

He noted that the European Commission had been working on shaping the oncology landscape in Europe through various programmes, the latest of which is the Europe’s Beating Cancer Plan.

This document was being implemented in parallel with the EU Cancer Mission plan from the research and innovation directorate.

Of interest to cancer centres, the Europe’s Beating Cancer Plan sets out an objective to establish an EU network of national comprehensive cancer centres and ensure that 90 per cent of eligible patients have access to such centres by 2030. The Cancer Mission plan aims to support the creation of a network of comprehensive cancer infrastructures.

These actions have led to the projects CraNE and CCI4EU, to which the OECI has been contributing.

Dr Burrion also provided an overview of the cancer centre accreditation landscape in Europe which, aside from the OECI, includes two systems run by organisations in Germany (Deutsche Krebshilfe, which operates a programme similar in approach to that of OECI, and Deutsche Krebsgesellschaft, which runs a tumour-specific programme).

Topical

Member of the Gathering Around Cancer organising committee, Dr Megan Greally, told the Medical Independent (MI) that the committee was keen to maintain a focus on accreditation, as several Irish centres are engaged in this process. She also noted that other topical areas, such as surgery for GI cancer and drug access, were reflected in the two-day conference agenda.

Also speaking to MI, Prof John McCaffrey, member of the conference organising committee, noted that the “OECI process is our process of accreditation, and it allows us to look at who our relationships are with, and are we doing things to standard”.

“Trinity and the RCSI have completed the process, and UCD [University College Dublin], UCC [University College Cork], and UCG [now University of Galway], are all in the process of doing it with their cancer centres.” He noted that the two OECI speakers are “very senior” in the organisation, “So the fact that they came here, they are keen to help us get it right.”

Prof McCaffrey agreed engaging in the process was time-consuming. “But you need to have a dedicated staff member as the coordinating person and the rest of it is going through your institution and looking at what you do correctly and what you do not do correctly and pointing out through an accreditation process, where you need to get things right,” he said. “Like the multidisciplinary process, everybody does it, but do you do it properly…. And ultimately, with all of these processes, it has the patient at the centre… all of these things are meant to improve patient outcomes, and that is why we are all signed up to it.”

Meanwhile, Prof McCaffrey noted that the first version of Gathering Around Cancer had taken place just over 10 years previously, “and it just gets better and better every year.”

He also acknowledged the event would not happen without the support of the pharmaceutical industry by way of unrestricted grants.

The other member of this year’s organising committee was Prof David Gallagher.