National audit

The Healthcare Quality Improvement Partnership (HQIP) is responsible for several national healthcare quality improvement programmes, including the National Clinical Audit and Patient Outcomes Programme (NCAPOP) on behalf of NHS England, the Welsh government and in some cases other devolved authorities.

National Clinical Audit and Patient Outcomes Programme (NCAPOP)

There are two programmes of work within NCAPOP; the National Clinical Audit Programme and the Clinical Outcome Review Programme.

There is also further information explaining how NCAPOP topics are selected and how to access data from the NCAPOP audits.

National Clinical Audit (NCA)

The National Clinical Audit Programme is made up of 30 clinical audits. More details on this programme and the individual audits can be found on their web pages.

Clinical outcomes review programme

The Clinical Outcome Review Programme was formally known as the 'Confidential Enquiries' and are designed to help assess the quality of healthcare, and stimulate improvement in safety and effectiveness by learning from adverse events and other relevant data. Further information on current enquiries is available on their website.

Patient surveys

The Picker Institute have done a wide array of national patient surveys to capture patient experience, including inpatient and outpatient surveys, emergency services surveys and many others.

Publication of individual consultant results from National Audit

Consultant Outcomes Publication (COP) is an NHS England initiative launched with ten audits in 2013 and managed by HQIP. The number of audits publishing quality measures at the level of individual consultant doctor expanded to twelve in 2014 and the data was also published on MyNHS website.

To find out more details on the individual audits and their publication timetable please go to the NHS Digital website.

You can also sign to HQIPs newsletter.

Further details of audit results at both a unit and clinician level are available on the specialist surgical association websites listed below.

Specialty society/organisation	Clinical audit/registry title	Outlier policy
Society for Cardiothoracic Surgery (SCTS)	National Adult Cardiac Surgery Audit	SCTS outlier policy
British Obesity & Metabolic Surgery Society	National Bariatric Surgery Register
The Association of Coloproctology of Great Britain and Ireland	National Bowel Cancer Audit Programme
British Cardiovascular Intervention Society	Adult Coronary Interventions
British Thoracic Society and SCTS	National Lung Cancer Audit	See SCTS
British Association of Head and Neck Oncology	National Head and Neck Cancer Audit	TBA
Society of British Neurological Surgeons	National Neurosurgery Audit Programme
British Orthopaedic Association	National Joint Registry
British Association of Endocrine and Thyroid Surgeons	BAETS national audit
Association of Upper Gastrointestinal surgeons of Great Britain and Ireland	National Oesophago-Gastric Cancer Audit	TBA
British Association of Urological Surgeons	BAUS registry	TBA
Vascular Society of Great Britain and Ireland	National Vascular Registry
Association of Breast Surgery (ABS)	National Audit of Breast Cancer in Older Patients
Association of Coloproctology of Great Britain and Ireland (ACPGBI).	National Bowel Cancer Audit
British Association of Urological Surgeons (BAUS)	National Prostate Cancer Audit

                                                                                                                                                           

Managing outliers

• Surgeons and the services they work inshould first review audit data submission to ensure that audit returns and outcome results accurately reflect their practice.
• If it appears that your outcomes are outside the accepted norm, this should enable the start of a conversation with your appraiser to identify the nature and basis for the concern. This can take place in the form of a local investigation that closely examines the data for anomalies, and looks at the environment and structure of the team/unit and your case mix before considering you as an individual. The College will be able to assist in the early stages of such an investigation.
• Each audit provider will have a policy in place for managing potential outliers, available from the audit website. These are listed above in the table of audits.