The National Bowel Cancer Audit (NBCA) is a national clinical audit commissioned and funded by the Health Quality Inmprovement Partnership (HQIP). It has been reporting nationally since 2002 and is run by the Clinical Effectiveness Unit in partnership with the Association of Coloproctologists of Great Britain and Ireland, and the Clinical Audit Support Unit of the Health and Social Care Information Centre. Its aim is to evaluate the quality of care received by patients with bowel cancer in England and Wales.
NPCA started on the 1 April 2013 and is the first national clinical audit of the care that men receive following a diagnosis of prostate cancer. It is designed to collect information about the diagnosis, management and treatment of every patient newly diagnosed with prostate cancer in England and Wales, and their outcomes. The audit is managed as a partnership between a team of clinical, cancer information and audit experts from the British Association of Urological Surgeons, the British Uro-oncology Group, the National Cancer Registration Service and CEU. NPCA is commissioned by the Healthcare Quality Improvement Partnership on behalf of NHS England.
This audit started in June 2011 to build on the success of the first National Audit of Oesophago-gastric Cancer, which started in October 2006 and for which the last data was collected in June 2009. It is being carried out in partnership with the Association of Upper Gastrointestinal Surgeons and the British Society of Gastroenterology, and the National Clinical Audit Support Programme of the Health and Social Care Information Centre. The audit is funded by the Healthcare Quality Improfement Partnership (HQIP).
Established in April 2016, The National Audit of Breast Cancer in Older Patients (NABCOP) is a national clinical audit run by the Association of Breast Surgery (ABS) and the Clinical Effectiveness Unit (CEU) of the Royal College of Surgeons of England (RCS). It is commissioned and funded by the Health Quality Improvement Partnership (HQIP). The NABCOP evaluates and compares the quality of care provided to women aged 70 years or older by breast cancer services in England and Wales.
The National Vascular Registry (NVR) is a national clinical audit commissioned and funded by the Health Quality Improvement Partnership (HQIP). It is run by the Clinical Effectiveness Unit at the Royal College of Surgeons of England. The NVR is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NCAPOP is a closely linked set of centrally-funded national clinical audit projects that collect data on compliance with evidence based standards, and provide local trusts with benchmarked reports on the compliance and performance. They also measure and report patient outcomes. The NVR will look at structure, process and outcome measures for the quality of care received by patients undergoing vascular surgery.
The NVR collects data and reports on the process of care and outcomes following the main index procedures of vascular surgery. These procedures fall into the three main areas undertaken by vascular surgeons in the UK:
- Repair of abdominal aortic aneurysm (both open repair and EVAR)
- Carotid interventions to prevent stroke (both surgical endarterectomy and stenting)
- Operations of the lower limb, including angioplasty, infrainguinal bypass and amputation
This is a registry of all children born with cleft lips and palates in England, Wales and Northern Ireland, their treatment, and the outcomes. The CEU has been the host of this database since April 2005. Typically, children with a cleft lip and/or palate need a mixture of care, from birth to adulthood, from professionals from different disciplines. This is why it is important to record information on these children from birth or diagnosis, and into adulthood to inform their care. CRANE is funded by NHS England.
The Audit aims to evaluate the quality of care received by patients undergoing emergency abdominal surgery (laparotomy) in England and Wales. It is being carried out by the National Institute of Academic Anaesthesia's Health Services Research Centre on behalf of the Royal College of Anaesthetists in partnership with the Clinical Effectiveness Unit and the Intensive Care National Audit & Research Centre (ICNARC). The Audit has been commissioned by the Healthcare Quality Improvement Partnership (HQIP) and it is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). NELA began on the 1st December 2012, and examined the organisation of emergency laparoscopic surgery within NHS hospitals in its first year. The results of this have been published, and are available from the NELA website (link below). In January 2014, NELA began collect data about the care received by patients and the outcomes of care, and will start reporting the results on these aspects of care in 2015.
The Clinical Effectiveness Unit uses Hospital Episode Statistics (HES) data to support our program of national clinical audits and service evaluations that examine the quality of care delivered by the English NHS. In particular, we use HES data to produce information on patterns of clinical practice and patient outcomes for English NHS organizations.
