National Emergency Laparotomy Audit

NELA 2019


The National Emergency Laparotomy Audit (NELA) looks at the structure, process and risk-adjusted outcome measures for the quality of care received by patients undergoing emergency laparotomies. NELA will compare against standards of care such as those detailed the NCEPOD reports, and the Department of Health/Royal College of Surgeons of England's Higher Risk General Surgical Patient (2011).

The aim of the audit is to generate data that drives Quality Improvement (QI). QI will be facilitated through dissemination of collected data as well as workshops and seminars to drive specific QI projects alongside data collection.


NELA was launched in December 2012 by the National Institute of Academic Anaesthesia Health Services Research Centre on behalf of the Royal College of Anaesthetists. NELA partners with the Clinical Effectiveness Unit of the Royal College of Surgeons of England and is being run in conjunction with surgical and other key stakeholders who provide specialist advice and review the audit design, conduct, draft reports and recommendations.

NELA was commissioned by the Healthcare Quality Improvement Partnership (HQIP), following evidence of a high incidence of death, and a wide variation in the provision of care and mortality, for patients undergoing emergency laparotomies in hospitals across England and Wales. The audit is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP), a set of centrally-funded national clinical audit projects that collects data on compliance with evidence-based standards and provides local trusts with benchmarked reports on the compliance and performance.


Reports are available outlining the results from the first and second years of patient data collection (2014-2015). Each report provides a breakdown of participating hospitals performance against existing Standards and makes recommendations for Commissioners, Hospitals and Clinicians.

An initial Organisational Audit report of participating hospital in the National Emergency Laparotomy Audit outlining the results, conclusions and recommendations from the audit was published in May 2014; a second Organisational Audit is in process and will be published during 2017.

These reports are available for download from the Reports section of the NELA website.

NELA data collection is ongoing. NELA is currently funded until December 2020.

Related Websites
The NIAA Health Services Research Centre is not responsible for the content of external internet sites