Funded by the Health Foundation, the Emergency Laparotomy Collaborative (ELC) was established in 2015 using a quality improvement (QI) approach. The Collaborative brought together 28 hospitals and 24 NHS trusts across three AHSN regions: Kent Surrey Sussex; Wessex; and West of England.
Emergency laparotomy is a major surgical procedure, with 30,000 to 50,000 performed every year in the UK. However at the time the Collaborative was established around 15% of patients were reported to die within 30 days of surgery. Over 25% of patients remained in hospital for more than 20 days after surgery, costing the NHS over £200m a year. According to the annual figures from the National Emergency Laparotomy Audit these figures have improved since 2015.
The ELC grew from the successful Emergency Laparotomy Pathway Quality Improvement Care bundle project (ELPQuiC) carried out three years prior to the launch of the Collaborative in four hospitals in the South of England. Over an eight-month period, crude 30-day mortality was reduced by 25% and P-POSSUM risk adjusted 30-day mortality by 42%.
All six acute trusts in the West of England adopted this evidence-based practice as part of the collaborative pathway.
The Sixth Patient Report of the National Emergency Laparotomy Audit was published in November 2020 and it highlighted Gloucestershire Royal Hospital as one of the best performing trusts in England and Wales. This builds on the success of Southmead Hospital and Weston Hospital who were both highlighted in 2019.
We are always looking for individuals or organisations to get involved in the work we do, and continue to support quality improvement in surgical work.
We are currently working on PreciSSIon (Preventing Surgical Site Infection across a region) a collaborative project to reduce the incidence of surgical site infection after elective colorectal surgery.
If you are in the West of England and wish to find out more about our Emergency Laparotomy or our Surgical Site Infection work, please contact Kevin Hunter.