Improving the quality of healthcare
National Confidential Enquiry into Patient Outcome and Death
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Medical & Surgical Clinical Outcome Review Programme

NCEPOD has been commissioned by the Healthcare Quality Improvement Partnership (HQIP) to undertake the Medical & Surgical Clinical Outcome Review Programme on behalf of NHS England, Department of Health Northern Ireland, the Welsh Government, and Jersey.

The Medical & Surgical programme is one of four Clinical Outcome Review Programmes which are designed to help assess the quality of healthcare, and stimulate improvement in safety and effectiveness by systematically enabling clinicians, managers and policy makers to learn from adverse events and other relevant data. The other programmes are;

This programme began in 1988 as a co-operation between the Association of Anaesthetists and the Association of Surgeons who established a National Confidential Enquiry into Perioperative Deaths with an aim to examine the quality of care delivered to surgical and anaesthetic patients who had died in hospital within 30 days of a surgical procedure.

In 1999 the programme transferred to the National Institute for Health and Clinical Excellence (NICE) and further to a consultation in 2002 the remit of the programme was extended to review the care received by medical patients as well as surgical patients. In addition, near miss morbidity cases were included as well as cases of mortality.

Objectives of the programme:

  • Assess the quality and safety of health services, highlighting variation, both positive and negative, in the provision, safety and quality of healthcare.
  • Promote improvements in service quality through local and national learning, and the provision of quality improvement resources.
  • Reduce inequalities in access to, experience of, or outcomes from the delivery of care.
  • Influence clinical practice, commissioning, service provision, policy, and education by making recommendations to improve outcomes for patients.
  • Ensure that all hospitals are aware of good practice examples of quality improvement initiatives for each topic area.
  • Complement and contribute to the work of other healthcare organisations.
  • Put patients and those important to them at the centre of the development and delivery of all aspects of the work programme.
A protocol to describe the key features of the Medical and Surgical Clinical Outcome Review Programme can be found here:
Understanding Practice in Clinical Outcome Review Programmes tool (UPCORP) - guidance and checklist
View the healthcare quality improvement plan for this programme