Annual Report 2019 - 2021
We are thrilled to bring you the third edition of the national Perioperative Quality Improvement Programme's Annual Report.
PQIP is a research study being led by the National Institute of Academic Anaesthesia Health Services Research Centre, working on behalf of the RCoA and a range of stakeholders. PQIP has continued to work towards reducing the risk of complications after major surgery through ensuring that patients get the best possible care throughout their perioperative pathway. It is wonderful to see more hospitals than ever collecting patient data and thousands of patients providing their own feedback on satisfaction with care and longer-term quality of life. PQIP’s work is a benefit to teams across the country, giving them the opportunity to act on their own quality data and helping them to improve the quality of the perioperative pathway for their patients.
Professor Ramani Moonesinghe, Chief Investigator, Perioperative Quality Improvement Programme, said:
"What a couple of years it has been. Our last PQIP Collaborative event was held almost exactly two years ago at King’s Place – an event of great joy, celebration and optimism. Of course, the world has changed almost indescribably since then, and we have all been affected by it. Many of you will have endured personal loss, extreme pressure at work, and been challenged by the limitations of lockdowns at home. Many of you will have had an extremely challenging Summer at work, and while vaccination offers huge hope, we know that COVID-19 will be here to stay for at least a while, and its legacy for very much longer. Everyone in the PQIP central team offers you our thanks and admiration for all you have done for the NHS and our patients. On a different note, I
also want to offer my personal thanks to the members of the PQIP project team who have helped to write this report – Kylie, Georgina, Cecilia, Cristel, Christine and Dominic – a huge effort in difficult times.
"COVID-19 has obviously had a big impact on PQIP. The average number of locked cases since our last report is 90 cases per week, compared with 101 in our first cohort and 178 in our second. However, the average number of locked cases between the last report and when COVID-19 hit the NHS in March 2020 was 203 per week. So, we are really optimistic that we will now get back up to more than 200 patients recruited per week, as a result of your continuing amazing efforts, and yet more hospitals joining every month.
"We are at an exciting point in PQIP. We have started analysing the data collected on patients who had their surgery before March 2020. We will soon have some great results to share with you through journal publications and presentations. We are collaborating with clinical trials teams to run embedded studies to further improve the evidence base for what we do – the first of these, VITAL, will compare IV and inhalational anaesthesia in patients having major surgery in at least 40 NHS hospitals and starts recruiting in Autumn 2021.
"The general landscape for patients having surgery in the NHS is even more challenging than ever before, because of waiting list growth and the risk of patients becoming more deconditioned while they wait for surgery. For this reason, there has never been a greater need for the type of improvements which PQIP is trying to promote. We know the value of individualised risk assessment in shared decision making and perioperative planning, how DrEaMing within 24h is associated with reduced length of stay, and how really good pain management is associated with better processes and outcomes of care. We have identified our five improvement targets for this year around really trying to focus on local QI to reduce morbidity and length of stay, rather than just collecting data for research. Now has also never been a better time for you to try to leverage the need to improve outcomes and efficiency to get what you need from your trusts and systems to support PQIP related QI.
"Your continued support for PQIP and for our patients is truly inspirational. We hope that you are able to stay safe, well and take care of yourselves. Thank you for everything you do. We hope you enjoy reading this report."