We hold a full copy of the HES database and use it as a source of hospital data on individual patients. In some circumstances, we link HES data to mortality data from the Office for National Statistics (ONS) to describe patterns of survival after hospital treatment. The linked HES-ONS data allows a study to include deaths which occur after discharge from hospital (which are not available from HES data alone). This produces a more complete picture of health care outcomes for organizations and patients.
A number of studies are being carried out to assess the usefulness of HES data to evaluate quality of care and healthcare performance. One particular project looked at what types of treatment patients received when they suffered from having air or fluid between their lungs and their ribs, and whether patients suffered from this condition again after having surgery.
The HES datasets are supplied by NHS Digital and cover hospital admissions, outpatients visit, and Accident and Emergency (A&E). Mortality data are supplied by the Office of National Statistics via NHS Digital. The Office for National Statistics is the data controller for the death register. The data we receive are not shared with any other organization, and will only be kept for the duration of the project.
Study of hospital admissions in early-years of life
We are using NHS hospital data to describe the use of hospital services by young children and how this might be linked to the health of a child’s mother during and prior to pregnancy. The study aims to provide a better understanding of how the health of the mother and child are inter-related, and help inform improvements to maternity services and child health.
We have some understanding about how a child’s health is linked to the circumstances of the mother during pregnancy. For example, mothers who smoke during pregnancy are more likely to give birth to smaller babies. These circumstances may also influence how often children are admitted to hospital. This study is looking at this issue using hospital data that are routinely collected within the NHS. This avoids the time and cost involved with collecting new data on large numbers of people. It also allows information on maternal and baby healthcare records to be brought together. At present, healthcare information for mothers and babies is not routinely linked and there is a lack of information on which maternal factors are most important.
Access to and outcomes of joint replacement for patients with long-term conditions
The aim of this project is to investigate access to elective hip and knee replacement surgery for patients with different long-term conditions and the outcomes of this surgery. The project will use anonymised data that has already been collected on patients treated in English NHS hospitals. The anonymised data has been provided by NHS Digital, the nation’s provider of information and data in health and social care.
The information we are using comes from two sources. First, we will use questionnaire data from patients who have had a hip or knee replacement surgery that was collected by the Patient Reported Outcomes Measures (PROMs) survey. Patients completed a PROMS questionnaire before their surgery and this will be used to investigate access to surgery. They also completed a PROMs questionnaire after surgery which will be used to describe the outcomes of their treatment. We have also obtained Hospital Episode Statistics (HES) data for patients who completed the PROMS survey. The HES data provides information about admissions to hospital before and after their hip or knee replacement. NHS Digital has also provided us with information about those patients who participated in the PROMs survey who have passed away after their surgery, including date and cause of death.
If you prefer us not to use your data in this project or have any further questions about this project, please contact Belene Podmore at Belene.Podmore@lshtm.ac.uk.
Liver transplantation as a treatment for hepatocellular carcinoma: a study using existing electronic data
The aim of this project is to investigate the best use of liver transplantation to treat patient’s hepatocellular carcinoma (HCC). HCC is the most common form of liver cancer.
Annually over 2000 new cases of HCC are being diagnosed in the UK. Overall survival of HCC patients is poor with less than 30% alive at one year. Prognosis is best for patients who receive a liver transplant with about 75% alive at five years.
The emergence of liver transplantation as a curative option for HCC has increased the gap between patients waiting for transplantation and the availability of suitable livers. Identifying the role of liver transplantation in the treatment of patients with HCC is therefore important in helping to improve outcomes in these patients.
To answer our research questions, we will use data that has already been collected on patients treated in English NHS hospitals. The data will be obtained from three different national datasets and then linked together. It will contain no data items that could be used to directly identify individuals.
The three linked datasets include (a) the liver cancer dataset, managed by the National Cancer Registration and Analysis Service (NCRAS) and used to identify all patients with HCC in England (b) the Hospital Episode Statistics (HES) database, managed by NHS Digital and used to determine comorbidities, treatments and outcomes, and (c) the UK Liver Transplant (UKLT) Registry, managed by NHS Blood and Transplant (NHSBT) and used to evaluate the outcome of liver transplantation.
Further information for patients whose data may be included in this study can be found in the fair data processing statement.
If you prefer us not to use your data in this project or have any further questions, please contact David Wallace at David.Wallace@lshtm.ac.uk.