FTP2.12 The National Consultant Information Programme (NCIP) and its effect on current Colorectal surgical practice, specifically looking at Exenteration of Pelvis for Lower Gastrointestinal Cancer

Aim

Extract and contextualise relevant data from NCIP tool, focusing on exenteration of pelvis for lower gastrointestinal (GI) cancer. Understand Covid's impact on surgical practice, and any variations seen at trust and national level, to gain insight into current colorectal surgical practice in England.

Method

Pseudonymised data extracted from NCIP dashboard by NHS England Improvement data analysts. NCIP data is primarily from Hospital Episode Statistics, and other relevant databases and registries. Various metrics were analysed including pre-Covid-19 or during Covid-19, frequency of cases, procedure sub-group, length of stay (LOS), readmission and mortality. Data contextualised by comparing observed data with previous literature, if possible.

Results

687 cases from April 2018-March 2022. All elective, all 17+ years. 340 cases between April 2018-March 2020 and 347 cases between April 2020-March 2022.

4 procedures: 11 Lateral Lymphadenectomies, 20 Other Exenterations, 161 Posterior Exenterations, 495 Total Exenterations. Decrease in frequency of cases post-covid for all procedure sub-groups except total exenteration (5% increase).

40 centers across England, 99.27% of cases performed at NHS trusts. Center variation observed with numerous providers doing less than 10 cases in the 4-year period.

Average length of stay (LOS): 23.65 days ± 0.75 with 95% CI [22.18, 25.12], however maximum LOS of 154 days.

30-day readmission was 21.83%. 90-day mortality was 2.47%.

Conclusion

Impact of Covid-19 pandemic not observed in the data. Significant variation observed at provider level for each procedure sub-group, possibly contributing to variation seen in metrics such as LOS. Data suggests the need for further exploration into observed variation.