St James’s University Hospital, The Leeds Teaching Hospitals Trust: NELA – improving care for emergency laparotomy patients

Emergency laparotomies carry a high risk of morbidity and mortality. To mitigate this, The Leeds Teaching Hospitals Trust has introduced a new specialist nursing role focused solely on patients needing this procedure.

Thought to be the first of its kind, the National Emergency Laparotomy Audit nurse specialist post is designed to improve patient outcomes and experience, not least by enabling improved care coordination.

The nurse specialist means emergency laparotomy patients in any ward or department have a single point of contact. So too do staff on the ward, who are supported in caring for a highly complex and unwell group of patients through daily reviews.

And there is now improved collaboration with elderly medicine specialists, with more regular and proactive reviews of older surgical patients.

From 2015-16 to 2016-17, overall observed mortality from emergency laparotomies fell from 9.3 per cent to 7.3 per cent; median length of stay from 11 to 9.5 days; and returns to theatre from 6.9 to 5 per cent.

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Click here for more details on the HSJ Patient Safety Awards 2018.


  • Manchester University Foundation Trust and NHS Transformation Unit: ERAS+ – preparing patients and families in the best way possible for major surgery – Highly commended
  • Clarendon Paediatric Theatres, Leeds Children’s Hospital: Parent pagers
  • Royal National Orthopaedic Hospital Trust: Pre-operative assessment clinic cardiology service
  • Sherwood Forest Hospitals Foundation Trust: Implementing a multidisciplinary perioperative pathway of patients with, or at risk of, obstructive sleep apnoea
  • The Leeds Teaching Hospitals Trust: Scan4Safety
  • Torbay and South Devon Foundation Trust: Implementing patient blood management to reduce the need for allogeneic blood in surgery
  • Warrington and Halton Hospitals Foundation Trust: Transfuse and check