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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
