Intensive Care National Audit & Research Centre

Intensive Care National Audit & Research Centre
Name	Intensive Care National Audit & Research Centre
Formation	1990s
Headquarters	United Kingdom

Intensive Care National Audit & Research Centre is an independent charity and clinical audit organisation focused on adult critical care in the United Kingdom. It maintains national clinical datasets, delivers benchmarking reports, and supports clinical research across NHS England, NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland. The centre collaborates with academic institutions, professional bodies, and international partners to inform health policy and quality improvement.

History

The centre was established in the context of late 20th-century reforms influenced by events such as the Bristol heart scandal, the rise of clinical governance, and initiatives like the Modernisation Agency. Early links were formed with the Royal College of Physicians, Royal College of Anaesthetists, Faculty of Intensive Care Medicine, and university departments including University of Oxford, University College London, and Imperial College London. Funding and governance intersected with programmes from the Department of Health and Social Care, the National Institute for Health and Care Excellence, and the Medical Research Council. Milestones include development of national audit tools during the era of the Calman reforms and expansion of data linkage capabilities following reports by the Health Select Committee.

Organisation and Governance

The organisation operates as a registered charity and independent body with governance involving trustees drawn from institutions such as the Royal College of Nursing, British Medical Association, and universities including University of Cambridge and King's College London. Executive leadership liaises with stakeholders including the NHS Confederation, Care Quality Commission, Public Health England, and devolved administrations like the Scottish Government. Strategic partnerships extend to the Wellcome Trust, National Institute for Health Research, European Society of Intensive Care Medicine, and bodies like the Academy of Medical Royal Colleges. Corporate governance references frameworks from the Charity Commission for England and Wales and compliance with standards promoted by the Information Commissioner's Office.

Data Collection and Methodology

Data collection protocols align with standards used by organisations such as the Office for National Statistics, the Clinical Practice Research Datalink, and registries like the Trauma Audit and Research Network. Patient-level data are captured from intensive care unit electronic systems used in trusts including Guy's and St Thomas' NHS Foundation Trust, Addenbrooke's Hospital, and St Thomas' Hospital. Methodology incorporates severity scoring systems such as APACHE II, SOFA score, and routines similar to registries like the Paediatric Intensive Care Audit Network. Data governance employs techniques advised by the Information Governance Alliance, with linkage to datasets from the NHS Blood and Transplant, Office of National Statistics, and research cohorts at University of Edinburgh and University of Glasgow.

Major Programmes and Services

Key programmes include national audit cycles, benchmarking reports for units such as Royal Brompton Hospital and Queen Elizabeth Hospital Birmingham, and service evaluations in partnership with the National Health Service (NHS). Services include real-time dashboards used by management at Barts Health NHS Trust, quality improvement collaboratives led with NHS Improvement, and training modules co-developed with the Intensive Care Society and Society of Critical Care Medicine. During public health emergencies, the centre has coordinated surge capacity reporting with Public Health England, NHS England and NHS Improvement, and international agencies like the World Health Organization.

Research and Publications

The centre produces peer-reviewed outputs in collaboration with academic groups from University of Manchester, University of Bristol, Newcastle University, and University of Southampton. Publications appear in journals such as The Lancet, BMJ, Critical Care Medicine, and Intensive Care Medicine. Research themes include outcomes research, health services evaluation, and studies linked to trials sponsored by the National Institute for Health Research and the Medical Research Council. Collaborative projects have engaged consortia including the UK Critical Care Research Group, International Severe Acute Respiratory and emerging Infection Consortium, and university partners like University of Liverpool.

Impact and Influence on Policy

Audit findings have informed policy papers and guidance by bodies such as the National Institute for Health and Care Excellence, the Department of Health and Social Care (United Kingdom), and regulators like the Care Quality Commission. The centre's data have been cited in parliamentary inquiries, reports by the National Audit Office, and strategic planning for NHS capacity used by NHS England. Its outputs influenced commissioning decisions at regional organisations including Clinical Commissioning Groups (CCGs) and integrated care systems drawing on evidence used by Healthwatch England and professional standards set by the General Medical Council.

Criticisms and Challenges

Critiques mirror those faced by other data-intensive bodies such as the Office for National Statistics and the Care Quality Commission: concerns over data completeness raised by stakeholders including patient groups like Action for Pulmonary Fibrosis and professional organisations like the British Thoracic Society, challenges in interoperability across electronic health record vendors exemplified by issues at trusts including Mid Staffordshire NHS Foundation Trust and debates about data access highlighted in cases before the Information Commissioner's Office. Additional challenges include sustaining funding from sources such as the Wellcome Trust and National Institute for Health Research, and maintaining international collaborations with networks like the European Society of Intensive Care Medicine and the World Health Organization.

Category:Health care organizations based in the United Kingdom