Editorial policy

This policy covers information produced for CancerHelp UK's

• Cancer type sections
• About cancer sections (to be re-named Cancers in general)
• Coping with cancer sections

There is a separate policy document covering production of information for the clinical trials database on CancerHelp UK. There is a separate policy document covering production of information for the tips and stories section.

Major new content is planned by the CancerHelp UK team according to the site's current content plans. Subjects for new content are selected according to

• Feedback from site users
• Feedback from patient advisors
• Previously identified gaps in site content
• Current issues in oncology

In addition to major new content, suggestions for new content for the Questions and Answers section is reviewed monthly and based on

• Questions sent in by site users
• Press coverage of new developments
• Feedback on frequently asked questions from the Cancer Research UK information nurse team

Detailed planning of the writing programme is set twice yearly by the head of CancerHelp UK and clinical information manager, following discussion with the CancerHelp UK team. Subjects for inclusion in the Questions and Answers section are selected in consultation with the Cancer Research UK information nurse team, based on their knowledge of current areas of service user interest.

Material for CancerHelp UK is originated internally by the CancerHelp UK team. Material can also be sourced outside Cancer Research UK with the agreement of the head of the CancerHelp UK team. Material can be commissioned externally if

• The writing resource is not available within the team
• External sources of expertise have been identified

All external writers will be given details of the house style and a copy of the CancerHelp UK writers' guidelines. Their work will be subject to the same procedures as information produced internally (ie the editorial workflow and specialist review process).

Production of information both internally and externally is overseen by the clinical information manager, who is responsible for setting deadlines, commissioning reviewers and coordinating the production process to publication on the website.

When a section is commissioned, the writing and editorial team will meet to discuss the structure, content, illustrations, appropriate reviewers and deadlines.

Material for the Questions and Answers section is either suggested by members of the information nurse team or by clinical members of the CancerHelp UK editorial team, informed by site feedback.

Thorough background research is carried out by the writer before beginning the draft of a new section. This comprises a thorough literature review and check of mandatory sources for clinical sections. Literature review covers the 5 years prior to writing, searching for

• Systematic reviews
• Major randomised controlled trials
• Review articles published in the British Medical Journal, the New England Journal of Medicine, The Lancet and Lancet Oncology, and relevant specialist journals eg urology

For clinical sections, mandatory sources are as follows

• Current published NICE and SMC guidance
• Cochrane reviews
• Medical practice guidelines published by the relevant UK medical bodies (ie Royal colleges, British Society of Haematology etc), SIGN and COIN
• Published US National Cancer Institute (NCI) treatment summaries
• Cancer Research UK CancerStats series
• Our own internal records of current and closed clinical trials, and trial results, including trials conducted at Experimental Cancer Medicine Centres (ECMC)
• External cancer clinical trials bodies: National Cancer Research Network (NCRN), Medical Research Council (MRC) plus others as relevant (eg Haematology Trials Group)

CancerHelp UK has a very specific house style, which is detailed in the CancerHelp UK writers' guidelines. These also detail the format for sections of information on CancerHelp UK, which must be kept to.

The house style must be adhered to for all site content, except for material sent in by site users and added to 'Your Tips and Stories'. The latter may be altered to remove material that could cause offence to others or statements that could compromise the aims and beliefs of Cancer Research UK or CancerHelp UK. We reserve the right to make minor changes to assist with clarity, for example correcting spelling or grammar where necessary. All changes to Your Tips and Stories contributions are kept to a minimum.

The writer is responsible for producing a first draft of new material, which will be passed to the web editor for editing re plain English, grammar and link consistency. The web editor post requires that the holder does not have a clinical background so that this post can also assess ease of understanding for a lay audience. If necessary, a dialogue is initiated between the writer and web editor to clarify any issues.

The second draft is submitted to the clinical information manager for fact checking and further editing as necessary. Further amendments may be needed, following detailed feedback from the editing process.

Following external review, the clinical information team implement reviewer comments, as appropriate. Following this, the head of CancerHelp UK reviews the section before it goes live on site. The head of CancerHelp UK may review the section prior to external review, particularly if there is any area of discussion or controversy.

A complete section of CancerHelp UK requires the writer to produce

• Page titles and urls
• Meta description text for each page
• The body text
• Sketches for diagrams to be commissioned from medical illustrator
• Reading list
• Useful organisations list
• Glossary terms for any new technical words used in the section that are not already included in the glossary
• Key wording for every page produced
• Sources page (the 'Where this xxx information comes from' page)

The writer must produce page titles for all pages which will work as web addresses (urls) for the site.  Urls are formed from the page titles, with hyphens between the words.  The writer should check the site to make sure that each page title is not already in use.  

Meta description data is used as the basis for the brief page descriptions that appear in internal and external searches.  It is generally formed from the introductory sentence and bullets for each page, which will necessarily include keywords relevant to the page content.

