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Patient Information

Please click on the links below to download a copy of the NELA Patient Information leaflet or on the individual FAQs for further information.

What is an Emergency Laparotomy?

An emergency laparotomy is a major operation where the surgeon has to cut open the abdomen (stomach area). It is called "emergency" because it must be done very soon or even immediately and cannot wait until a later date. It might be carried out for several reasons including internal bleeding, perforation (burst), obstruction (a blockage) or infection. In many cases it might be the only option available in order for the patient to get better.

What is NELA?

NELA stands for National Emergency Laparotomy Audit. The National Emergency Laparotomy Audit (NELA) is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme on behalf of NHS England and the Welsh Government. A clinical audit like NELA is where an independent body assesses the quality of care in hospitals by looking at how it treats the patients and the outcomes of those patients. NELA is a national clinical audit, so that means it is being carried out in over 180 hospitals in England and Wales. NELA will look at the quality of care received by patients undergoing emergency laparotomy.

Why are we carrying out the NELA at this hospital?

We want to improve the care that patients undergoing emergency surgery receive. To do this we will collect important information on how well your hospital is providing care to you. We will then give hospitals all the valuable information we have obtained. This will highlight areas of their service where they are doing well, and areas in which they can improve. It will also allow hospitals to compare themselves with others all around the country. All hospitals in England and Wales that carry out emergency laparotomy are expected to participate in this audit.

What information is collected?

We will be collecting information about the care you received whilst you were in hospital. This will include information about the investigations and treatment you received, how long it took for different parts of your treatment to be given, and whether you went to a critical care bed after your surgery. Full details of what is being collected can be found the NELA website -

What confidential information is collected?

The confidential information we are collecting is your name, date of birth, NHS number (everyone in the country has a unique number), postcode and sex. The benefit of collecting these personal details is that it enables us to match our information with other national sources of information and this will give us a fuller picture of how well you recovered for surgery (for example, whether you have been readmitted to hospital after you went home).

To create this in-depth picture of your care, we send your personal details (NHS number, date of birth, postcode) to NHS Digital (England) and to NHS Wales Informatics Service (Wales). NHS Digital will then use these details to find information within the English Hospital Episode Statistics database, while NHS Wales Information Service will find information within the Patient Episode Database for Wales. In addition, NHS Digital and the NHS Wales Informatics Service will inform us about people who may have passed away using data collected by the Office for National Statistics. The linked information is returned to the NELA study team in an anonymised format. No health care information is transferred to NELA with your personal identifiers. Your personal details will not be shared with anyone outside the NHS or research team.

What happens to the confidential information?

We will be collecting this information through a very secure website. Only the hospitals participating, the doctors and nurses working on the NELA in the hospital and the NELA project team will have access to the website. The confidential information will be coded when it is transferred and your information is stored safely in accordance with NHS recommendations, standards and regulations.

To reduce the amount of data that hospitals collect for NELA, we share your NHS number with NHS Digital (the national body that collects health care data) so that the project can receive Hospital Episode Statistics (HES) and Office for National Statistics (ONS) data. NHS Digital provide the HES and ONS data to NELA in an anonymous format. The data are then analysed at The Royal College of Surgeons of England, Clinical Effectiveness Unit.

Data from the audit may also be shared for the purposes of research in order to help improve patient care, and these are listed below. Sharing data with researchers will always be under relevant legal and information governance regulations. Wherever possible only non-personal information will be shared. None of your personal information will ever be made public.

What other benefits may arise from the use of my information?

Occasionally, the National Emergency Laparotomy Audit is asked to support medical research to improve surgical care. Researchers make these requests directly to HQIP who will then contact NELA after the application has been reviewed to ensure it is in the public interest. More information on this process can be found at the:

In supporting medical research, we take care to ensure there are appropriate safeguards in place to protect patient confidentiality and ensure the data are used securely.

Why haven't I been asked for permission to use my information?

Because some patients are very sick before and after they have had an emergency laparotomy, it would be very hard to ask all patients for their consent. It is important that we get information from all patients, not just those that are well enough to give consent. That's how we can provide an accurate overview of quality. It can be a distressing time for patients and their families, and asking them about this project at this time would not be their most important priority.

What if I do not want to have my confidential information included?

Please email and put "Patient request to opt-out" in the subject line. We will then contact the hospital to make sure that they do not enter your details into the audit. If they have already entered your details, we will ask for them to be removed. Alternatively, please notify a member of your local care team that you wish to opt out. We will then ensure that your details are not entered in the audit. If they have already been entered, we will ask for them to be removed.
If you prefer you can also call the NELA Helpline on 020 7092 1683.

Additional Research

If you had surgery between March 2014 and October 2015 in a participating hospital, your non-personal data may be shared with a study team at Queen Mary University London for the purposes of research. This data will be combined with information from the Office for National Statistics and Hospital Episode Statistics in order to investigate long term outcomes. The study is called EPOCH, please visit their website for more information:

Download this Patient Information as a PDF

 NELA Patient Information Leaflet v6.pdf (252 KB)