•	Introduction	•	Associated Registries
•	Members	•	Publications
•	National Vascular Database Start Up	•	Contact Information
•	National Vascular Database Dataset Definitions	•	Constitution
•	Data base entry point - Coming Soon	•	Clinical Governance
•	NICE Guidelines	•	Terms of Reference
•	NCEPOD Report on Abdominal Aortic Aneurysm
•	Society's response to NCEPOD Report on Abdominal Aortic Aneurysm
•	Vascular Registries
•	Workload Survey
•	The Vascular Society Survey of Haemodialysis Access Practice - results
•	The Vascular Society Survey of Haemodialysis Access Practice - results 03
Past Reports
•	National Vascular Database 2004
•	National Vascular Database 2002
•	National Vascular Database 2001

Members

Mr T Lees FRCS MD [Chairman until 2009]
Consultant Vascular Surgeon, Freeman hospital, Newcastle upon Tyne
Email: Tim.Lees@nuth.nhs.uk Tel: 0191 223 1269

Mrs Sara Baker, Based in Bournemouth
Contact Details

Dr Dave Prytherch Information specialists, data PhD
Based at Portsmouth University

Mr T Lees (Chairman)
Mr D Berridge (until Nov 2008)
Mr J J Earnshaw (until Nov 2010)
Professor J Michaels (until Nov 2008)
Mr P Madhavan (until Nov 2009)
Mrs S Baker
Dr D Prytherch
Dr L O’Grady (BSIR rep)
Dr D Wilson Nunn (VASGBI rep)
Mr P Barker
Mr D Baker
Mr S Parvin
Professor G Stansby
Mr C Gibbons (co-opted)
Mr P Holt (co-opted)
Mr V Smyth (co-opted)

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Contact Information

Mrs Sara Baker
Audit and Research Associate
Royal Bournemouth Hospital
Vascular Surgical Unit
Post Point D20-21
Castle Lane East
Bournemouth BH7 7DW

Tel: 01202 303626 ext 5939
Fax: 01202 704622

E-mail: sara.baker@rbch.nhs.uk

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Introduction

In 1991 it became clear that the VSSGBI, as the as the Vascular Surgeons’ professional body, needed to set standards for the surgical treatment of vascular disease. Therefore the Audit and Research Committee was developed as a centralised research panel charged with surveying and collating national vascular practice. Initially c ritical limb ischemia, carotid surgery and aneurysm mortality were surveyed as well as transfer times for patients with life threatening aneurysm rupture, contribution was by invitation to well established and busy vascular units in the UK. Publications on the optimum patient management were distilled from these surveys.

Since then the data collection has grown steadily and this year on year data now forms the National Vascular Database. This database has assumed an ever increasing role in allowing surgeons to scrutinise their results alongside national figures, with the aim of improving outcomes.

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Work of the committee & collaborations

Management of the National Vascular Database, analysis of the data, and publication of outcomes comprises the largest proportion of the work undertaken by the A&R committee.

In addition collaborations with the Royal College of Physicians and the Health Care commission have examined the care pathway and timelines for patients requiring a carotid endarterectomy operation. Publications on the organisation of carotid endarterectomy services have been circulated and the results of the 2 year clinical audit will be published in Summer 2008. More recently the inclusion of data items on topical surgical site infections and other infection related problems has enhanced the NVD’s value to the society. Further advisory meetings are also underway with the Celtic infection audit group.

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Constitution of the Audit and Research Committee

Council nominate and elect an Ordinary Council Member to chair the Committee. The term of office of the Chairman is four years. The Committee usually comprises three Ordinary Members of Council (in addition to the Chairman) as well as a number of co-opted “external” members as deemed appropriate by the chairman. Mrs Sara Baker is the data coordinator for the committee and is employed on a sessional basis by the society.

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National Vascular Database Information

Four indexed procedures constitute the current NVD database, Abdominal Aortic Aneurysm [AAA] repair by any method, both elective and emergency; surgical Carotid Endarterectomy [CEA], infrainguinal bypass surgery [IIB] and more recently lower limb amputation [AMP] . Each of these operations requires specific surgical expertise to perform but also requires multidisciplinary teams to look after a variety of aspects of patient care peri-operatively. Data about the patients’ relevant medical history, the immediate intra-operative and postoperative events and recovery timings and the outcome are included. These data are then analysed after risk adjustment to provide a national view of surgeons and hospital’s performance for these indexed procedures. Publications have been produced for the Healthcare Professionals, and these are also available in the public domain. Contributing surgeons have received personal reports of their own risk adjusted performance set against the national average for governance and for personal appraisal.

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National Vascular Database Start Up

Newly appointed surgeons are advised to contact our research associate Mrs Sara Baker, to activate their on line account , and  for information about their local hospital code.

The Vascular Society’s preferred data collection method is by the secure website accessed via secure log-on to a purpose built web tool.  Other methods of data collection can be used if preferred and the data can be imported into the webtool. However,  it is essential to note that the data for submission to the NVD must be in a standard format for upload  - it must conform to the the data dictionary [link]  to ensure standardisation If you choose to use this method please try and import data at an early stage to ensure that you have your data in the correct format.

