Nonemergency colectomy for inflammatory bowel disease: the National Consultant Information Programme (NCIP) used to highlight colorectal surgery practice and outcomes in England 2018-2022.

Abstract

Introduction: The National Consultant Information Programme (NCIP) tool provides a platform for NHS consultants to benchmark their practice and for trusts to have a purview of the range, variation and outcomes of surgical procedures. Surgery remains an effective strategy for the treatment of inflammatory bowel disease (IBD) despite advances in medical therapy. This study leverages the NCIP data to assess the current trends of colectomies for IBD and the impact of COVID-19.

Methods: Pseudonymised data (demographics, number and types of colectomy per provider, resection approach and stoma formation) were collected from the NCIP for IBD Dashboard and analysed against outcomes such as readmission, length of hospital stay and mortality.

Results: A total of 132 providers performed 3,907 colectomies for Crohn's and 1,942 colectomies for ulcerative colitis (UC), with 76 (57.58%) performing more than 20 cases over the four-year period. More cases were performed laparoscopically, 55.46% and 61.17% for Crohn's and UC, respectively. Transverse colectomy had the highest readmission rate (29%) for Crohn's, whereas ileoanal anastomosis was highest at 29.37% for UC. Mortality rate was 0.23% and 0.82% for Crohn's and UC, respectively. Length of hospital stay was increased significantly in both Crohn's disease and UC by open procedure and stoma creation.

Conclusions: This study showed significant variation in practice across centres, with the volume of procedures performed in each centre being an influencing factor in the variation, especially when considering the incidence of stoma creation and surgical approach. This achieved the aim of the NCIP to keep a benchmark of standardisation across NHS practice.