Why does the audit use the pre-2004 NCEPOD classification?

The audit uses the pre-2004 National Confidential Enquiry into Patient Outcomes and Death (NCEPOD) classification of surgical urgency, despite there being an update to this.

The arguments to maintain the pre-2004 NCEPOD definition are that the classification based on this definition correlates strongly with:

• known risk factors for emergency treatment (age, socio-economic deprivation, and presence
of co-morbidity)
• the mode of admission coded in HES
• the observed 90-day mortality.

Introducing a new classification system for a key characteristic of the surgical procedure would make it impossible to compare outcomes in different audit periods which would in turn make it impossible to monitor trends in outcome over time, which is one of the key functions of the audit.