The Confidential Enquiries Louise Parker Associate Director, Research & Development...

The Confidential Enquiries

Louise ParkerAssociate Director, Research & Development

(Confidential Enquiries)

The National Confidential Enquiries

CEMACH- Maternal and Child Health

The National Confidential Enquiries

CEMACH- Maternal and Child Health

CISH- Suicides and Homicides by those in contact

with the mental health services

The National Confidential Enquiries

CEMACH- Maternal and Child Health

CISH- Suicides and Homicides by those in contact

with the mental health services

NCEPOD- PeriOperative Deaths (Patient Outcomes and

Deaths)

CE : Historical Objective

To identify areas of substandard clinical care contributing to adverse patient outcome

CE : Historical Objective

To identify areas of substandard clinical care contributing to adverse patient outcome

To make recommendations for change

Some Examples

CEMACH- Management of amniotic fluid emboli post caesarean

section

- Back to sleep

Some Examples

CEMACH- Management of amniotic fluid embolis post caesarean

section

- Back to sleep

CISH- Removal of ligature points from acute wards and

‘joined-up’ transition to the community

Some Examples

CEMACH- Management of amniotic fluid embolis post caesarean

section

- Back to sleep

CISH- Removal of ligature points from acute wards and

‘joined-up’ transition to the community

NCEPOD- Provision of emergency theatres and supervision of

junior doctors

Historical approach

Largely observational studies involving scrutiny of case notes by expert panel

Current and Future Challenges

Extended Remit Context Health and Social Care Act Robust Methodologies

Extended Remit

Each CE has been asked to widen its scope- CEMACH - to include children

- NCEPOD - to include adverse outcomes in live patients

- CISH - to look at violent behaviour in addition to homicide

Extended Remit

Each CE has been asked to widen its scope- CEMACH - to include children

- NCEPOD - to include adverse outcomes in live patients

- CISH - to look at violent behaviour in addition to homicide

Each brings challenges of accessing high quality information

Context : finding the niche

In 1999 NICE gained responsibility for funding the CE

Other organisations - partners and stakeholders- Royal colleges

- National Patient Safety Agency

- CHI (CHAI)

- NSF

- ONS, NHS, Coronial System, review of child death, review of homicide

Health and Social Care Act

Issues of access to patient data and patient consent

Methodologies

Moving from qualitative to quantitative study methods

The Challenge

Identifying the unique place for the CE within the current NHS structures

The Challenge

Identifying the unique place for the CE within the current NHS structures

Complimenting the role if NICE in producing authoritative guidance

The Challenge

Identifying the unique place for the CE within the current NHS structures

Complimenting the role if NICE in producing authoritative guidance

Working in areas which will have the biggest potential for impact on patient outcome

The Strategy

Working with together and with NICE- Associate Director for R&D

- CE Advisory Committee - chaired by Professor Catherine Peckham

- CE Working Group

Working with NICE

Sharing expertise and developing common strategies

Working with NICE

Sharing expertise and developing common strategies

Exploring common data capture pathways with other agencies (eg NPSA an ONS)

Working with NICE

Sharing expertise and developing common strategies

Exploring common data capture pathways with other agencies (eg NPSA an ONS)

Developing transparent and inclusive mechanisms for topic selection

In Summary New strategy to include

recommendations for- Topic selection

- Methodologies

- Dissemination of findings

- Recommendations