Any items for the Questions and Answers section that have been forwarded by the Cancer Research UK information nurse team will be anonymised. (The nurses' replies to individual service users must have had any names and other identifying features removed before they are sent to the CancerHelp UK team.) These items routinely need some additional clarification or content to render them suitable for a wider audience - they are not intended to be used verbatim.

Each information draft is edited by the CancerHelp UK editorial team and checked for

• Readability
• Grammar
• Punctuation
• Style
• Links throughout each section, to other parts of the site and to other sites
• Referencing
• Accessibility
• Relevance

Normally there will be a minimum of two drafts. The first is produced by the writer. This will be edited by the web editor for language, grammar and house style in line with the writing guidelines and style guide. The web editor will also check the consistency of link notation used throughout the section.  Any technical or sense queries will be returned to the writer after the web editor's edit. The finished, edited draft will be checked by the clinical information manager prior to sending for external review. Writing and editorial staff will usually be in close contact throughout the writing and editing process. All content is reviewed by the head of CancerHelp UK either pre or post external review.

'Questions and Answers' are edited and adapted by the specialist nurse writer from individual replies to queries from service users. These drafts then go through the editorial process outlined above. Attention is paid first and foremost to the use of plain English and to generalising the content so that the finished text will be of most use to the most people.

Once the final draft of a new section has been produced, it will be sent to a minimum of two external specialist reviewers and one or two lay reviewers if possible. Where possible, draft illustrations are sent at the same time.

The review process is coordinated and implemented by the CancerHelp UK clinical information nurses, who maintain all records and timetables. The overall process is managed by the clinical information manager. Reviewers are asked to return their completed reviews within 6 weeks of receiving them.

Reviewers are selected individually for each section, according to the needs of that section. Normally, for a specific cancer, this consists of one oncologist and one cancer surgeon. For cancers that are not normally treated with surgery, e.g. leukaemia, two oncology haematologists could be selected. Other health professionals can also be specialist reviewers, including specialist nurses, oncology pharmacists, dieticians and physiotherapists. For the Coping with Cancer sections, reviewers may include GPs, community cancer nurses, and other professionals with areas of relevant expertise. Reviewers are selected by the clinical information manager, in consultation with the clinical members of the CancerHelp UK team.

Once all external reviewers' comments have been incorporated, new sections are sent to the head of CancerHelp UK for final review.

The pages of all returned external reviews are all kept on file in hard copy or as an electronic copy. A ticking / crossing system is used to indicate which comments have been incorporated and when. If comments from reviewers are rejected, this is noted and explained on the review copy. The clinical information team will contact the specialist reviewer about any areas of confusion or inconsistency that cannot be otherwise resolved.

There are separate guidelines for professional and lay reviewers. Professional reviewers are paid an annual retainer, in return for a maximum of one yearly review and the promise of a prompt response to one-off queries that may occur during the year (for example, checking a paragraph to be included about a new form of treatment). Payment is not made until the completed review has been returned. CancerHelp UK retains the right to withhold payment of the annual retainer if reviews are not carried out to a satisfactory standard (to be determined on an individual basis by the head of CancerHelp UK, in consultation with the clinical information manager).

Drafts for the Questions and Answers section that do not need external review are checked internally, either by another member of the CancerHelp UK clinical team or by the Cancer Research UK information nurses. Once they have been approved, they can be published on site. Should there be any queries or areas of controversy, the draft Question and Answer is sent to the relevant specialist reviewer prior to publishing. All Questions and Answers are included in material sent to external reviewers for periodic review (eg breast cancer 'qanda' are sent out with the breast cancer section).

Review for video and diagrams
Videos are usually produced with the input of relevant specialists, as they are consulted during writing of the script or preparation of the diagram.  For example, the script for 'exercises for breast cancer' was written with input of specialist physiotherapists.  Specialist input is recorded as part of the production process. If specialists are not included in production, then the video / diagrams should be sent to specialists for review before being put on to the site.  Periodic review will then take place as part of the regular review process.

Where possible, two lay reviewers are contacted for each new section, or section that is going out for periodic review (if not reviewed at time of writing). The lay reviewers are people who have had cancer themselves or are relatives of people with cancer.

In addition to lay review, usability and readability testing is carried out periodically with representatives of the site's main user groups ie people diagnosed with cancer, relatives of those diagnosed with cancer, health professionals and those concerned about cancer symptoms.

Following the incorporation of reviewer comments, proof reading of all new content (including Questions and Answers) should be carried out on the final draft, to ensure that information contains no spelling, typing or grammatical errors. Proof reading is carried out by the head of CancerHelp UK during her final reading of each section after external review and just prior to publishing. Content may be mounted on site prior to this final check, but is not made live until after proofing and checking.

Whoever mounts the content (see publishing) must check each page on the front end of the site for layout errors or non working links.

CancerHelp UK has an on line content editing and management system. All site content is mounted through this system, including illustrations.  Site content is mounted by either the CancerHelp UK Administrator or Web Editor.

All meta data must be put into the system at the same time as the content is mounted ie page title, url, keywords, meta description.

