SP10.3 Colectomy for Inflammatory Bowel Disease (IBD) – use of the National Consultant Information Programme (NCIP) to highlight colorectal surgical practice in England

Introduction The NCIP tool uses HES data from Trusts to understand the spread and variation of a range of surgical procedures. There are two forms of IBD; Crohn’s and Ulcerative Colitis (UC). This work uses NCIP to contextualise data and understand Covid-19’s impact and the current practice of colectomy for IBD in England. Method Pseudonymised data was extracted from NCIP dashboards by NHS England Improvement data analysts. Various metrics were analysed including surgical approach, frequency of cases, length of stay (LOS), incidence of stoma maturation and readmission, and mortality. Results 3907 Crohn’s and 1942 UC cases performed from April 2019-March 2022. Decrease observed in frequency during Covid-19. Crohn’s: 47.76% laparoscopic cases. 17.42% of total providers did <10 cases in 4-year period. Average LOS was 9.01 days ± 0.16 with 95% CI [8.70, 9.32], p<0.001. Mean stoma rate was 31.73% in units performing ≥20 cases. 30-day readmission was 17.33%. 90-day mortality was 0.23%. UC: 56.54% laparoscopic cases. 47.29% of total providers did <10 cases in the 4-year period. Average LOS was 10.39 days ± 0.29 with 95% CI [9.82,10.96], p<0.001. Mean stoma rate was 87.09% in units performing ≥20 cases. 30-day readmission was 21.94%. 90-day mortality was 0.82%. Conclusion Covid-19 decreased current practice for IBD colectomies, possibly due to RCS guidance recommending temporary suspension of non-cancer surgery during the pandemic. Lower laparoscopy rates than expected. Significant centre variation and variation in stoma rate observed. Data suggests stoma creation within episode is a contributor to higher average LOS and readmission rate (p<0.05).