These FAQs will hopefully answer the questions you may have about the National Ophthalmology Database Cataract Audit. If you have other questions, please contact the project team on [email protected].
Q1: What is the RCOphth NOD?
A1: The RCOphth NOD is the Royal College of Ophthalmologists National Ophthalmology Database. It was established under the auspices of the Royal College of Ophthalmologists (RCOphth) in 2010 to collate pseudonymised data collected as a by-product of routine clinical care using electronic medical record (EMR) systems for the purposes of national audit, research and establishing meaningful measures for revalidation.
Q2: What is the National Cataract Audit?
A2: The National Cataract Audit is an audit of cataract surgery performed in adult patients. The audit is an important quality assurance measure of cataract surgery which is the most frequently performed procedure in the NHS.
Q3: How can our organisation participate in the audit?
A3: All organisations providing cataract surgery in the United Kingdom or the Channel Islands are eligible to participate in the audit. If your organisation would like to join the audit, please contact [email protected] We will be pleased to confirm your eligibility and invite your organisation to participate in the audit.
Q4: How do I submit data into the audit?
A4: Organisations using the Medisoft EMR system will have their data remotely extracted from the EMR and submitted to the RCOphth NOD. Organisations using the Open Eyes EMR system can extract their data from the EMR using the in-built extraction mechanism and submit to the RCOphth NOD. Organisations using other databases which collect data compliant with the Minimum Cataract National Data Set for National Ophthalmology Audit Database are responsible for submitting their data to the RCOphth NOD in a suitable format. The process of submission is to upload the data to the RCOphth NOD website for the RCOphth NOD statistician to download. For Medisoft centres and one Open Eyes centre the data is transferred via a secure FTP server connection to the RCOphth NOD statistician due to the volume of data in these files. This option is open to other organisations with an N3 connection upon request.
Q5: We don’t have an EMR as we have an in-house database, can we still participate in the audit?
A5: If your organisation uses an in-house database in your cataract service, you will be able to participate in the audit provided the data are compliant with the audit dataset. Please contact [email protected] to request a copy of the minimum dataset for the cataract audit. This will give you more information on what will be needed, including the data formats. We will be pleased to discuss how best to proceed with possible inclusion.
Q6: How long will the audit run for?
A6: The first four annual audit years ran from September to August. From April 2020, the audit data collection year changed to align with the NHS years i.e. 01 April - 31 March and annual data collections will continue accordingly.
Q7: When will the audit data extraction occur?
A7: Data extraction/ submission will take place annually shortly after the close of the data collection period for audit cycles. All organisations are contacted in advance and provided with the relevant year’s submission dates.
Q8: What standards will be used for the audit?
A8: As a general guide, the NICE Cataract Surgery guideline NG77, https://www.nice.org.uk/guidance/ng77 will be used for the audit. The actual comparisons levels for PCR and VA loss are reviewed annually from the audit data to reflect changing rates of these complications over time. The comparison level chosen reflects the underlying rate for consultant surgeons, which are currently 1.1% for PCR and 0.9% for VA loss.
Q9: What data will be collected for the audit?
A9: Please refer to the national datasets section on the homepage. The Cataract Minimum Dataset will form the basis of the audit.
Q10: How long will data be kept for and when will it be destroyed?
A10: The RCOphth is the data controller and has overall authority over the data and all aspects of its use. The RCOphth will determine the duration of data retention in line with the principles of the General Data Protection Regulation (GDPR).
Q11: Where will the audit report be published and who will have access to these?
A11: The audit reports are publicly available on www.nodaudit.org.uk website. Our first report which was published in April 2016 was based on historic data and provided us with a mechanism for refinement of the methodology. Information included in this initial report is limited as the audit was in a developmental phase. All completed prospective audit reports are available on the audit website and these include case complexity adjusted outcomes for PCR and VA loss for participating organisations. Case complexity adjusted PCR and VA loss results are available on the public section of the audit website for named consultant and independent surgeons, and for named surgical centres. Audit year results for organisations are provided to both the Care Quality Commission and The Getting It Right First Time Programme.
Q12: Does the RCOphth NOD database hold patient identifiable data?
A12: The RCOphth NOD database does not hold any patient identifiable data but does have a unique ID for each patient in order that data extracted from multiple visits can be appropriately matched to the correct patient record. The data are therefore pseudonymised. The unique pseudonymous identifier will be automatically assigned by each submitting organisation and therefore only the patient’s hospital together with its EMR software provider (if EMR enabled) will be able to identify the patient. This degree of anonymization is standard in other national databases and the approach will be extended to non-EMR sourced data.
It is possible that the audit will seek to extract patient identifiable data in the future to facilitate linkage at patient record level with other clinical datasets to enhance the scope and impact of the audit. If so, a legal basis for this data flow would first be established and the participating centres including their Caldicott Guardians would be informed.
Q13: Does the audit have a section 251 exemption?
A13: The audit does not currently have a section 251 exemption and as such no patient identifiable data will be extracted. The College intends to apply for an exemption to facilitate linkage with other databases such as NHS Digital and NHS Wales Informatics Service. If S251 exemption is granted then all centres will be informed of the changed status of the audit, and permissions for data extraction will be revised accordingly.