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V The Precursor- Lunn & Mushin study

V Inception- 1988
V 1 st report- 1990
V Standards
V Recommendations
V Classification of intervention
m  


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V The confidential and anonymous pilot study of mortality associated with
anaesthesia (Lunn and Mushin, 1982)

V Úovered inpatients from five regions in England, Wales and Scotland

xIMS

V To assess peri-operative information

- to improve clinical practice of anaesthesia

V To provide comparative figures between regions to facilitate this

V To establish an index of contemporary standards

- to permit future comparisons
 {m{ 
Lunn & Mushin study-
Ôoped to combine surgical and anaesthetic enterprise but this
proved impossible.

V 1982 a joint venture between surgical and anaesthetic specialties

initiated Ȃ
V 1 yr Ȃ 3 regions

CEPOD:
Estd 1988
Confidential Enquiry into Perioperative Deaths

Reviewed surgical and anaesthetic practice over one year in three

regions
m

  
V undertaking confidential surveys & research

V Publishing the results for

-reviewing the management of patients
-maintaining & improving standards care
-the protection and monitoring of public health
-benefits the public
-For research, audit and training
 m


V mÚEPOD states that its work

Does not involve new treatments

Does not involve additional therapies/investigations

Does not involve allocation to treatment groups

Does not involve randomisation.

Ô




V Organizations or individuals wishing to submit a study
complete a Study Proposal
V Proposals should be relevant to the current clinical
environment
V Shortlist proposals
V Proposal is developed,Literature review,Methods
explored
V Proposals presented to SteeringGroup
V Score proposals and vote best two6
 º 

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DOES NOT INVOLVE

new treatments

additional therapies or investigations

allocation to treatment groups

randomisation

research ethical approval is not required for its studies

V NCEPOD is independent of the Department of Ôealth and the
professional associations

Trustees- oversee charitable & corporate governance

Steering Group-nominated representatives of the various medical

Royal Úolleges & Associations

Five observers- ensure clinical integrity

-mational Patient Safety Agency (mPSA)
-the Úoroners Society
-the Institute of Ôealthcare Management
-the Scottish Audit of Surgical Mortality
-The Institute for Ôealth and Úlinical Excellence
NCEPOD is mainly funded by the Department of Health via NPSx
Ô
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V Úompleting mÚEPOD questionnaires make a valuable
contribution

V Review their clinical management

V Personal reflection

V Úontinuing medical and professional development value

for individual consultants

V Self directed Úontinuous Professional Development in

their appraisal portfolio.
V How does NCEPOD select studies?

V What happens if it finds a case that gives cause for

concern?

V Can an individual refer a case to NCEPOD?

V How does NCEPOD's work affect patients?

 





V IMMEDIATE

V URGEmT

V EXPEDITED

V ELEÚTIVE
 
CODE Ȃ 1

Life-saving or
Limb/organ-saving
intervention.

Resuscitation <>
with Surgical Rx

Within minutes
OPERATE

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Code 2

Acute onset or
deterioration

Threatens life, limb

or organ survival

Within a




÷ 
  


  
  
 
 
Code 3

Stable patient requiring

early intervention

mot life threatening

Within days- OPERATE

  

 


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V Úode 4

V Planned, Booked , Routine Admission

V Time of surgery Ȃ Planned

V Elective Theatre List

NCEPOD comply with the Data Protection xct,
Confidentiality and Ethical xpproval

V There are two Government Acts, related to

confidentiality

The Data Protection Act 1998

The mÔS Act 2006

î 
V Deaths in xcute Hospitals:
Caring to the End? (2009)

V xcute Kidney Injury: xdding Insult to Injury (2009)

V Systemic xnti-Cancer Therapy: For better, for worse? (2008)

V Coronary xrtery Bypass Grafts: The heart of the matter (2008)

V Sickle: x sickle crisis? (2008)

V Trauma: Who Cares? (2007)

V Emergency xdmissions: x journey in the right direction? (2007)

V The Coroner's xutopsy: Do we deserve better? (2006)

V xbdominal xortic xneurysm: x service in need of surgery? (2005)

V xn xcute Problem?(2005)

V Scoping our practice (2004)

V Who Operates When? II (2003)

V Functioning as a Team? (2002)

V Changing the Way we Operate (2001)

V Then & Now (2000)

V Percutaneous Transluminal Coronary xngioplasty (2000)

V Interventional Vascular Radiology and Interventional

Neurovascular Radiology (2000)

V Extremes of xge (1999)

V Perioperative Deaths - The 1996/7 Report of NCEPOD

V Perioperative Deaths - The 1995/6 Report of NCEPOD

V Perioperative Deaths - The 1994/5 Report of NCEPOD

V Perioperative Deaths - The 1993/4 Report of NCEPOD

V Perioperative Deaths - The 1992/3 Report of NCEPOD

V Perioperative Deaths - The 1991/2 Report of NCEPOD

V Perioperative Deaths - The 1990 Report of NCEPOD

V Perioperative Deaths - The 1989 Report of NCEPOD

V Perioperative Deaths - The 1987 Report of NCEPOD