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 clinician-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. 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.
NCIP is a Department of Health and Social Care (DHSC) programme, led by Professor Sir Norman Williams, and is being delivered through the Getting It Right First Time (GIRFT) programme, led by Professor Tim Briggs. A founding principle of NCIP has been that it should be a resource for the profession, led by the profession.
The NCIP portal
The NCIP portal is a digital product 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.
NCIP is a clinically-led programme, mirroring the philosophy of GIRFT programme. GIRFT clinical leads are working with their colleagues from specialty associations and Royal Colleges to develop the portal content in terms of procedures and metrics, as well as navigation and usability.
We are currently building the portal for an initial 12 surgical specialties and plan to run a pilot with a small number of trusts during 2019 before rolling out nationally to all trusts during winter 2019/20.
It is intended that, in time, NCIP will be extended to the remaining surgical specialties, medical specialties and GPs.
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.
The table below illustrates some of the procedures included for three 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|
The initial 12 NCIP surgical specialties are: cardiothoracic surgery, ENT, general surgery, neurosurgery, obstetrics and gynaecology, oral and maxillofacial surgery, ophthalmology, orthopaedics, paediatric surgery, spinal surgery, urology and vascular 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