Despite there being approximately 3,000 surgeons performing cataract surgery in the UK, the NOD Cataract Audit had not flagged up any active surgeon who was an outlier for their complication rates since inception a decade ago. This is primarily because of the statistical definitions applied in the previous version of the Cataract Audit Outlier Policy.
We have therefore re-evaluated this Outlier Policy as it relates to surgeons’ Posterior Capsule Rupture (PCR) rates to make it a more practical and useful tool for supporting safe delivery of care and driving quality improvement.
PCR rates utilised in this process are adjusted to take into account the complexity of cases each surgeon is taking on, and surgeons’ PCR rates have always been easily accessible via the NOD website. However, the NOD Cataract Audit team have not been actively flagging up high PCR rates. This is also changing and we will now contact people directly when risk-adjusted PCR rates are above certain thresholds.
While such communications may not be happily received, the NOD Cataract Audit team feel that the failure to flag up such PCR rates to surgeons in the past may have been a missed opportunity to drive quality improvement, as not everyone is checking their own rates on the NOD website. This process is aimed to support surgeons to evaluate their practice and guide discussions at annual appraisals. Full details regarding the updated policy can be found at the following link: NOD cataract outlier Policy Final.pdf