About the National Clinical Improvement Programme
The National Clinical Improvement Programme (NCIP) aims to support clinicians with learning and continuous self-development with respect to the services they deliver. The programme will provide both team and clinical-level activity and metrics about the whole of a clinician’s practice, and links to relevant service delivery research and other evidence, delivered through a secure online portal hosted by NHS Improvement. Our ambition is to provide a unique service – a single point of access to existing information from Hospital Episode Statistics (HES), audit and registry, and private sector. It is anticipated that consultants will use the portal to support their personal development and learning.
NCIP is a clinically-led programme, mirroring the philosophy of GIRFT (Getting It Right First Time). GIRFT clinical leads are working with their colleagues from professional societies and Royal Colleges to select the procedures and metrics that will be included within NCIP. These clinician groups are also designing the way in which this information will be displayed to ensure it is beneficial to their professional colleagues.
NCIP has begun working with consultants in surgical specialties with a view to expanding into medical specialties in future. During 2019, the programme will share information with consultants from a few pilot trusts across a range of specialties including general surgery, paediatric surgery and urology (see the table below). This will be followed by a phased roll-out to clinicians in other trusts towards the end of the year. This approach – testing with a smaller set of clinicians and then rolling out more widely – is how the programme expects to work with consultants and their teams across all specialities. Consultants from most surgical specialties can expect to have access to NCIP information during 2019.
Developing metrics through clinical engagement
GIRFT clinical leads are working with their colleagues from professional societies and Royal Colleges to select the procedures and metrics that will be included within NCIP.
We are considering universally presenting metrics such as volume of procedures, length of patient stay or day case rate, and readmission rate. Other metrics such as re-operation rates, revision rates, complication rates and mortality may be presented for procedures where they are deemed appropriate. NCIP expects to begin by calculating metrics using clinical audit and HES data. We expect the number and type of metrics displayed within NCIP to grow and change over time as more data are made available and where clinicians suggest which metrics are the most useful.
It is intended that, in time, the NCIP programme will be extended to GPs giving them individual level information to support them to reflect and learn.
The table below illustrates the procedures that are under consideration for inclusion within NCIP for the first three specialties for which we have had significant engagement with clinicians.
|Paediatric surgery||General surgery||Urology|
|Umbilical hernia repair||Colorectal resections for cancer||PCNL|
|Circumcision||Oesophago-gastric resections for cancer||Nephrectomy|
|Inguinal hernia repair||Laparoscopic cholecystectomy||Cystectomy|
|Hypospadias repair||Incisional hernia repair||Radical prostatectomy|
|Pyeloplasty||Inguinal hernia repair||Scrotal exploration|
|Congenital diaphragmatic hernia repair||Bariatric surgery||Hydrocele repair|
|Male bladder outflow obstruction surgery|
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This page will continue to be updated as the Programme progresses.
The Academy and the Medical Royal Colleges fully support hospital consultants having access to meaningful information and outcomes data on which to compare themselves with national benchmarks to support their learning and development which will, in turn, improve patient care. We believe that understanding their data will assist clinicians in their natural drive to improve standards and the quality of care. Colleges have been involved in the development of NCIP from an early stage and support its continuing development.
Professor Carrie MacEwen, Chair of the Academy of Medical Royal Colleges
It is important that as a profession we robustly analyse and evaluate our surgery so that we can understand how best to improve the care we provide to patients. The National Clinical Improvement Programme will offer another powerful tool to help surgeons scrutinise their performance.
Professor Derek Alderson, President of the Royal College of Surgeons