Key Audit Documents
EmLap
NoLap
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NELA+ audits delivery of care against existing standards. Beginning in NELA+ Year 10 (1st April 2023), the standards and metrics against which NELA+ will report can be found here:
Standards are calculated using the following:
Previous to Year 10, NELA audited care against standards which can be found here:
Previous to Year 10, standards were calculated using the following:
NoLap Cohort Audit Standards
Standards of care can be found here.
Standards are calculated using the following: NoLap Standards Calculations from April 2023
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Please find below PDF versions of the online data collection instrument for your information. All data entry will be carried out through the online data collection web tool; this proforma exists to assist.
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NELA+ includes patients treated in England, Wales, or Northern Ireland who are aged 18 years and over and who undergo an expedited, urgent, or emergency (NCEPOD definitions) abdominal procedure on the gastrointestinal tract. The NoLap cohort includes patients treated in England, Wales, or Northern Ireland who are aged 18 years and over, with a diagnosis of bowel ischaemia or bowel perforation for which surgery is indicated, but who do not undergo surgery.
Further information on the inclusion and exclusion criteria for NELA+ can be found here:
• Inclusion/exclusion criteria
• Inclusion/exclusion criteria in tabular format
• FAQs
Further information on the inclusion and exclusion criteria for NoLap can be found here:
• Inclusion/exclusion criteria
• FAQsOPCS Labels for Procedures in the NELA+ Dataset (UPDATED JUNE 2019)
There are over 400 OPCS codes that might be used to code patients undergoing emergency laparotomy. The codes in the form here should allow people to identify potential procedures within NELA+, but hospitals will need to filter out those procedures that do not meet the NELA+ inclusion criteria.We do not recommend that hospitals use OPCS codes as the sole mechanism to identify patients for inclusion into NELA+. The inclusion/exclusion criteria are defined according to clinical definitions, not coding definitions. For this reason, it will be extremely difficult for hospitals to provide accurate audit data using OPCS codes to retrospectively identify patients.
The audit is intended to be completed by clinical teams as the patient progresses through the emergency laparotomy pathway. The data entry tool has been designed to facilitate this as much as possible.
Diagnostic Codes for NoLap
Diagnostic codes being used for NoLap can be found here.
IMPORTANT NOTE: THE ICD-10 DIAGNOSTIC CODES AND ALGORITHM ARE ONLY FOR CASE ASCERTAINMENT PURPOSES. THESE ARE SUBJECT TO CHANGE IN SUBSEQUENT YEARS. NELA DOES NOT RECOMMEND USING ICD-10 DIAGNOSTIC CODES AS PART OF REALTIME DATA COLLECTION.
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Please refer to this document for further information about the NELA outlier policy/process.
The NELA policy for defining outliers for NELA Year 11 (23 Apr 2024 - 31 Mar 2025) can be found here.
The NELA policy for defining outliers for NELA Year 10 (1 Apr 2023 - 23 Apr 2024) can be found here.
The NELA policy for defining outliers for NELA Year 9 (1 Dec 2021 - 31 Mar 2023) can be found here.
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The NELA+ Quality Improvement Plan for 2022-2025 can be found here.
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This guidance explains what the term ‘Cause for Concern’ means in the context of national clinical audits and clinical outcome review programmes. It is designed to support the organisations who deliver these programmes as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) to understand:
Their own responsibilities,
What they should expect from healthcare providers and/or healthcare commissioners,
How HQIP should be engaged in the process,
The need to develop their project-specific Cause for Concern policies.
Find it here: Cause for Concern
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In an effort to reduce the time and resource required to complete data collection, the NELA+ team review datasets annually. Data items that are no longer relevant or for which a sufficient amount of data has been collected historically are removed. NELA+ will also rely on data available from national-level datasets, like NHS England's Hospital Episodes Statistics (HES), where possible instead of asking audit teams for information that is already captured in these datasets.
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