Medical Blog - Health Care Commission and ICNARC.

In March 2009 the Health Care Commissions published a report which referred to the “appalling care” delivered by Mid Staffordshire NHS Trust in the UK. The report states that there were deficiencies at "virtually every stage" in the care of people admitted as emergencies to the Mid Staffs Hospital. Sir Ian Kennedy, the Commission's Chairman, said: "This is a story of appalling standards of care and chaotic systems for looking after patients. There were inadequacies at almost every stage in the care of emergency patients.  There is no doubt that patients will have suffered and some of them will have died as a result. We look regularly at rates of mortality across the NHS in England. This statistical analysis served as a trigger - it raised questions which the investigation sought to answer".
This was an example of how careful monitoring of patient outcomes (audit) quickly enabled a failing hospital to be identified in the UK. The problem is, if you don’t audit you can’t trigger! If you don’t collect relevant data on patient outcomes, then how will you know if you are doing well, OK or really badly? Patients could be dying more often than they should but there would be no way of knowing. Take Intensive Care for example. Currently over 80% of adult, general Intensive Care Units (ITU) in the UK participate in ICNARC (Intensive Care National Audit and Research Centre). Critical care units volunteer to join and collect information about all the patients they admit to their unit. These data are sent to ICNARC. ICNARC validates and analyses these data. ICNARC generates reports which show how the unit compares with other ITUs, and helps the unit understand more about the care they deliver. It aims to assist them in decision-making, resource allocation and most importantly, to ensure patient well being and safety is maintained. Most of all, they know if they are doing a good job or not. Unfortunately, not all ITUs participate in ICNARC ......

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