About the National Clinical Improvement Programme
The National Clinical Improvement Programme (NCIP) aims to support NHS consultants with learning and continuous self-development with respect to their specialty.
The programme involves creating a secure online portal to provide consultant surgeons with their individual-level activity and metrics across their practice. Users will receive personal login details to access data on their patient outcomes and comparative national benchmark data.
A founding principle of NCIP has been that it should be a resource for the profession, led by the profession. The portal is being delivered through the GIRFT programme and 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. Individual consultant-level data will not be available for external publication.
The intention is to:
- Support scrutiny of patient outcomes at individual consultant level.
- Enable consultants to identify potential improvements to their clinical practice.
- Promote learning to improve patient safety and outcomes.
The NCIP portal
The NCIP portal is a digital tool that NHS consultants in England – surgeons in the first instance – will use to review their personal patient outcomes data alongside comparable national and unit level data.
Five NHS trusts are currently trialling the portal as part of the programme’s early adopter phase. The NCIP team has developed metrics for 112 procedures, across an initial eight specialties, which NHS consultants can analyse at individual and unit level, supporting their learning and helping them to identify potential improvements. Access to the data is restricted to the registered consultant users .
GIRFT’s specialty clinical leads have provided support to the programme, working in collaboration with their specialty associations and Royal Colleges to develop the portal content in terms of procedures and metrics, as well as navigation and usability.
It is intended that, in time, the portal will be extended across all surgical specialties and medical specialties.
Work is focusing on embedding and evaluating the early adopters’ experience of the portal before the programme is rolled out to other NHS trusts.
Developing metrics through clinical engagement
NCIP has worked with colleagues from the specialty associations and Royal Colleges to select the procedures and metrics that will be included within NCIP. These include 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. 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.
Metrics are being developed for the following surgical specialties: cardiothoracic surgery, ENT, general surgery, neurosurgery, obstetrics and gynaecology, oral and maxillofacial surgery, ophthalmology, orthopaedics, paediatric surgery, spinal surgery, urology and vascular surgery.
The table below illustrates some of the procedures included for three of the specialties:
|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