NCEPOD / CEPOD National Confidential Enquiry into Post Operative Deaths
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Transcript of NCEPOD / CEPOD National Confidential Enquiry into Post Operative Deaths
National Confidential Enquiryinto Patient Outcome and Death
21 years of promoting improvements in health care
The Precursor- Lunn & Mushin studyInception- 19881st report- 1990StandardsRecommendationsClassification of intervention
Principal precursor to NCEPOD The confidential and anonymous pilot study of mortality associated
with anaesthesia (Lunn and Mushin, 1982)
Covered inpatients from five regions in England, Wales and Scotland
AIMS:
To assess peri-operative information - to improve clinical practice of anaesthesia
To provide comparative figures between regions to facilitate this
To establish an index of contemporary standards - to permit future comparisons
INCEPTIONLunn & Mushin study- Hoped to combine surgical and anaesthetic enterprise but
this proved impossible.
1982 a joint venture between surgical and anaesthetic specialties initiated –
1 yr – 3 regions
CEPOD:Estd 1988Confidential Enquiry into Perioperative Deaths
Reviewed surgical and anaesthetic practice over one year in three regions
NCEPOD - purposeundertaking confidential surveys & research
Publishing the results for -reviewing the management of patients -maintaining & improving standards care -the protection and monitoring of public
health -benefits the public -For research, audit and training
NCEPOD Studies
NCEPOD states that its work:
*Does not involve new treatments
*Does not involve additional therapies/investigations
*Does not involve allocation to treatment groups
*Does not involve randomisation.
How does it select studies?Organizations or individuals wishing to
submit a study complete a Study ProposalProposals should be relevant to the current
clinical environmentShortlist proposalsProposal is developed,Literature
review,Methods exploredProposals presented to SteeringGroupScore proposals and vote best two6
GOAL
“Does this service reach a predetermined standard?”
“What standard does this service achieve?”
Modified nominal group technique
NCEPOD can therefore state that its work:DOES NOT INVOLVE
new treatments
additional therapies or investigations
allocation to treatment groups
randomisation
research ethical approval is not required for its studies
NCEPOD is independent of the Department of Health and the professional associations
Trustees- oversee charitable & corporate governance
Steering Group-nominated representatives of the various medical Royal Colleges & Associations
Five observers- ensure clinical integrity -National Patient Safety Agency (NPSA) -the Coroners Society -the Institute of Healthcare Management -the Scottish Audit of Surgical Mortality -The Institute for Health and Clinical Excellence
NCEPOD is mainly funded by the Department of Health via NPSA
How NCEPOD helps ?Completing NCEPOD questionnaires make a
valuable contribution
Review their clinical management
Personal reflection
Continuing medical and professional development value for individual consultants
Self directed Continuous Professional Development in their appraisal portfolio.
How does NCEPOD select studies?
What happens if it finds a case that gives cause for concern?
Can an individual refer a case to NCEPOD?
How does NCEPOD's work affect patients?
Classification of InterventionIMMEDIATE
URGENT
EXPEDITED
ELECTIVE
I M M E D I A T E
CODE – 1
Life-saving orLimb/organ-saving intervention.
Resuscitation <> with Surgical Rx
Within minutes OPERATE
Next available operating theatre, even “break-in”
to existing lists
U R G E N TCode 2
Acute onset or deterioration
Threatens life, limb or organ survival
Within hours OPERATE
Day-time Emergency listOr Out of hours Emergency theatre
EXPEDITEDCode 3
Stable patient requiring early intervention
Not life threatening
Within days- OPERATE
Elective list “spare” capacity or Day time “emergency”(Not Night)
E L E C T I V E
Code 4
Planned, Booked , Routine Admission
Time of surgery – Planned
Elective Theatre List
NCEPOD comply with the Data Protection Act, Confidentiality and Ethical Approval
There are two Government Acts, related to confidentiality
*The Data Protection Act 1998
*The NHS Act 2006
ReportsDeaths in Acute Hospitals:
Caring to the End? (2009)
Acute Kidney Injury: Adding Insult to Injury (2009)
Systemic Anti-Cancer Therapy: For better, for worse? (2008)
Coronary Artery Bypass Grafts: The heart of the matter (2008)
Sickle: A sickle crisis? (2008)
Trauma: Who Cares? (2007)
Emergency Admissions: A journey in the right direction? (2007)
The Coroner's Autopsy: Do we deserve better? (2006)
Abdominal Aortic Aneurysm: A service in need of surgery? (2005)
An Acute Problem?(2005)
Scoping our practice (2004)
Who Operates When? II (2003)
Functioning as a Team? (2002)
Changing the Way we Operate (2001)
Then & Now (2000)
Percutaneous Transluminal Coronary Angioplasty (2000)
Interventional Vascular Radiology and Interventional Neurovascular Radiology (2000)
Extremes of Age (1999)
Perioperative Deaths - The 1996/7 Report of NCEPOD
Perioperative Deaths - The 1995/6 Report of NCEPOD
Perioperative Deaths - The 1994/5 Report of NCEPOD
Perioperative Deaths - The 1993/4 Report of NCEPOD
Perioperative Deaths - The 1992/3 Report of NCEPOD
Perioperative Deaths - The 1991/2 Report of NCEPOD
Perioperative Deaths - The 1990 Report of NCEPOD
Perioperative Deaths - The 1989 Report of NCEPOD
Perioperative Deaths - The 1987 Report of NCEPOD