Organisational Audit Overview

The first NELA Organisational Audit took place between July 2013 - October 2013 and the results were published in May 2014.

The second NELA Organisational Audit took place in October 2016 and the results were published as part of the Third Patient Audit Report.

• There are around 50-60 questions to answer within 8 sections.

• The organisational audit asks about the infrastructure available within your hospital that relates to the delivery of care to patients undergoing Emergency Laparotomy. For example:
  
  • Number of critical care beds as a proportion of total beds
    
  • Whether surgical staff are free from elective commitments whilst on-call
    
  • Working patterns of on-call clinical staff
    
  • Availability of pre-operative imaging and interventional radiology
    
  • Availability of emergency theatres
    
  • Availability of routine daily input from Medicine for the Care of Older People in pre-operative and post-operative care

• Respondents need to gather information from others to get accurate answers, e.g. anaesthetic and surgical clinical directors, theatre managers, etc. It is important that information is accurate as we will be producing a report that details the provision of emergency surgical care on a named hospital basis.

• The actual questionnaire should take around 30 minutes to complete, but you will need to gather accurate information from others within your hospital to ensure that your data accurately reflects the situation within your hospital.

• The organisational audit is an online questionnaire.

• We will require that you complete one organisational form per hospital. It is likely that different hospitals within the same Trust have a different set up with regard to the provision of emergency surgical care. In addition, we will ultimately hope to produce outcome data on a named hospital basis, rather than pooled for all hospitals within a single Trust.

NELA conducts organisational audits because there are clear standards with regard to the infrastructure that should be available for the provision of care for the emergency surgical patient. These have been drawn from:

• The Higher Risk General Surgical Patient: Towards improved care for a forgotten group (2011). The Royal College of Surgeons of England/Department of Health.

• Emergency Surgery: Standards for unscheduled care (2011). The Royal College of Surgeons of England.

Organisational audits allow us to compare provision of care to those standards. It will also enable us to understand more fully how provision of care relates to outcome when the patient data is available.

NELA is one of the NCAPOP (National Clinical Audit and Patient Outcomes Programme) audits funded by the Department of Health through HQIP. The NHS standard contract requires that organisations providing NHS care must participate in all relevant NCAPOP audits and enquiries. If providers do not participate in relevant NCAPOP audits they will be in breach of their contract with their commissioner, therefore any non-participation would need to be agreed with the commissioner and CQC as the regulator. Further information is available on the HQIP website.