Pancreatic cancer and pancreaticoduodenectomy

Summary

A request was made for statistics on pancreaticoduodenectomy referrals, costs, and patient outcomes in the Isle of Man between 2014 and 2018. The Department of Health and Social Care disclosed that only three such surgeries were performed, all at the Royal Liverpool Hospital, but refused to provide referral numbers or costs as the data was not held in a reportable format.

Key Facts

• Between 2014 and 2018, only three pancreaticoduodenectomy surgeries were completed for IOM patients.
• All three surgeries were performed at the Royal Liverpool Hospital.
• The authority could not provide referral numbers because the patient administration system records referrals by specialty, not by specific procedure.
• Cost data per procedure was withheld because it would require creating or deriving information not currently held.
• The response was issued on 11 June 2019 regarding a request received on 27 May 2019.

Data Disclosed

• 2014 to 2018
• two Pylorus Preserving Pancreaticoduodenectomy surgeries
• one Pancreaticoduodenectomy
• Royal Liverpool Hospital
• 17,000 patient transfers per annum
• 27 May 2019
• 11 June 2019

Exemptions Cited

• Section 8(3) of the Freedom of Information Act (things a public authority is not required to do)
• Section 11(3)(b) of the Freedom of Information Act (requirement to create or derive information)

Original Request

Question 1: How many IOM patients were referred for a pancreaticoduodenectomy (Whipples procedure) in the years 2014 to 2018, please state number of patients by each year? Question 2: How many of these IOM patients underwent a pancreaticoduodenectomy? Question 3: How many of these patients were treated by the Royal Liverpool? Question 4: Other than the Royal Liverpool, what other hospitals are patients referred to for pancreaticoduodenectomy? Question 5: How much does it cost the Isle of Man Government per pancreaticoduodenectomy? Question 6: What were the ages of the patients referred for a pancreaticoduodenectomy (please group by age i.e. 20-25, 25-30 until the age of 65 where the ages should be split per year)? Question 7: What is was the mortality rate of those patients that underwent a pancreaticoduodenectomy (during surgery or within 3 months thereafter)? Question 8: Are IOM cancer patients entitled to a second opinion and if so, is this advised to them clearly? Question 9: For chemotherapy, how many patients have had Peripherally Inserted Central Catheter (PICC) lines inserted for the years 2014 to 2018? Question 10 For chemotherapy, how many patients have had PORTS inserted (a port is a small medical appliance that is installed beneath the skin, a catheter connects the port to a vein) for the years 2014 to 2018, please state number of patients by each year? Question 11: The Minister for Health has recently stated that there are approximately 17,000 patient transfers per annum. Does this figure include parties escorting a patient? Please provide the figures for parties escorting a patient, their cost and the reason for escort.

Data Tables (1)

Full Response Text

Chief Executive: Angela Murray Freedom of Information Team DHSC Crookall House Demesne Road Douglas IM1 3 QA

(01624) 642621 dhsc@foi.gov.im Website: www.gov.im/dhsc

Our ref: 840165 11th June 2019

Dear ###

We write further to your request which was received on the 27th May 2019 and states:

"Question 1: How many IOM patients were referred for a pancreaticoduodenectomy (Whipples procedure) in the years 2014 to 2018, please state number of patients by each year? Question 2: How many of these IOM patients underwent a pancreaticoduodenectomy? Question 3: How many of these patients were treated by the Royal Liverpool? Question 4: Other than the Royal Liverpool, what other hospitals are patients referred to for pancreaticoduodenectomy? Question 5: How much does it cost the Isle of Man Government per pancreaticoduodenectomy? Question 6: What were the ages of the patients referred for a pancreaticoduodenectomy (please group by age i.e. 20-25, 25-30 until the age of 65 where the ages should be split per year)? Question 7: What is was the mortality rate of those patients that underwent a pancreaticoduodenectomy (during surgery or within 3 months thereafter)? Question 8: Are IOM cancer patients entitled to a second opinion and if so, is this advised to them clearly?

