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2017 – 2018 Prospective Annual Report of the NOD Audit Published

12 September 2019

Successfully completing another year of data collection from across 70% of eligible NHS trusts in England and Wales, the third prospective NOD Audit report on cataract surgery during 2017 – 2018 is published today, 12 September 2019.

Cataract surgery is the most frequently performed elective surgical procedure in the UK with 414,000 cataract operations undertaken in England and 20,000 in Wales during 2017-2018.  Of the 232,083 cataract operations received for this period, 217,875 were eligible for analysis (50% of all cataract operations undertaken).

This national annual report is a snapshot of the standards of surgical performance and care and continues to clearly indicate that NHS patients continue to receive high quality surgery care.

Data completeness was excellent, around 100% for the posterior capsule rupture (PCR) outcome as it is a compulsory operative field in electronic medical records. Since 2010, the audit reports a 37% overall reduction in visual acuity (VA) loss and a 38% overall reduction in PCR complications, improving greatly on the 30% PCR reduction reported in 2016 -2017.

Key Findings

  • A 38% overall reduction in PCR complications since 2010
  • In the 2017-18 reporting period only 1.2% of operations were affected by PCR
  • A 37% overall reduction in VA Loss since 2010
    • Observed VA loss was 0.7% for 2017-18, compared to 0.9% used for risk adjustment
  • Reduction in PCR complications since 2010 equates to ~3,400 fewer complications annually across the NHS
  • Cost saving from avoided PCR complications ~£2 million per annum
  • Close to 100% data completeness for PCR outcomes, currently a compulsory field in Electronic Medical Records (EMRs)

NOD is a vital safeguard of patient safety and a promoter of best practice, potentially eradicating variation in the provision of cataract surgery and patient care. NOD enables a cataract surgeon to compare their performance against that of their peers nationally and helps inform decision making for patients.

The Royal College of Ophthalmologists would like to thank everyone who has contributed to and helped to develop NOD.  The NOD team look forward to continuing work with providers on developing the audit further to continue improvements in skills and learning for the profession and ultimately for the quality of care provided to patients.

About the National Ophthalmology Database Audit

The Royal College of Ophthalmologists (RCOphth) was commissioned in 2014 by the Healthcare Quality Improvement Partnership (HQIP) to run the National Ophthalmology Database (NOD) Audit Programme as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP).

The NOD Audit collects data on cataract surgery performed in England and Wales and provides individual surgeons, healthcare providers and the public with benchmarked reports on performance, with the aim of improving the care provided to patients.

The annual report and the key findings summary are available for download from the publications section of the NOD audit website.

Outcomes of individual centres and consultant surgeons are available on the NOD Audit website and will be available on the MyNHS website.

The commissioning arrangement of the NOD Audit changed from 1 September 2019 as the audit funding received via HQIP, and its associated inclusion in the NCAPOP, ended on 31 August 2019. The RCOphth is working with trusts, other providers and industry to source alternative funding.

For more information about the audit, please visit www.nodaudit.org.uk and if you have any questions, please contact noa.project@rcophth.ac.uk.