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Privacy policy

What is the aim of the National Emergency Laparotomy Audit?

NELA is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme on behalf of NHS England and the Welsh Government.

The National Emergency Laparotomy Audit (NELA) is being carried out by the National Institute of Academic Anaesthesia's (NIAA) Health Services Research Centre on behalf of the Royal College of Anaesthetists.

The NELA aims to improve the quality of care for patients undergoing emergency bowel surgery (emergency laparotomy) through the provision of high quality comparative information from hospitals in England and Wales who undertake emergency laparotomies.  

What information do we collect about you and how do we use this?

We collect information about the care patients received whilst they are in hospital.  This includes information about the investigations and treatment received, how long it took for different parts of treatment to be given, and whether a patient went to a critical care bed after surgery.  The personal information we collect is name, date of birth, NHS number, postcode and sex. 

NELA patient data is submitted directly to NELA by clinical teams treating the patient or from the hospital records. 

NELA will not publish information that can enable individual patients to be identified.   

By collecting and sharing this information, we are able to highlight areas where hospitals are doing well, and areas in which they can improve the quality of care for patients so that they can put plans in place to achieve this.  It will also allow hospitals to compare themselves with others in England and Wales and in doing so improve the quality of care by sharing examples of good practice.

Data Controller

As commissioners of the NELA, HQIP are the data controllers for the patient data submitted to the audit i.e. they are the organisation in control of processing the data. 

Legal basis for processing personal data

NELA currently has approval under Section 251 to collect patient level data (reference number: CAG 5-07(d)/2013) for all emergency laparotomy patients admitted to hospital.  More information on section 251 is available here: 

The rationale for this is that as many emergency laparotomy patients are extremely unwell before and after they have had an emergency laparotomy, it would not be feasible to ask all patients for their consent. 

How we protect your data

The RCoA takes the security of your data seriously. In order to prevent unauthorised access or disclosure, we have put in place suitable physical, electronic and managerial procedures to safeguard and secure the information we collect online.

Local clinical teams enter patient data into a secure web-based tool provided by Net Solving Ltd.  Only the hospitals participating via the doctors, nurses and clinical audit staff and the NELA project team will have access to the web-based tool.  Security and confidentiality is maintained through the use of passwords and a person specific registration process.  

Patient confidentiality and level of data collected

The patient information received and managed by the NELA team is treated as confidential. The information is only available to the NELA team in a pseudonymised format, with individual patients only distinguished by a computer-generated sequence of numbers. This data will be retained for the duration of the audit and 5 years after it is completed.

We maintain the confidentiality and security of patient information in the following ways: 

  • All reports are produced at an aggregate level (national, regional, hospital).
  • In each audit publication, the statistical information is reviewed to ensure the risk of identification is minimised, and where necessary, small numbers are suppressed. This assessment follows guidelines issued by the Office for National Statistics - Review of the Dissemination of Health Statistics: Confidentiality Guidance (PDF).

Management of patient data by the NELA team

The NELA team are based at the Royal College of Anaesthetists (RCoA) and the Royal College of

Surgeons of England (RCS). Both the RCoA and RCS conform to the General Data Protection Regulation (GDPR) and other legislation that relates to the collection and use of patient data, and has strict security measures in place to safeguard patient information. NELA stores the pseudonymised patient data on a secure computer to which only authorised audit team members have access. The IT system has various levels of security built into it, including:

  • ID password security: the data is stored on a password protected system, which prevents unauthorised users gaining access.
  • The stored data files are encrypted.

Who we share data with

NELA only shares patient-level data following a strict governance procedure to ensure compliance with the General Data Protection Regulation (GDPR).  

NELA has permission to link patient-level data with other national databases on a case-by-case basis.

NELA holds a current Data Sharing Agreement with

  • NHS Digital for the English hospital data (Hospital Episode Statistics)
  • Office for National Statistics (ONS) for the death register
  • National Wales Informatics Service (NWIS) for the Welsh hospital data (Patient Episode Database for Wales (PEDW))
  • Intensive Care National Audit & Research Centre (ICNARC) for critical care data

Linkage with HES data enables NELA to compare the number of records submitted to NELA with the number recorded retrospectively in HES to ensure high data quality. This linkage also enables analyses on the associations between those undergoing emergency laparotomies and other medical conditions. Linking with ONS data allows NELA to report mortality rates in the first 30 days after patients are admitted to hospital. Linkage with PEDW data enables NELA to compare the number of records submitted to NELA with the number recorded retrospectively in PEDW data to ensure high data quality. Linking NELA data to ICNARC data allows longer-term analysis into critical care data.

Researchers may apply to NELA’s Data Controller (the Healthcare Quality Improvement Partnership, HQIP), for access to NELA data.  These requests undergo a stringent approvals process as outlined here. 

What if I do not want my information used by the Audit? 

As a patient, you can choose to opt out of NELA.  Opting out will not affect the care a patient receives.  Please email and put "Patient request to opt-out" in the subject line. We will then contact the hospital to request that they do not enter your details into the audit. Alternatively, please notify a member of your local care team that you wish to opt out.  

If your details have already been entered into the NELA database, your rights to access, change or remove your information may be more limited, as we need to manage your information in specific ways in order for research and reports to be reliable and accurate.  If your data has not yet been used for analysis, it will be removed from the NELA database. If your data has already been used for analysis, we will not be able to remove information about you that we have already obtained and used.  To safeguard your rights, we will use the minimum personally-identifiable information possible.

If you prefer you can also call the NELA Helpline on 020 7092 1683.

Changes to our privacy policy

We keep our privacy policy under regular review and we will always include the latest version on this web page.

The privacy policy was last updated on 11 May 2018

Who can I contact about this notice?

RCoA has a Data Protection Officer  - Sharon Drake who can help you with any queries about the information in this privacy notice:

You also have the right to lodge a complaint with the Information Commissioner’s Office (ICO), the supervisory authority in the UK responsible for the implementation and enforcement of data protection law, if you have concerns about the way your personal data is being handled.  You can contact the ICO via their website  - or by calling their helpline – 0303 123 1113.