A fall in overall post-operative mortality rates, improvements in access to multi-disciplinary opinions, increased use of laparoscopic (keyhole) surgery and a recognition that urgent or emergency surgery carries a three fold increase in post-operative death over elective cases are amongst the findings published today in the annual report from the national audit of bowel cancer.

The report, commissioned by the Healthcare Quality Improvement Partnership and published today by The NHS Information Centre on behalf of the Association of Coloproctology of Great Britain and Ireland, gives a detailed appraisal of bowel cancer care in England and Wales. All but three trusts submitted data to the audit which reports on the management of over 23,000 cases of bowel cancer over the one year period from August 2008 to July 2009.

Among its key findings, the report shows:

• Overall participation by trusts has increased to 98 per cent as compared with 95 per cent in 2009.
• Case ascertainment continues to improve with an estimated 74.7 per cent and 97.3 per cent of cases from English and Welsh trusts respectively being submitted.
• Overall post-operative mortality following major resection in elective cases was 2.6 per cent which is an improvement compared with previous years. Post-operative mortality in urgent and emergency cases was 7.7 per cent. Differences were again noted between Networks and Trusts.
• Some form of surgical procedure was performed in 75 per cent of cases and a major resection was undertaken in 60 per cent of patients. Urgent or emergency surgery was performed in 23 per cent of cases.
• Laparoscopic procedures continued to increase, with 25 per cent of cases being completed laparoscopically.
• The proportion of cases discussed at a multi disciplinary team rose to 95 per cent (from 83.7 per cent in the 2009 report) and, where stated, 80 per cent of cases were seen by a nurse specialist (an increase from 51.2 per cent in 2009 report).

Professor Paul Finan, the clinical lead for the audit said:

“The national bowel cancer audit has clearly been embraced by almost all trusts within England and Wales and the information obtained should have a direct effect on the management of patients with this common cancer. It is encouraging to see a continued fall in post-operative mortality, but the increased mortality observed when operating in the urgent or emergency situation should prompt particular attention to cases that present acutely. It is hoped that the national bowel cancer screening initiative and earlier recognition of the symptoms of bowel cancer by the public will be reflected in improved outcomes for this disease.”

From 7 June the National Bowel Cancer Audit Report can be accessed at www.ic.nhs.uk/bowelreports

ENDS

1. The NHS Information Centre is England's authoritative, independent source of health and social care information. It works with more than 300 health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which helps providers improve their services and supports academics, researchers, regulators and policymakers in their work. The NHS Information Centre also produces a wide range of statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care and workforce and pay statistics.

2. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP). Their purpose is to engage clinicians across England and Wales in systematic evaluation of their clinical practice against standards and to support and encourage improvement in the quality of treatment and care. The programme currently comprises 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions, including diabetes.

3. The Association of Coloproctology of Great Britain and Ireland is a multi-disciplinary organisation whose membership, consisting of medical, nursing and associated healthcare professionals, treat most patients with bowel cancer. The bowel cancer audit was intially developed by the Association over ten years ago and is now one of the national cancer audits commissioned by HQIP.

4. For media enquires or to request an interview with a clinical lead about the audit, please contact:

• The NHS Information Centre press office - mediaenquies@ic.nhs.uk or 0845 2576990
• Royal College of Surgeons press office - communications@rcseng.ac.uk