This week (19 – 23 June) is Clinical Audit Awareness Week, a national annual campaign that promotes and celebrates the impact of clinical audits in healthcare.
RCOphth runs the world renowned National Ophthalmology Database Audit and is recognised by clinicians, NICE, GIRFT and industry as an important safety and research tool that is used to audit the treatment of cataracts; recently, the potentially blinding disease of age-related macular degeneration (AMD) has been added to its work.
Without data, such as the comprehensive insights that NOD provides, health and patient outcomes could not be monitored to identify areas of improvement or where high quality care is delivered.
NOD is a collaborative Quality Improvements and Assurance database which drives improvements in eye healthcare by monitoring and analysing the outcomes of Cataract Surgery and Age-related Macular Degeneration (AMD) services for the UK to inform patient care and safety.
Using insights from the NOD, the RCOphth is able to improve patient outcomes through systematic review of care against explicit criteria and implement changes in the delivery of services at a national and local level. By continuing to monitor the outcomes, we can continue to improve safety and standards, including performance and the training of ophthalmologists.
NOD informs aspects of care such as:
- by collaborating with the Care Quality Commission, Getting it Right First Time (ophthalmology) and the National Eye Care Restoration and Transformation Programme
- setting evidence-based standards on what determines good care, where patients have received it
- highlighting health inequalities such as access to care and monitoring how this changes over time
- providing a national overview of the impact of interventions and empowering local comparison to drive change in services
Since its launch in 2010 auditing cataract surgery, NOD has
- helped to drive overall reduction in intraoperative complications
- through improvements, potentially is able to make financial saving of £2million for the NHS per year by avoiding complications and associated costs of postoperative visits and further treatment
- Identifies patients at high risk of complications, ensuring that they are operated on by appropriately experienced surgeons
- Enables surgeons to compare their performance against that of their peers nationally, promoting learning and best practice
Most recently in 2022, the first NOD Age-related macular degeneration (AMD) audit report was published and is a significant milestone in benchmarking the delivery of AMD treatment in the UK, using data recorded as part of routine clinical care. It reflects the desire and willingness of ophthalmologists throughout the UK to quality assure the care they provide for many thousands of patients who have the rapidly progressive ‘wet’ form of AMD.
Some of the key findings from the AMD report include:
More than 90% of eyes retained stable vision at the end of the first year of treatment and avoided a ‘significant’ further decrease in vision.
- Almost 20% of eyes (1 in 5) experienced a ‘significant’ improvement in vision and more than 40% (4 in 10) had ‘good’ vision (close to driving standard) after the first year of treatment.
- The most frequent number of injections per eye in the first year of treatment was 7 and almost 70% (7 in every 10) of injections were administered by trained staff who were not doctors, such as nurses or optometrists.
- Treatment appeared to be safe, with a low number of serious side-effects. For example, the risk of serious infection after an injection was around 1 in 6,500.
The NOD will continue to deliver high quality audit data and collaborative working across the eye sector to improve outcomes for patients and improvements in ophthalmologists’ performances.
We are grateful to our funding partners* and look forward to welcoming more units to join NOD. Email [email protected] or visit nodaudit.org.uk for more information.
Funding partners include:
Bausch + Lomb, Bayer, Macular Society, Novartis, Roche.