Clinical Effectiveness Unit (CEU)

The Clinical Effectiveness Unit (CEU) at the Royal College of Surgeons of England (RCS England) is committed to enhancing patient outcomes and evidence-based practice by conducting rigorous clinical research and national clinical audits.

Our history and mission

The Clinical Effectiveness Unit (CEU) was established in March 1998 as an academic collaboration between the Royal College of Surgeons of England (RCS England) and the Department of Health Services Research & Policy of the London School of Hygiene and Tropical Medicine (LSHTM).

The CEU was formed after a review of the RCS England Surgical Epidemiology and Audit Unit (funded by the Department of Health to undertake clinical audit projects and to measure patient satisfaction with surgical services) recommended the creation of an academic link with a local university.
Since its inception in 1998, the CEU has become a national centre of expertise in the methods, organisation, and delivery of large-scale studies on the quality of surgical care. It has undertaken national projects on vascular surgery, cancer care, emergency bowel surgery, joint replacement, and the treatment of children with a cleft lip or palate.

The findings from these projects have directly influenced medical practice as well as clinical policy in the UK.

Our aim and objectives

The CEU’s primary aim is to improve patient outcomes and promote evidence-based medicine by conducting national clinical audits and research studies that help to improve the quality, organisation and management of health services within the NHS. The CEU strives to be a national centre of expertise in the quality of surgical care through multidisciplinary collaborations and methodological excellence.

Key objectives:

Deliver national clinical audits that provide essential information for healthcare commissioners and providers to improve patient care.
Produce accurate and impactful results through rigorous scientific methods, ensuring the design and conduct of our audits and research deliver meaningful findings for clinicians and patients alike.
Develop advanced methodologies for assessing healthcare quality and patient outcomes.
Promote excellence in surgical research and clinical audit across the UK through collaboration with surgical specialist associations and the royal colleges.

Our team

The CEU’s strategy emphasises joint clinical and methodological leadership. To achieve this, the CEU has established collaborative partnerships with many Royal Colleges and medical associations as well as the Department of Health and Social Care and NHS bodies.

It is a project-based organisation and has a multidisciplinary character, currently consisting of around 40 staff members with clinical and non-clinical backgrounds. Staff have expertise in health services research, medical statistics, epidemiology, public health, surgery and medicine. Eight staff have academic appointments at the LSHTM. Professor David Cromwell (Professor of Health Services Research at the LSHTM) has been the CEU’s Director since May 2011.

The activities of the CEU are overseen by the RCS England Research Committee which includes RCS England Council members, surgeons from various subspecialties, and senior academics.

What we do

The CEU has developed a strategy for its involvement in national audit projects. An essential element of this strategy is that audit projects are viewed as epidemiological studies of the quality of health care. We use epidemiological methods to generate high quality quantitative evidence on the processes and outcomes of care as well as on their determinants.

The methodological requirements of the CEU's projects do not differ from those of any epidemiological study. They are designed to have:

Representative patient samples for accurate and generalisable results.
Clear, well-defined measures of both care processes and patient outcomes.
Robust analysis techniques to deliver reliable and actionable findings.

In addition to national clinical audits, the CEU also offers training and mentorship for surgeons. The short-course programme, aimed at both trainee and senior surgeons, equips participants with essential skills in patient-oriented surgical research. These courses have received positive feedback by over 500 participants. We also support research projects for trainee surgeons, fostering the next generation of surgical researchers.