National Vascular Registry

The National Vascular Registry (NVR) will be for NHS-funded vascular surgery and is expected to include several significant changes in scope compared to the existing specification (which runs to 31/12/2027 and is available on request using the registration link). The initial contract is anticipated to be for a period of 3 years, with an indicative a maximum total budget for England only (see below regarding devolved nations) as follows: up to £1,619,337 excluding VAT and £1,943,204.including VAT. Bids exceeding the maximum total budget will be rejected. It is currently expected that the extension value will be a 2 year pro rata of the core 3 year funding, estimated at £1,079,558 excluding VAT (England only). The figures stated here are based on the scope including England only. Other devolved nations could be included (particularly Wales) but details have not been finalised. The maximum contract value would be adjusted if additional areas are included. There is also potential to include aspirational intent measures (which will be defined in the service specification). All values stated may be subject to change and the final values will be given when the tender goes live. SCOPE OF THE AUDIT The role of a national clinical audit is to stimulate healthcare quality improvement through the provision of high-quality information on the organisation, delivery and outcomes of healthcare, together with tools and support to enable healthcare providers and other audiences to make best use of this information. Outcomes are benchmarked against national guidance and standards e.g. quality standards from the National Institute for Health and Care Excellence (NICE), and those from other established professional and patient sources. Successful national audits are those where the individuals providing the data can also improve the system, and there is a shared understanding of what good care looks like. The National Vascular Registry was established in 2013 and currently collects information on five vascular surgical procedures: Repair of abdominal aortic aneurysm (AAA) Carotid endarterectomy Lower limb angioplasty Lower limb bypass Lower limb amputation Since 2020 the NVR has collected device data for certain procedure types – the contractual arrangements for this have changed over time, and HQIP and funders are considering whether this should form part of the current contract opportunity. The overarching aim of this audit is to stimulate improvements in care for patients undergoing vascular surgery through the provision of high-quality comparative data from all providers of these services by measuring and reporting variations in quality of care and patient outcomes. For all HQIP-commissioned national clinical audits, the default expectation is that existing, routinely collected digital data will be used wherever available, and bespoke collection of data is avoided unless there is no other means of sourcing the data capable of meeting the needs of the project. Potential sources of existing digital data can include national data collections (for example, Hospital Episode Statistics and the Patient Episode Database for Wales), and Electronic Patient Records (EPR) data (whether from the system providers or via local data extraction and upload). Data is most useful locally for healthcare improvement when its provision to clinical teams is timely, the data is refreshed regularly and appropriate tools, support and guidance accompany the data outputs. The intent is for all of these features of the audit to be implemented and improved during the period of this contract.

This audit programme is expected to:

a)Develop a robust, high-quality audit designed around key quality indicators likely to best support local and national quality improvement; b)Achieve, articulate and maintain close alignment with relevant NICE national guidance and quality standards throughout the audit, as appropriate; c)Enable improvements through the provision of timely, high-quality data that compares providers of healthcare, and comprises an integrated mixture of named trust, health board, commissioner, MDT, possibly consultant or clinical team level and other levels of reporting; dEngage parents, carers and families in a meaningful way, achieving a strong patient voice which informs and contributes to the design, functioning, outputs and direction of the audit; e)Consider the value and feasibility of additional data linkage, at an individual patient level, to other relevant national datasets either from the outset or in the future, and plan for these linkages from the inception of the contract; f)Ensure robust methodological and statistical input at all stages of the audit; g)Identify from the outset the full range of audiences for the results and other audit outputs, and plan and tailor them accordingly; h)Provide audit results in a timely, accessible and meaningful manner to support quality improvements, minimising the reporting delay and providing continual access to each unit for their own data; i)Utilise strong and effective project and programme management to deliver audit outputs on time and within budget; and j)Develop and maintain strong engagement with local clinicians, networks, commissioners, patients and their families and carers and charity and community support groups in order to drive improvements in services.