Additional fields may be included at a local level but these must be removed prior to merging with the National Vascular Database centrally, free text fields are available for qualifying data.

THE WEBSITE IS THE ONLY METHOD OF DATA TRANSFER WHICH WILL BE ACCEPTED.

Live data collection is advised so that the real time national mortality displayed reflects the true figure, for centres with an established surgical audit programme at least monthly uploads are recommended after data validation by local surgeons.

In 2007 the society commissioned Dr Foster intelligence to explore a more immediate method of data entry and analysis, the resulting tool conforms to the criteria set out by the Audit and Research Committee and provides it’s members with a simple and effective monitoring tool. The product will produce analysis and report for individuals, centres and the society as a whole.

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NICE, guidelines

The society has a number of expert colleagues who provide advice to NICE committees on topics relating to vascular services and novel procedures. Proper audit of novel procedures provides both a tool for the innovative surgeon and a protection. The society supports good audit and seeks to include novel procedures in the National Vascular Database either directly or indirectly via the associated registries such as the RETA and Venous Forum records.

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Registries of Endovascular Procedures

The vascular society members continue to collaborate with their radiology colleague and contribute to three endovascular registries: the Registry for the Treatment of Abdominal Aortic Aneurysms (RETA), the Thoracic Stent Registry and the Carotid Stent Registry. These registries are supervised by the UK Endovascular Registry Group which has representation from the The Vascular Society, the British Society of Interventional Radiologists and the Society of Cardiothoracic Surgeons. The Safety and Efficacy Register of New Interventional Procedures (SERNIP) has previously indicated that all such procedures should be submitted to a registry unless they are part of a randomised controlled trial. These procedures are now under consideration by the Interventional Procedures Advisory Committee of the National Institute of Clinical Excellence.

• The RETA Registry forms the audit trail or 'front door' to the Endovascular Aneurysm Repair Trial (EVAR) for both new centres and new devices. All procedures performed outside the trial should continue to be entered into the RETA Registry.
• All endovascular procedures for thoracic aortic dissections, transections or aneurysms should be entered into the Thoracic Stent Registry.
• The Carotid Stent Registry will form the audit trail for the new International Carotid Stenting Study (ICSS). All carotid stent procedures performed outside the ICSS trial should be submitted to the Carotid Stent Registry.

You can download all of the Registry forms as they become available from this page.

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Publications

Tang T, Walsh SR, Prytherch DR, Lees T, Varty K, Boyle JR; Audit Research Committee of the Vascular Society of Great Britain and Ireland.
BHOM, a data economic model for predicting the outcome after open abdominal aortic aneurysm surgery.
Br J Surg. 2007 Jun;94(6):717-21

Aylin P, Lees T, Baker S, Prytherch D, Ashley S.
Descriptive study comparing routine hospital administrative data with the Vascular Society of Great Britain and Ireland's National Vascular Database.
Eur J Vasc Endovasc Surg. 2007 Apr;33(4):461-5; discussion 466. Epub 2006 Dec 15.

Risk- adjusted predictive models of mortality after indexed arterial operations using a minimal data set. Prytherch DR; Ridler BM and Ashley S; on behalf of the Audit and Research committee of the Vascular Society Great Britain and Ireland British Journal of Surgery 2005;92 (6):714-8.

McCollum PT, da Silva A, Ridler BM, de Cossart L
Carotid Endarterectomy in the UK and Ireland: audit of 30-day outcome. Committee for the Vascular Surgical Society.
Eur J Vasc Endovasc Surg 1997; 14(5): 386-91

da Silva AF, Desgranges P, Holdsworth J, Harris PL, McCollum P, Jones SM, Beard J, Callam M
The management and outcome of critical limb ischaemia in diabetic patients, a national survey. Audit committee of The Vascular Surgical Societyof Great Britain & Ireland
Diabet Med 1996; 13(8): 726-8

Recomendations for the management of chronic critical lower limb ischaemia. Audit committee of The Vascular Surgical Societyof Great Britain & Ireland
Eur J Vasc Endovasc Surg 1996; 12(2): 131-5

Campbell WB, Ridler BM, Szymanska TH
Current management of acute leg ischaemia: results of an audit of the Vascular Surgical Society of Great Britain & Ireland
Br J Surg 1999; 86(9): 1498-503

Lees TA, Beard JD, Ridler BM, Szymanska T
A survey of the current management of varicose veins by members of the Vascular Surgical Society
Ann R Coll Surg Engl 1999; 81(6): 407-17

Campbell WB, Ridler BM, Szymanska TH
Two year follow-up after thromboembolic limb ischaemia: the importance of anticoagulation
Eur J Vasc Endovasc Surg 2000; 19(2): 169-73

Prytherch DR, Ridler BM, Beard JD, Earnshaw JJ; The Audit and Research Committee of The Vascular Surgical Society of Great Britain & Ireland
A model for national outcome audit in vascular surgery
Eur J Vasc Endovasc Surg 2001; 21(6): 477-83

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