Our response to COVID-19

Published: 17 Mar 2020

This page was originally published on 17 March 2020 and has been subject to regular updates since. The current content reflects the latest position. If you have previously visited this web page we advise carrying out a hard refresh to ensure you’re viewing the latest version. You can do this by simultaneously holding down the control key and F5 key on a PC, or by holding the Shift key and clicking the refresh icon on a Mac.

Last update: 15 June 2021

Impact of COVID-19 on NCAPOP

HQIP update regarding Covid-19 and the NCAPOP programme




12-07-21 Government Government announced ‘England moves to Step 4 from 19 July’:  ‘(COVID-19) Coronavirus restrictions: what you can and cannot do’
15-06-21 Government Government updated guidance: ‘(COVID-19) Coronavirus restrictions: what you can and cannot do’
27-05-21 NCAPOP Providers
(Newsletter/HQIP website)

Letter from Professor Stephen Powis, National Medical Director for NHS England and Improvement to HQIP to inform ‘In order to support the National Clinical Audit Patient Outcome Programme (NCAPOP) with monitoring and improving patient care, please accept this letter as notice that NHS England and Improvement is mandating a restart to data collection in England for the NCAPOP’

Read the full letter here

17-05-21 Government Government issued guidance: ‘(COVID-19) Coronavirus restrictions: what you can and cannot do’
22-02-21 Government

Government-issued guidance:

COVID-19 Response – Spring 2021 (Roadmap)

COVID-19 Response – Spring 2021 (Summary)

26-01-21 NHSEI to Trusts

Communication from Amanda Pritchard Chief Operating Officer, NHS England & NHS Improvement to NHS trusts and foundation trusts: Reducing burden and releasing capacity to manage the COVID-19 pandemic.

Page 7/10: Section: 2) Reporting and assurance: Point number 13

‘Clinical audit: Given their importance in overseeing non-Covid care, clinical audits will remain open. This will be of particular importance where there are concerns from patients and clinicians about non-Covid care such as stroke, cardiac etc. However, local clinical audit teams will be permitted to prioritise clinical care where necessary – audit data collections will temporarily not be mandatory.’

04-01-21 Government announcement

Government issued ‘National lockdown: Stay at Home’ guidance


01-12-20 HQIP website update Advice from the CQC: It is important for trusts to have assurance about the safety of their services, they must do so regardless of any disruption caused by the pandemic and any changes to the National Audit programme. While the CQC will take into account the circumstances, the CQC still expect them to ensure their services are safe. Trusts should speak to their local CQC team regarding any related concerns.
18-11-20 HQIP website update The Communication from Amanda Pritchard Chief Operating Officer, NHS England & NHS Improvement to NHS trusts and foundation trusts on the 28-03-2020 has not been stood down. Whilst participation and data entry is not currently mandated, many of the NCAPOP platforms and web-tools have remained open. This is because there are concerns from patients and clinicians that care for those with long term conditions might particularly suffer whilst the focus moved to COVID care. Participation in NCAPOP and data entry should not impact on front line clinical covid care, the care of patients with covid should take priority during the pandemic.
05-11-20 Government announcement

Covid Wave 2: Government announces national lockdown


July – October 2020 HQIP and NCAPOP Providers HQIP worked with NCAPOP Providers to identify and establish the impact of Covid on data collection. HQIP has agreed bespoke arrangements with each Audit Provider for work-stream activity and outputs.
13-07-20 HQIP to NCAPOP  Providers

NCAPOP newsletter issued to NCAPOP Providers relating to COVID-19-impacted outlier management – modification of notification stages for alarms.

“We previously wrote to you on the 02/04/2020 with a requirement to pause outlier processes which would have been in (or due to enter) the data checking and escalation phase. Key reporting and management functions are now restarting in the NHS. HQIP, NHS England/Improvement, the Care Quality Commission and Welsh Government have agreed that checking and escalation should now also restart using a modified process. Publication of outliers can then proceed as per normal SRP processes. These modifications to HQIP’s standard guidance for England and Wales are for notification stages 5-7 (Table 1) for alarm level outliers. Clean versions are available online here: https://www.hqip.org.uk/outlier-management-for-national-clinical-audits

These changes should be reflected in an updated project outlier policy for the cohort affected and should be communicated to participant services and within your publications, where applicable.”

06-07-20 NHSEI to Trusts

Communication from Amanda Pritchard Chief Operating Officer, NHS England & NHS Improvement to NHS trusts and foundation trusts re ‘Stepping back up of key reporting and management functions’.

Next steps on NHS response to COVID-19

This is in keeping with Stage 2 of the Government’s COVID-19 recovery planning ‘We have now passed the initial peak of COVID-19 and are well into phase 2 of our recovery planning’.

In relation to NCAPOP the letter stated:

National clinical audits and outcome review programmes (HQIP): in order to support NHS recovery and NHS recovery, the Healthcare Quality Improvement Partnership (HQIP) will begin to work with national clinical audit and outcome review programme providers to identify key data items for collection from national clinical audits and outcome review programmes. This is in addition to intensive care, child mortality database and maternity audits, which have continued to collect data throughout the surge period’.

