Number of elective procedural FCEs (Finished Consultant Episodes)

What this data shows:

A finished consultant episode (FCE) is a standard NHS measure. In most cases it represents a single admission to hospital under the care of a named consultant – in this audit a consultant neurosurgeon. Consultant neurosurgeons are responsible for both planned (elective) and emergency (non-elective) care. Most elective admissions involve a surgical procedure (operation). Elective procedural FCEs therefore cover a substantial part of the operative practice of consultant neurosurgeons. The data used in this outcome publication has been derived from three years’ of NHS England Hospital Episodes Statistics (HES).

How the data is gathered:

Neurosurgeons undertake a wide range of planned operations that include simple procedures lasting less than one hour, where the risk of death is close to zero, and complex procedures lasting more than twelve hours, where the risk of death may be over 10% (1 in 10). Thus the risk of death from a planned neurosurgical operation may differ by more than a 100-fold.There is no typical operation undertaken by all neurosurgeons in sufficient numbers that it may be used as a sole indicator of outcome. By reporting the outcome of all elective operations undertaken by neurosurgeons, this audit provides an overview of planned neurosurgical activity in England.  The risk of surgery depends not only on the operation but also on the age and medical condition of the patient. It is now common for patients over the age of 70 to undergo major neurosurgical procedures when the benefits to the patient outweigh the increased risks.The outcome of modern operations does not depend solely on the skill or judgment of individual surgeons. In many of the operations assessed in this audit neurosurgeons have operated jointly in teams with surgeons from other specialties.

More information about the data source:

HES data is dependent on the accuracy and completeness of clinical coding undertaken by the Trusts responsible for Neurosurgical Units in England. Trusts adopt different procedures to validate their coding before it is provided to the NHS. Working through the Neurosurgical National Audit Programme, consultant neurosurgeons have reviewed the coding of deaths in this audit to ensure that the data is as accurate as possible.

Data Source:

University Hospitals Birmingham Health Information Department as contracted by the Neurosurgical National Audit Programme (NNAP).

Data Period:

Annual 1st April 2013 – 31st March 2016

Data Supplier:

University Hospitals Birmingham Health Evaluation Department as contracted by the Neurosurgical National Audit Programme.

Further Information:

Further information is available on the NNAP website and via the NNAP Chair, Mr Richard Nelson – Richard.nelson@nbt.nhs.uk