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National Ophthalmology Database Audit

The Royal College of Ophthalmologists (RCOphth) has been commissioned by the Health Quality Improvement Partnership (HQIP) and funded by NHS England and the Welsh Government to manage the National Ophthalmology Database (NOD) Audit as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). The NOD audit was initially funded for 3 years from September 2014 to August 2017 and this has now been extended for a further two years from September 2017 to August 2019.

The NOD Audit will prospectively collect, collate and analyse a standardised, nationally agreed cataract surgery dataset from all centres providing NHS cataract surgery in England & Wales to update benchmark standards of care and provide a powerful quality improvement tool. In addition to cataract surgery, electronic ophthalmology feasibility audits have been undertaken for glaucoma, retinal detachment surgery and age related macular degeneration (AMD). These have now been completed and permission from the funders to publish these is awaited.

The audit will continue to utilise validated and risk (case complexity) adjusted measures of quality which discriminate between centres and surgeons. All EMR databases with national dataset compliant data are eligible for data submission. The first prospective phase of the audit commenced data collection from September 2015 to August 2016, for which centres with paper based records were provided with data collection tools for participation. A web based tool for automated return of visual acuity and refractive data from optometrists has also been made available to centres. In addition to the audit outputs, relevant aspects of the audit will be submitted for peer reviewed publication in medical journals.

Following appropriate local information governance permissions, data from electronically enabled units are remotely extracted to a secure server within the NHS firewall. Data are pseudonymised, checked for errors as far as possible and descriptive analyses produced. Summarised data are presented on the audit website, www.nodaudit.org.uk such that contributors can view data from their own centre in the context of data from all other participating centres. Contributors are also able to use these data for personal audit with benefits in terms of appraisal and revalidation.

The NOD audit team initially demonstrated proof-of-concept for this project with the publication of the legacy data report in April 2016 and through a number of peer reviewed publications. The first prospective annual report of the cataract audit was published in July 2017, and all the audit reports can be accessed from the publication section of the NOD website (https://www.nodaudit.org.uk/resources/publications-annual-report).

The audit is currently collecting data for the second prospective audit period which will run from 1 September 2016 to 31 August 2017 with the next round of data collection from 1 September 2017 to 31 August 2018.

For more information, please visit www.nodaudit.org.uk or contact the NOD project team via email noa.project@rcophth.ac.uk.