CEU projects

Explore our ongoing projects to learn about the significant work we are doing to improve clinical effectiveness and patient outcomes in clinical care. 

Some projects have their own website that provides more information on the project as well as access to project reports and publications. 

Current CEU projects

National Vascular Registry

The National Vascular Registry (NVR) was established in 2013 to measure the quality and outcomes of care for adults who undergo major vascular procedures in NHS hospitals, and to support vascular services to improve the quality of care for these patients. The NVR is a national clinical audit commissioned by the Health Quality Improvement Partnership (HQIP), and is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP).  

The NVR publishes information on the care and outcomes for people who have emergency and elective procedures at NHS vascular units in the following three areas: 

• 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.

For more information visit the Vascular Services Quality Improvement Programme (VSQIP) website.

CRANE Database

This is a registry of all children born with cleft lips and palates in England, Scotland, Wales and Northern Ireland, their treatment, and the outcomes. The CEU has been the host of this database since April 2005 and has produced a series of annual reports and other publications. 

Typically, children with a cleft lip and/or palate need a mixture of care from birth to adulthood from professionals working in different disciplines. CRANE collects information on these children at birth or at diagnosis and into childhood. This includes information about the surgical treatments children have had, and how they are getting on in terms of their speech, hearing, growth, dental health and overall health.  

For more information visit The Cleft Registry and Audit NEtwork (CRANE) website. 

National Emergency Laparotomy Audit (NELA)

The NELA 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 located at the Royal College of Anaesthetists.  Staff from the Clinical Effectiveness Unit provide methodological expertise within the NELA. The Audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP) and began on the 1 December 2012. Results have been published in annual reports, which are available from the NELA website.

Use of Hospital Episode Statistics (HES) Data

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. 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 civil registration (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 a person is discharged from hospital (which are not available from HES data alone). This produces a more complete picture of healthcare outcomes for organizations and patients.

The HES and civil registration datasets do not include sensitive personal information such as name, address, or postcode. Individuals are labelled with an anonymous identifier which makes it impossible to identify people without adding other information. We are supplied with the datasets on the condition that we do not add data from other sources.

An aim of some projects that use the HES database is to expand the evidence base concerning the effective delivery of services at a national level. The project findings typically have implications for policy makers and commissioners of care as well as for clinicians and NHS organisations and are therefore published in medical journals or disseminated at national/ international conferences.  Other work aims to improve the methods used to evaluate services. A particular focus is the prediction of the risk of surgery for patients based on their disease characteristics. These predications then allow the calculation of risk-adjusted provider outcomes. This is fundamental because it enables differences in the mix of patients treated at the providers to be taken into account and ensures the benchmarking of providers against each other is fair.

Two examples of our work using the HES data published as papers in medical journals are:  

1. Fowler AJ, Wahedally MAH, Abbott TEF, Prowle JR, Cromwell DA, Pearse RM. Long-term disease interactions amongst surgical patients: a population cohort study. Br J Anaesth. 2023; 131(2):407-417
2. Wahba AJ, Phillips N, Mathew RK, Hutchinson PJ, Helmy A, Cromwell DA.  Benchmarking short-term postoperative mortality across neurosurgery units: is hospital administrative data good enough for risk-adjustment?  Acta Neurochir (Wien). 2023; 165: 1695-1706

Please email us at ceu@rcseng.ac.uk if you have any questions about our privacy policy or patient-level information we hold. 

Past Projects

The CEU has undertaken a range of projects since it began in 1998. These have included:

• National Audit of Breast Cancer in Older Patients (NABCOP) (until 2022)
• UK Cardiothoracic Transplant Audits (until 2012)
• UK Liver Transplant Audit Report (until 2012)
• National Mastectomy and Breast Reconstruction Audit Report (2011)
• National Study of Subarachnoid Haemorrhage (2006) 
• National Prospective Tonsillectomy Audit (2005)

If there is a report from a previous project that you wish to obtain, please email us at ceu@rcseng.ac.uk.