23-06-20 Government announcement

1st wave lockdown lifted by Government



HQIP to NCAPOP  Providers

(Audit provider newsletter containing the above letter and outlier guidance)

In light of the impact of the Covid-19 pandemic, NCAPOP providers should adopt the following modifications to the outlier process for data cohorts awaiting publication:

  1. Where data has been collected by the audit and the statistical analysis is underway or about to start, but no results have been sent for checking by Trusts / Health Boards flagged as potential outliers, then the analysis should be completed. If the analysis identifies potential outliers, the outlier process should not start until the pandemic has subsided and an assessment can be made of whether the Trusts / Health Board have the capacity to review and check the data.
  2. Where results have been send for checking to a Trust / Health Board as a potential outlier – terminate all remaining outlier activity for those Trusts / Health Board (halt any remaining checking / no escalation if checked data are being reanalysed and this confirms outlier status / no publishing of outlier status).
  3. Where outlier data has been checked, verified and escalation has commenced (e.g. letters being prepared for Trust or Health Board / HQIP / CQC or NHS Wales) – halt the process, suspend the remaining escalation stages.

Audits should not publish results that allow NHS organisations flagged as (potential or confirmed) outliers if the outlier process has been affected. Where appropriate, it may be desirable to publish indicator values for all organisations but without labelling any as an outlier in the annual report. Alternative options are not to publish affected indicator results or all organisations in the annual report, or to delay the publication of the annual report. Please consult with HQIP about the proposed way forward. Decisions will be taken collaboratively on a case by case basis.


NCAPOP Providers

(Newsletter/HQIP website)

Caveat placed on the NCAPOP report schedule:  ‘The schedule for NCAPOP reports is subject to alterations as the health system prioritises activity relating to the Covid-19 pandemic. Reports will be published as soon as possible but we are unable to confirm exact dates at this stage’.

HQIP to NCAPOP  Providers

(Email and on HQIP website)

HQIP issued a guidance letter to NCAPOP (audit and CORP) Providers.
28-03-20 NHSEI to Trusts

Communication from Amanda Pritchard Chief Operating Officer, NHS England & NHS Improvement to NHS trusts and foundation trusts.


Letter page 5 of 10 stated:

All national clinical audit, confidential enquiries and national joint registry data collection, including for national VTE risk assessment, can be suspended. Analysis and preparation of current reports can continue at the discretion of the audit provider, where it does not impact front line clinical capacity. Data collection for the child death database and MBRRACE-UK-perinatal surveillance data will continue as this is important in understanding the impact of COVID-19.

23-03-20 Government announcement

Covid Wave 1:  Government announces national lockdown


17-03-20 NHSEI to Trusts

Communication from Amanda Pritchard Chief Operating Officer, NHS England & NHS Improvement to NHS trusts and foundation trusts setting out important and urgent next steps on the NHS response to COVID-19:


The letter set out actions to:

  • Free up the maximum possible inpatient and critical care capacity
  • Prepare for, and respond to, the anticipated large numbers of COVID-19 patients who will need respiratory support
  • Support staff, and maximise their availability
  • Play our part in the wider population measures newly announced by Government.
  • Stress-test operational readiness

Remove routine burdens, so as to facilitate the above.

NCAPOP reports schedule

Unchanged: The schedule for NCAPOP reports is subject to alterations as the health system prioritises activity relating to the Covid-19 pandemic. Reports will be published as soon as possible but we are unable to confirm exact dates at this stage.

Data Access Requests

New and existing applications and subsequent data releases may be delayed as we prioritise urgent COVID–19 requests.

Update from the National Joint Registry: Covid-19 and the suspension of elective surgery

Following NHSE wider notification to hospitals of the gradual resumption of elective surgery and associated audit activity in order to support NHS recovery as the Covid-19 pandemic lessens, the National Joint Registry advises data entry staff in all NHS and independent hospitals where joint surgery has resumed, that data entry capture should also resume as normal, in accordance with the volumes of procedures performed.

It is also important that the reduced volumes of arthroplasty procedures that have taken place over the past four months are correctly recorded on the NJR. These are likely to be small numbers of urgent and emergency procedures, but it is essential that we are able to monitor the outcomes of these patients through the NJR’s usual monitoring procedures. We therefore ask that hospitals review their surgical caseload over this period to ensure that any missed cases are entered retrospectively onto the NJR.

For patients: the British Orthopaedic Association has helpfully published some Frequently Asked Questions for patients, which they will keep updated as the coronavirus situation unfolds.

Our working arrangements

All our employees are working remotely for the time being. We’re using video conferencing services for our internal and external meetings.

As our headquarters building has closed, we will not be processing any letters or invoices that have been posted to us since March 17 2020. All correspondence should be emailed to the relevant department. If you have posted mail to us since March 17, please be sure to email the relevant department with an electronic version of what you sent or email [email protected]

Keeping in touch with HQIP

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