Bowel cancer outcomes publication: information for surgeons

Information for surgeons about the Clinical Outcome Publication (COP) reporting programme and policies.

Publication of future outcomes

Clinical Outcome Publication (COP) will continue to report case number and 90-day mortality for elective colorectal cancer resections at surgeon and Trust/hospital level for patients diagnosed during a rolling 5 year period of April to March. It is not anticipated that any additional outcomes will be reported at individual surgeon level.

The following additional Trust/hospital level outcomes will be reported for all patients with colorectal cancer (emergency and elective) treated in the corresponding audit period:

COP Reporting Year Additional Trust Outcomes Notes
2016 Rate of major resection Crude rates with no outlier reporting
Case ascertainment Including patients who do not undergo surgery
2017 30 day unplanned readmission Outlier reporting; risk-adjusted
Percentage length of stay >5 days Outlier reporting; risk-adjusted
2018 Positive circumferential rectal resection margin rates
Proportion of colonic resections with >12 lymph nodes reported
2019 Unplanned rates of return to theatre Outlier reporting; risk-adjusted

It is anticipated that any outcome included in the NBOCA Annual Report may eventually be published under COP. Reporting periods (usually one year) for each new metric in COP will be based on the reporting period for that metric in the Annual Report. The new outcomes will be reported in addition to all previous outcomes each year.

These outcomes have been selected as they reflect quality of care and may be reliably reported based on current levels of data completeness.

ACPGBI reporting policies for COP

Surgeons will have data published alongside the Trust where they were working on 31 March of the final year of data collection, even if they have subsequently moved to another Trust. Where data has accumulated from more than one Trust, there will be a comment to this effect.

If there were no cases registered against a surgeon’s GMC number for the final two year period within the five year cumulative data period, the surgeon’s outcomes will not be published.

If there were no cases registered against a surgeon’s GMC number for the final twelve months of the five year cumulative data period, the surgeon’s outcomes will be published on the ACPGBI website with a comment that no cases have been recorded for this period, but will not be submitted for publication to NHS Choices.

Surgeons who submit insufficient data items to allow risk adjustment will have unadjusted mortality rates reported, with an explanatory note.

Patients who undergo surgery in the independent sector will be included in COP if their data are submitted by the MDT. They will be included in individual surgeon data with a comment to this effect.

Potential negative outliers will be notified in advance of publication to allow verification and re-submission of data, according to NBOCA’s pre-publication outlier policy. Confirmed negative outliers will have the opportunity to respond to NHS Digital and to have brief edited comments included on presentation of results on the ACPGBI website.

Clinical Audit Platform

Access to the Clinical Audit Platform for verification of data is available to all surgeons. Access requires creation of Single Sign On (SSO) at https://clinicalaudit.hscic.gov.uk and approval from the Trust Caldicott Guardian.

The contact address at NHS Digital for NBOCA is bowelcancer@nhs.net

View ACPGBI’s surgeon outcomes data here

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