Question 9: For chemotherapy, how many patients have had Peripherally Inserted Central Catheter (PICC) lines inserted for the years 2014 to 2018? Question 10 For chemotherapy, how many patients have had PORTS inserted (a port is a small medical appliance that is installed beneath the skin, a catheter connects the port to a vein) for the years 2014 to 2018, please state number of patients by each year? Question 11: The Minister for Health has recently stated that there are approximately 17,000 patient transfers per annum. Does this figure include parties escorting a patient? Please provide the figures for parties escorting a patient, their cost and the reason for escort."

I have detailed below the information that is held. Question 1: How many IOM patients were referred for a pancreaticoduodenectomy (Whipples procedure) in the years 2014 to 2018, please state number of patients by each year? Complying with the request for information would require the public authority to do one or more of the matters mentioned in section 8(3) (things a public authority is not required to do by the Act S11(3)(b)). While our aim is to provide information whenever possible, in this instance, complying with your request for information would require us to create or derive information from information that we hold. Referrals are entered into patient administration system (Medway) to a particular specialty and not for a particular procedure and so this information is not available in a reportable format. Question 2: How many of these IOM patients underwent a pancreaticoduodenectomy? From 2014 to 2018 two Pylorus Preserving Pancreaticoduodenectomy’ surgeries and one Pancreaticoduodenectomy’ were completed. Question 3: How many of these patients were treated by the Royal Liverpool? All surgeries noted in question 2 were performed at the Royal Liverpool Hospital. Question 4: Other than the Royal Liverpool, what other hospitals are patients referred to for pancreaticoduodenectomy? Question 3 relates, no treatment was undertaken at other hospitals.

Question 5: How much does it cost the Isle of Man Government per pancreaticoduodenectomy? Complying with the request for information would require the public authority to do one or more of the matters mentioned in section 8(3) (things a public authority is not required to do by the Act S11(3)(b)). While our aim is to provide information whenever possible, in this instance, complying with your request for information would require us to create or derive information from information that we hold. This information is not available in a reportable format. Question 6: What were the ages of the patients referred for a pancreaticoduodenectomy (please group by age i.e. 20-25, 25-30 until the age of 65 where the ages should be split per year)? At the time of their operation, patients 1 and 2 were between 55 to 80 years of age and patient 3 was over 80 years of age. Question 7: What is was the mortality rate of those patients that underwent a pancreaticoduodenectomy (during surgery or within 3 months thereafter)? All 3 patients survived beyond 3 months. Question 8: Are IOM cancer patients entitled to a second opinion and if so, is this advised to them clearly?

Yes, a second opinion leaflet is available via the Patient Safety and Quality Team. Question 9: For chemotherapy, how many patients have had Peripherally Inserted Central Catheter (PICC) lines inserted for the years 2014 to 2018? While our aim is to provide information whenever possible, in this instance the public authority does not hold or cannot, after taking reasonable steps to do so, find the information that you have requested S11(3)(a) of the Act refers. However we do have figures since November 2018. Since November 2018 to May 2019 64 PICC’s were sited.

Question 10 For chemotherapy, how many patients have had PORTS inserted (a port is a small medical appliance that is installed beneath the skin, a catheter connects the port to a vein) for the years 2014 to 2018, please state number of patients by each year? From 2014 to 2018 4 ports have been inserted. Question 11: The Minister for Health has recently stated that there are approximately 17,000 patient transfers per annum. Does this figure include parties escorting a patient? Please provide the figures for parties escorting a patient, their cost and the reason for escort. While our aim is to provide information whenever possible, in this instance the public authority does not hold or cannot, after taking reasonable steps to do so, find the information that you have requested S11(3)(a) of the Act refers. This information is not available in a reportable format however the figure includes parties escorting a patient.
Please quote the reference number 840165 in any future communications.

Your right to request a review

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Should you have any queries concerning this letter, please do not hesitate to contact me. Further information about freedom of information requests can be found at www.gov.im/foi.

I will now close your request as of this date.

Yours sincerely