1. British Children’s Orthopaedic Registries
BSCOS Annual Meeting
Liverpool 2015
David Rowland

2. Good Medical Practice (2013)
13.
22.
“You must take steps to monitor and improve the quality of your work.”
“You must take part in systems of quality assurance and quality improvement to promote patient safety.”

3. Using Outcomes Information for Revalidation in Trauma And Orthopaedic Surgery (2013 revision)
“Where there are identified national clinical audit(s) that cover your area(s) of practice, it is essential that you participate. This will be mandatory for revalidation.”

5. Unit Data Redislocation rate after open reduction of DDH <10%
Need for surgery after Pavlik harness treatment <20%
Need for surgery in non-syndromic cases of club foot treated <10% (excluding tenotomy or single tendon transfer)
Need for reoperation after SUFE treatment, apart from removal of metalwork, <10%, and late reconstruction

6. BSCOS Registries Available to all members of BSCOS
Funded by membership fee
Information and documents at bscos.org.uk/registry
Direct link: bscosregistry.org.uk

7. BSCOS Registries Primary aim to gather data for revalidation
Data should also be available for research
Single registry but separate pathways for each condition

8. Initial Launch Supracondylar Fracture of the Humerus
Slipped Capital Femoral Epiphysis
Ponseti Management of Clubfoot

9. Later Release Perthes' Disease Developmental Dysplasia of the Hip
Proximal Femoral Osteotomy

10. Forerunners National Joint Registry British Spine Registry
Non Arthroplasty Hip Register

11. Sub division of Bluespier
Professional company focussed on IT in healthcare
Development team includes Orthopaedic surgeons
Created British Spine Registry

12. Quality Outcomes Committee
BOA Sub-committee since 2014
Representatives from established and fledgling registries
Guidance for registry development, data processing, outlier management etc.
Aim to support but not control

13. Consent Discussed with ICO
No formal mechanism for approval of consent forms
Form follows
Principle 1of the Data Protection Act - fair processing of data
Schedule 2 & 3 of DPA - consent for storage of sensitive personal data

14. Patient Information Background behind registry
Reassurance re safety & confidentiality
Contact details
Instructions for removal of data

15. Data Management
Use of the Registry implies acceptance of BSCOS User Agreement and Data Policy
BSCOS is data controller and is registered with ICO
Amplitude is data processor
Individuals need not register separately with ICO if simply entering data onto registry. Any other manipulation requires registration at ico.org.uk

16. Caldicott Guardians Oversee application of Caldicott Principles
Registries need not have their own Caldicott Guardian
Each Trust or Health Board will have a CG and that person should be approached before data are uploaded to a registry
Caldicott Guardian pack on download page

17. Individual Reports
Each surgeon able to create report for own practice without data request
Customisable
Compare to registry data or to standards from literature
Useful for revalidation and appraisal

18. Outliers Any dataset will have outliers
Management policy being discussed by BOA Quality Outcomes Committee
Aim to keep anonymity where possible
Individual reports will show that person if they are an outlier and facilitate discussion at appraisal
Annual BSCOS reports will also identify outliers

19. Data Retrieval Each surgeon has access to own data
No surgeon shall be able to view another surgeon’s data
Requests may be made for anonymised data for specific area

20. Audit & Research Submit request form to registry@bscos.org.uk
BSCOS will form a Sub-committee to review requests
Any publication must credit the BSCOS Registry and must include a member of BSCOS as an author
The sub-committee must be involved in any publication using comparative data from the Registry

21. Other Data Requests
No public money involved so protected against Freedom of Information requests
Registry can be classed as ‘developing’ for three years during which FOI not appropriate
Any recipient of FOI request has a duty to be helpful

22. Registry Sub-Committee
Chair from the BSCOS Board
3 additional members, initially from BSCOS board
Lay member?

23. Summary 3 pathways released today
3 more to follow after further development
Initial focus on data collection and refining pathways
Provisional analysis for next BSCOS meeting