UK National Flap Registry - Call for feedback

I am grateful to BAPRAS for the opportunity to lead the UKNFR following Peter Kalu, and previous custodians Richard Cole & Anita Hazari. Members of ABS continue to be significant contributors, and having completed an Oncoplastic TIG Fellowship, I am fully cognisant the  scope of services that are offered by ABS members.  

As a group of specialties we should be proud that the UKNFR is the first national registry of its type in the world to collect data on all major pedicled and free flap operations - the first case was entered into the registry in August 2015, and at the time of writing 9 years on there are over 11,000 patients entered from over 280 individual Consultant Surgeons from both public and independent sectors.  

The aim is simple - to improve outcomes following reconstructive surgery for our patients. The UKNFR has the potential to influence clinical practice, the logistics of service delivery, workforce planning, the delivery of training, procedural tariffs, and specialty scope. Beyond that, participation facilitates personal appraisal, revalidation, and national / international benchmarking.    

Prof. Sir Bruce Keogh wrote, in his comment on the first UKNFR report in 2019, ‘data entry into this registry should be a peer driven prerequisite for any surgeon or institution wishing to undertake such complex surgery.’ Our success as a group in improving standards in such complex cases means that success must now be measured by more than binary outcomes such as flap survival. Quality of life and whether we Get It Right First Time (GIRFT) should be shaping future practice. Big data is required to identify potential targets for incremental improvements. 

I am not naïve to the challenges that the UKNFR faces and the scale of the task at hand, and would welcome feedback or suggestions for change from ABS members. Plans are afoot with regards to the need for improved usability, and production of some meaningful outputs, and I will provide a more detailed update in this regard in due course.  

In the meantime, please involve the surgeons of tomorrow in your registry practice, utilise the wider multidisciplinary team to facilitate complete data entry, and encourage Consultant colleagues to follow your lead so that composite reports are representative of departmental practice and regional trends. For the majority of ABS members, this will mean entering data for chest wall perforator and latissimus dorsi flaps, and the GIRFT team will be cognisant of registry activity in upcoming virtual visits. My promise to you as UKNFR Lead is to facilitate use of the data to return your investment, with interest, for you, but most importantly for our patients.  

Benjamin Baker 

Consultant Plastic, Oncoplastic & Reconstructive Surgeon 

Manchester University NHS Foundation Trust 

UKNFR Audit Lead