The on line content management system automatically archives page versions, which are retained in the system with the date that version went live. If material is to be removed permanently from the site, it can be expired electronically.  Expiring content is conducted by the web manager or editor who will check for inbound links to that page and redirect them to appropriate live copy.  Expired pages can still be accessed by the web manager or trials dB administrator if necessary, eg for a user query.

The eRoom holds all drafts of new content produced during development, up to the live copy.

All pages must have the date the content was originally mounted, or last reviewed. Page dates are updated upwards through 'branch' pages ie when the breast cancer genes page is updated

• the risk and causes menu page date is updated
• the 'about breast cancer' section menu page date is updated
• the breast cancer section menu date is updated and so on

This ensures that each section carries the date when something within it was updated. When drilling down, it then is clear when each 'leaf' page was last updated specifically.

Page dating 'upwards' is now managed automatically within the content management system.  This is done by setting the page date function to 'major' on the page meta data screen before saving.  NB default is set to 'minor' to ensure that the page date does not change when minor editing takes place to correct typos or fix broken links, for example.

We do not provide any others dates on content as we believe that users find more than one date confusing. Furthermore with a site with such a long history, the original content production date is unhelpful.

We aim to review all content within 12 - 18 months of the last review date.  While most content will be reviewed within one calendar year from the current date, the next content review date will be no more than 18 months from the page date.

For existing site content, we have a strong commitment to retaining currency of information. All relevant NICE decision, treatment guidelines, major clinical trial results and other important changes are implemented on site as soon as possible after their publication. The clinical team of CancerHelp UK have sufficient expertise to implement these changes without prior external review. These changes are entered into the review database, so that a record is maintained for the next external review.

In addition to this system of maintaining currency, existing site sections are reviewed every 12 - 18 months. Review is carried out alternately externally and internally.  External review is carried out by up to two specialist reviewers. Internal review is carried out by a member of the CancerHelp UK clinical team or a member of the Cancer Research UK information nurse team. Each section is researched prior to sending to external reviewers so that areas of new content or controversy can be highlighted. Review preparation for both internal and external review is carried out by a search of sources listed in the researching section above.

Topics that are in the news can be featured on the CancerHelp UK home page, with a link to the relevant page or trial. Items may be selected because

• There is major press coverage of a cancer topic
• The Information Nurse team are experiencing a surge of enquiries on a particular topic
• A Cancer Research UK trial is being promoted by the Press Office

Major news items may also be featured on Facebook and Twitter, with a link to the relevant section of the CancerHelp UK website.

If required, to assist the information nurse team with demand, a feature may be specially written for the Questions and Answers section.

We have an RSS feed for news items in place on all appropriate cancer type landing pages.  Exceptions are for rare cancers, where there may be little current news and therefore RSS feed would be showing items that are several years old.  Before putting RSS in place, we will also vet the news items displayed where they may be sensitive, for example, genital cancers.

All CancerHelp UK site feedback sent to our inbox is read and noted by members of the team. Feedback contains suggestions for new material, questions on material that we do not currently supply and comments on the accessibility of the site and ease of use. We are happy to receive all feedback. Any comments received about inaccuracies on site, or technical difficulties are acted on as soon as they are received. Small problems can usually be solved the same day (typos, broken links etc). More complex queries are dealt with as soon as possible; within a week at most.

We will record and respond to all legitimate comments, suggestions and complaints, and take them into account when producing future information.  Complaints are responded to by the clinical information manager or head of CancerHelp UK.

Normally, feedback replies are sent by the web editor or clinical information officer. Clinical questions sent to the site are forwarded to the Cancer Research UK information nurse team.

Feedback received via individual page ratings (ie out of 5 stars) and additional comments freetext box is received anonymously and therefore cannot be responded to.  However all comments are noted for future content development and/or necessary corrections and clarifications.

We provide links to websites that provide information or services that would be useful to people affected by cancer.  Sites must provide information that is additional to information we provide.  There is a site policy of limiting lists of links, as we believe that long lists of links are less useful than shorter, more discriminating ones. This can be over-ruled with discretion. We would not wish to exclude a useful link solely on the grounds of number featured. Links will vary, depending on the subject and resources available. Because we receive a very large number of link requests and cannot include them all, links must be to organisations providing national services, rather than local, and be UK based. Unless there is a special consideration (generally that a service is useful to our audience and difficult to find) we do not include links to commercial companies or services.

All sites we link to must be reputable and produce reliable, high quality information that is regularly updated. Links are approved on an individual basis. Suitable links to include are discussed at CancerHelp UK team meetings, as are all ad hoc requests for links that we receive. The head of CancerHelp UK has the final say on the inclusion of individual links. We reserve the right to refuse to link to any website that we do not consider suitable for inclusion. Due to the many link requests we receive, our policy is to contact only those organisations whose request for a link is successful.

This policy will be reviewed on or before September 2013.

• Writers' guidelines
• Specialist reviewers guidelines
• Lay review guidelines