Surgery Data

Appendicectomy and Testicular Torsion data collection

Standard
Network Trusts to provide prompt assessment and treatment locally for children of 5 years of age and above with non-complex appendicitis or with suspected testicular torsion.

The 5 years of age threshold for appendicectomy and testicular torsion has been endorsed by both the South Thames Surgery in Children Network Working Group and by the General Paediatric Surgery and the STPN Board.

We expect each Trust in the Network to review relevant local policies to comply with this standard. If your Trust is not able to implement this standard within your Trust’s local policy due to internal workforce and other challenges please contact us at england.stpn@nhs.net

GIRFT Paediatric Surgery

The STPN SiC Network is responsible for implementing the recommendations from the GIRFT national reports andto report outcomes both to the ICSs covered by the Network (South East London, South West London, Surrey, Sussex and Kent) and nationally.

Recommendation 4 of the GIRFT Paediatric Surgery report is about improving the care of children requiring emergency paediatric surgery for appendicitis and testicular torsion.

Recommendation 4B

Trusts and Operational Delivery Networks to reduce the incidence of negative (normal) and complex appendicectomy rate by employing shared care between paediatricians and surgeons and adopting the appendicectomy model.

Recommendation 4D

Operational Delivery Networks to review capacity as necessary to ensure that all boys with suspected testicular torsion are assessed promptly and treated close to home to reduce the incidence of testicular loss.

To deliver on these recommendations, the STPN General Surgery and Urology Working Group has created two General Surgery Audits on appendicectomy and testicular torsion. Click images below to access the respective audits.

These audits have been rolled out across all trusts in the Network since April 2021 and should be embedded in each trust’s clinical governance processes and completed on a monthly basis.

We are aware that many trusts have been taking part in the CASAP audit which includes appendicectomy data. If you are one of these trusts. we do not require you to submit appendicectomy data as long as you are able to provide us with the data that we need (see KPIs below). However, we do ask that you still submit testicular torsion data either through the STPN form or through other means.

After completion of the audits, we will be looking at publishing our findings.

If you are unsure who submits this data for your Trust and/or would like to get involved with this work (juniors welcomed!), please contact england.stpn@nhs.net

Appendicectomy KPIs

Torsion KPIs

  • % of Appendicectomies Performed Within 12 Hours of Decision to Operate (recorded times only) Target: 100%
  • % of Simple Appendicectomies With LOS of <=72 Hours(recorded LOS only) Target: >=80%List
  • % of Complex Appendicectomies With LOS of <=6 Days (144 hours, recorded LOS only) Target: >=80%
  • Negative Appendicectomy Rate (recorded findings only) Target: <=5%
  • % of Appendicectomies Transferred Out 5 years and above
  • % Laparascopic Appendicectomies >80%
  • % Readmission Within 30 Days <5%
  • % of Torsions w. History of Pain <6 Hours That Went to Theatre within 1 Hr of Arrival at ED. Target: 100%
  • % of Torsions Transferred to another centre >5yrs of age <10%
  • % Orchidectomy over the age of 1 years <15%
  • % Readmission Within 30 Days <5%