HPR volume 16 issue 6: news (11 July 2022)
Updated 30 December 2022
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Surgical site infections in NHS hospitals in England: annual report in summary
The UK Health Security Agency has published the latest annual report of the national Surgical Site Infection Surveillance Service that summarises data submitted by 168 NHS hospitals and 8 independent sector NHS treatment centres in England. It covers surgery which took place in the financial year 2020 to 2021.
Surveillance data relating to 64,111 procedures and 591 surgical site infections (SSIs) – detected during inpatient stay or on readmission to hospital – were submitted. Compared to the previous financial year, the number of procedures submitted in 2020 to 2021 decreased by 51%. The decrease in procedures reflects the impact of coronavirus (COVID-19) on operational delivery within the NHS, including deferral of elective surgery and reduced capacity for surveillance.
NHS trusts performing surgery in any of 4 orthopaedic categories (hip replacement, knee replacement, reduction of long bone fracture and repair of neck or femur) are required to undertake surveillance of SSI for a minimum of one 3-month surveillance period per financial year. In 2020 to 2021, however, 11 eligible trusts did not meet the mandatory surveillance requirements, compared to 3 Trusts in the previous year.
Trust-level SSI risk results for mandatory orthopaedic categories are published as accompanying supplementary tables.
The annual report presents SSI risk benchmarks for each of 17 surgical categories, with commentary on trends in annual SSI incidence and variation among participating hospitals. It also includes risk-stratified SSI incidence data.
Key findings include that:
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10-year trends in annual (inpatient and readmission) SSI risk varied by surgical category – among the 10 categories assessed, 7 saw decreases in SSI risk from the previous year, with 5 categories decreasing to the lowest risk in 10 years
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the largest increase in SSI risk was for large bowel surgery (from 7.7% to 9.9%) reaching the highest SSI risk for that category since 2012 to 2013
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in 2020 to 2021, compared to 2019 to 2020, the data suggests that more complex surgeries were performed, as assessed by an American Society of Anesthesiologists (ASA) score of 3 or more, increases in median surgery duration and median length of stay, and whether multiple procedures were performed
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despite the increase in surgery complexity, most surgical categories saw a decrease in SSI risk in 2020 to 2021, which may reflect augmented infection control precautions in hospitals which were implemented to control COVID-19 transmission
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2 trusts were identified as high outliers for the mandatory surveillance categories (1 for hip, and 1 for reduction of long bone fracture) in 2020 to 2021
Infection reports in this issue
Creutzfeldt-Jakob disease (CJD) update (data to end of December 2021)
Laboratory confirmed cases of pertussis in England: annual and Q4 reports for 2021