1. Evaluation form

Dear Colleague,
Thank you for using our Fitness Assessment proforma for older patients in breast clinic. The purpose of the Fitness Assessment is to:
- Quantify frailty, formally assess cognitive function and evaluate a patient's overall health, and 
- be able to record the results of these assessments in a reproducible manner.
These assessments are likely to provide most utility to the clinical team if they are completed at the initial diagnostic visit, such that the results are available for the diagnostic MDT. Patients who are aged 70 years and older, English speaking and able to complete an Abbreviated Mental Test Score (AMTS) are eligible to participate. Any health professional involved in the care of a breast cancer patient can conduct the assessment.
We will not be conducting any formal analysis with the Fitness Assessment this year, but from April 2020 the components in the proforma will be collected as part of the breast cancer metrics for COSD version 9. When we receive these results, and they will form part of our future Annual Reports. 
We are grateful for any feedback and would like to invite you to complete this evaluation form on the content, practicality and utility of the proforma. It contains 17 questions and should take 5-10 minutes to complete.

1.  This evaluation form should be completed by the health professional conducting the Fitness Assessment.
2. You should be able to complete the evaluation form in one sitting. If you leave the form incomplete and return to it later, you may need to restart the form from the beginning (depending on your internet browser’s cookie settings).
3. Please answer the questions based on your experience of using the Fitness Assessment form.

If you have problems with the evaluation form or have questions about NABCOP, please contact the project team at nabcop@rcseng.ac.uk or on 020 7869 6139.
Thank you for your help and support.
Kieran Horgan, Breast Surgery Clinical Lead
David Dodwell, Oncology Clinical Lead
Katie Miller, Clinical Research Fellow
On behalf of the NABCOP Project Team

National Audit of Breast Cancer in Older Patients (NABCOP)
Clinical Effectiveness Unit, The Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London WC2A 3PE