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National Oesophago-Gastric Cancer Audit

 April 2017

New ERAS data items live in CAP

The audit has added two new non-mandatory data items to the surgery record for patients diagnosed from 1 April 2017.

The data items are about Enhanced Recovery After Surgery (ERAS) pathways following gastrectomies and oesophagectomies. (Note that ERAS may also be known as "fast-track surgery")

The two questions are:

Q1. What best describes the surgical pathway that this patient followed?

  1. A protocolised enhanced recovery (ERAS) without daily documentation in medical notes?
  2. A protocolised enhanced recovery (ERAS) with daily documentation in medical notes?
  3. A standard (non-ERAS) surgical pathway
Q2. Did the patient complete the ERAS pathway? 
  1. Yes
  2. No: but partial completion
  3. No: non-completion
  4. Unknown / not documented
There has been growing interest in innovative approaches to post-surgical recovery but there is limited knowledge on its application in upper GI surgery.

Based on its excellent coverage of surgical procedures in England and Wales, the audit is in a strong position to examine current practice, and these two new data items will enable us to give surgical centres some comparative results on this new topic.

The audit is planning a survey of ERAS protocols later this year. Protocols may differ between NHS trusts, so the audit will ask trusts to share their protocols (if available) with us.

We will then provide information back to the Upper GI surgical community on aspects of shared content and areas of difference, for example on ERAS components such as "preoperative nutritional assessment" or "early mobilisation".

This will enable the audit to report in much more detail on the use of ERAS in England and Wales, as well as limit the actual data collection to two simple questions.

The two new data items are now live in CAP for manual data entry and CSV file upload. The new dataset and an updated Data Manual and Proforma are available on the audit webpage.

 

Do I need to submit ERAS data now?

Patients diagnosed before 1 April 2016

  • No need to include ERAS data
  • The audit is still collecting treatment data for 2015-16 patients
  • The final submission deadline has not yet been set due to delays in obtaining ONS data.
Patients diagnosed between 1 April 2016 and 31 March 2017
  • No need to include ERAS data (but can be included if available locally).
Patients diagnosed from 1 April 2017
  • The ERAS data items should be collected and included in submissions.
CSV users
  • Third party IT suppliers, like Somerset Cancer Registry and Infoflex, are rolling out the introduction of ERAS in the NOGCA dataset through April and May
  • If you want to submit a surgery record (for any audit year), please ensure that it included 21 fields, even if you are not submitting any ERAS data.
  • A blank Excel file with the 21 column headings is available on the audit webpage for users to populate and save as a CSV file.

Checking your data

Trusts wishing to check their submissions can use these online reports within the CAP system:

  • Trust Extract
  • First Diagnosing Trust Count
  • Data Completeness
For the benefit of tertiary NHS trusts, the audit is planning to introduce a participation report that will show submissions for every trust based on submitting trust, rather than diagnosing trust.

There are also two reports available in CAP to help users with checking the data used in the Consultant Outcomes Publication:
  • Data Manager Check
  • Consultant Check Report
The Online Reports Guide and CAP User Guide are both available on the audit webpage.