Know your numbers – Using NCIP to improve patient care

The National Consultant Information Programme

From the inception of BAUS over 80 years ago, it is important to reflect on how far the practice of urology and the tools used to support that practice have come in that time. As well as radical developments in surgical innovation and practice, the use of data has become an essential part of our clinical practice.

Appraisal has become a keystone in consultant practice providing the opportunity to reflect on the whole of practice, and the General Medical Council (GMC) states that consultants must “review your performance against local, regional, or national benchmarking data where this is attributable and validated” as part of appraisal, and that this “could include morbidity and mortality statistics and/or complication rates.” ¹ The National Consultant Information Programme (NCIP) provides a practical way to meet this requirement for appraisals, while also enabling consultants to review their outcomes to support morbidity and mortality meetings, reflective practice, and data-informed clinical improvement.

The origins of NCIP

The impetus for NCIP came from the Paterson enquiry in 2017, which recommended:

there should be a single repository of the whole practice of consultants across England, setting out their practising privileges and other critical consultant performance data, for example, how many times a consultant has performed a particular procedure and how recently. This should be accessible and understandable to the public. It should be mandated for use by managers and healthcare professionals in both the NHS and independent sector. ²

This led to the development of the National Consultant Information Programme (NCIP), a free data platform containing personal consultant-level activity and outcomes data for consultant surgeons. It can be used to reflect on clinical practice and to improve clinical quality and patient safety, as well as providing high-level evidence for appraisals.

NCIP is now live in every acute NHS trust in England, and over 10,000 consultants can now access their NCIP data, using over 500 clinical procedure dashboards across 13 surgical specialities.

Crucially, NCIP is only available to clinicians:

NCIP is not more widely available to managerial staff or the public, although all NHS staff can view provider-level NCIP data through the Model Health System.

NCIP is a clinically led quality improvement tool, developed with the direct input of practicing surgeons. Urology was chosen as the vanguard speciality in 2018, and the platform was piloted nationally with urologists before being rolled out to other surgical disciplines. From the outset, BAUS has been a supportive partner helping us to develop the urology dashboards and promote the benefits of NCIP. BAUS helped pave the way for other speciality associations to work with NCIP during the development of further procedure dashboards across the 12 other surgical specialities now featured within the NCIP platform.

NCIP includes 36 urology dashboards (Table 1) covering andrology, endourology, general, functional, and oncology procedures. Data for stress urinary incontinence (SUI) and paediatric procedures – while housed within other specialities – are automatically pulled through to an individual consultant’s dashboard where they have performed more than four cases in a three year period.

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Table 1.

NCIP urology dashboards April 2026.

Each dashboard includes outcome metrics relevant and tailored to that procedure. These include length of stay, day-case rate, day case to inpatient conversion, readmissions, further procedures in a defined time period, and mortality.

This outcome data is presented alongside a variety of demographic and co-morbidity data which shows whether you are treating a particular at-risk patient population, which helps you to understand the data in your own local context.

Each dashboard compares consultant and provider-level outcomes to national figures. When viewing a time-series of provider-level data in the GIRFT section of the NHS Model Health System, it shows that nationally there is an increase in the number of day-case ureteroscopies and bladder tumour resections. The development of minimally invasive bladder to flow obstruction procedures has had mixed uptake (Figures 1 to 3).

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Figure 1.

Bladder cancer surgery (TURBT).

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Figure 2.

Stone surgery (ureteroscopy).

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Figure 3.

Bladder outlet surgery.

What is NCIP?

NCIP uses Hospital Episode Statistics (HES) as its primary data source. This means it requires no additional data submission from clinicians, and NCIP is automatically refreshed quarterly.

Crucially, NCIP tracks patients across all NHS trusts in England, meaning that a readmission to a different trust is still captured. Likewise, NCIP uses mortality data from the Office of National Statistics (ONS), which picks up all mortalities in the specified time period following a procedure. Consultants can also drill down into pseudonymised individual patient records and interrogate the specific diagnosis and procedure of the index and subsequent episodes, to ascertain whether subsequent outcomes were related to the original procedure or not. NCIP includes data for all NHS work carried out in private providers, as well as private work carried out in NHS providers. At present, private work undertaken in private providers is not included.

Practical applications: how I use NCIP

It is recommended that all consultants should regularly look at their NCIP data. Mr Sarb Sandhu, NCIP Urology Clinical Lead and Chief of Surgery and Planned Care at Kingston Hospital, reflects “I find it particularly useful for morbidity and mortality meetings to ensure we are not an outlier for readmission rates and other outcomes after TURBT and other endoscopic surgery. In addition, using the Oct 2022–Sept 2023 data (Figure 4) for my benign renal surgery practice, the median number of benign nephrectomies carried out in England was three compared to my practice where the number was sixteen.

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Figure 4.

Nephrectomy volume data.

I carried out 90% of operations laparoscopically, whereas nationally the number was 80% (43% robotic (Figure 5) and 37% laparoscopic (Figure 6)). There may have been incorrect accreditation of six of the sixteen patients. However, at a provider level this was not an issue.”

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Figure 5.

Mr S Sandhu, Kingston and Richmond NHS Foundation Trust robotic procedure NCIP data Oct 2022– Sept 2023.

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Figure 6.

Mr S Sandhu, Kingston and Richmond NHS Foundation Trust laparoscopic procedure NCIP data Oct 2022– Sept 2023.

NCIP can be used by urology consultants for

Case study: Gloucestershire Hospitals NHS Foundation Trust

The urology team at Gloucestershire Hospitals NHS Foundation Trust triangulated GIRFT, Model Health System and NCIP data and identified an opportunity to increase day-case rates in surgery for male bladder outflow obstruction. ³ They used NCIP data to identify the level of consultant variation within the unit – which helped persuade colleagues of the opportunity for change and secured investment from trust management.

This transformation was achieved because NCIP data made the variation visible and provided the evidence base to secure organisational support. Between April 2017 and March 2024 (Figures 7 and 8), their day-case rates rose from 5.5% to 75% – more than three times the national average of 22%, and their long-stay admissions halved. Emergency readmissions halved as well over the same time period.

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Figure 7.

Gloucestershire Hospitals NHS Trust day-case rates in surgery for male bladder outflow obstruction April 2017–March 2020.

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Figure 8.

Gloucestershire Hospitals NHS Trust day-case rates in surgery for male bladder outflow obstruction April 2021–March 2024.

Since this improvement, Gloucester have incorporated NCIP into their consultants’ appraisals and included it as part of their governance processes. NCIP data has also been used as evidence for business cases for new resources, including the successful bid for two new robotic-assisted surgery platforms.

Why everyone should use NCIP

To date, 57% of consultant urologists in England have logged into NCIP. While this represents a solid foundation, the aim is that all consultants should be making use of their NCIP data. Reviewing NCIP data, individually and as a team, should become business as usual.

Work is still to be done to improve NCIP, but your engagement and user feedback will help accelerate this process. Key to this is logging on, reviewing the dashboards, and feeding back your thoughts on areas to change and improve.

By helping drive accountability for high-quality care, NCIP supports the 10-Year Plan, and NCIP is endorsed by BAUS and the speciality associations of all 13 included specialities. We encourage all urology consultants to log in, as by knowing what data is shown in your dashboards, will you be able to help NCIP to improve.

How to get started with NCIP