19 December 2017

This week sees the release of the updated Clinical Outcome Publication (COP) onto the ACPGBI website. It encompasses data submitted to the National Bowel Cancer Audit (NBOCA) from over 80000 patients, treated by 801Consultants, in 144 Trusts in England.

Message from ACPGBI Executive lead for COP/Honorary Assistant Secretary

This year the data also includes two new unit-based outcome measures namely 30 day readmission rate and percentage length of stay over 5 days.  It is encouraging to report that overall 90 day mortality is improving year on year – currently 2.4% from 2.68% last year. There is one positive and one negative statistically outlying Trust, as well as two negatively outlying surgeons. COP however needs to be put into context. We as colorectal surgeons are only one part of the bigger multidisciplinary clinical team treating colorectal cancer patients. Nonetheless it shows that as professionals we are committed to transparency, improvement and patient care. One point raised with this year’s COP process relates to type 2 objections. This is where a patient declines to have their data put into an audit and put in the public domain. Whilst the national average is 2%, there are units in England where the local rate is as high as 11% which will significantly underestimate their activity. This is not a process that we can or would want to influence. No audit data is perfect. If anybody has any issues with the 2017 COP do not hesitate to contact me: charles.maxwell-armstrong@nuh.nhs.uk. I am grateful for the assistance of Angela Kuryba and Kate Walker in the Clinical Effectiveness Unit at RCSEng. Charles Maxwell-Armstrong ACPGBI Executive lead for COP/Honorary Assistant Secretary

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Message from the President

Public reporting of surgeon-specific 90-day mortality in colorectal cancer surgery in England was introduced in June 2013. Data from the National Bowel Cancer Audit indicates that since the introduction of COP the observed mortality has fallen. I hope that ACPGBI members will be reassured by this. I hope also that the extension of reporting as the Clinical Outcome Publication to include more unit based rather than individual outcome measures will be welcomed and further encourage members to submit timely and accurate data to the audit. This NBOCA has reported on 30 day readmission rate and percentage length of stay over 5 days. The 2018 report will include the proportion of colonic resections with more than 12 lymph nodes as well as positive resection rates after rectal cancer surgery. COP will be published on the NHS website on 2/1/18. If you have not been contacted by the NBOCA audit team, you can be reassured that there are no concerns about your data or your unit’s data. James Hill ACPGBI President

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