The Paediatric Intensive Care Audit Network (PICANet) is a collaboration between the University of Leeds and the University of Leicester. It is a project helping to continually improve how we treat and care for children in paediatric critical care (PCC).
PICANet collects data from Level 3 Paediatric Intensive Care Units (PICUs) and Specialist Paediatric Critical Care Transport Services in the United Kingdom and Republic of Ireland and discrete Level 2 NHS PCC units (sometimes referred to as ‘High Dependency Units’) in England.
PICANet was established to develop and maintain a secure and confidential high quality clinical database of paediatric intensive care activity in order to:
- Identify best clinical practice
- Monitor supply and demand
- Monitor and review outcomes of treatment episodes
- Facilitate healthcare planning and quantify resource requirements
- Study the epidemiology of critical illness in children
We collect these core datasets:
- PICU Admission data: The demographic and clinical data on all children admitted allows comparison of PICU activity at a local level with national benchmarks such as PCCS Standards. This dataset provides an important evidence base on outcomes, processes and structures that permits planning for future practice, audit and interventions.
- Referral and Transport data: This enables us to compare and audit these important aspects of care for children who need paediatric intensive care.
- Extra Corporeal Membrane Oxygenation (ECMO) Admission and Referral data
- Level 2 Unit Admission data
Background and Funding
The Paediatric Intensive Care Audit Network (PICANet) was established in 2001 by the Universities of Leeds, Leicester and Sheffield with the support of the paediatric intensive care community and their active support continues to be a key component of our successful progress.
Since November 2002, all NHS PICUs within England and Wales outside the Pan Thames region have been collecting data on consecutive admissions to their units. The Pan Thames units began data collection in March 2003, and the PICU at the Royal Hospital for Sick Children, Edinburgh in December 2004. The Royal Hospital for Sick Children, Glasgow in March 2007 and The Royal Belfast Hospital for Sick Children in April 2008. Our Lady’s Children’s Hospital, Crumlin and the Children’s University Hospital, Temple Street, both based in Dublin, have submitted anonymised data to PICANet from 2010. The non-NHS Harley Street Clinic PICU started contributing data in September 2010 followed by The Portland Hospital for Women and Children PICU in July 2013, to allow them to compare their performance against the national benchmark provided by PICANet.
The National Paediatric Critical Care Audit for the NHS Level 3 PICU and transport teams in England is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). HQIP aims to promote quality improvement in patient outcomes, and in particular, to increase the impact that clinical audit, outcome review programmes and registries have on healthcare quality in England and Wales. HQIP is led by a consortium of the Academy of Medical Royal Colleges, and the Royal College of Nursing.
Funders for the participation of the devolved nations and Republic of Ireland are NHS Lothian and NHS Greater Glasgow and Clyde in Scotland, the NHS Wales Joint Commissioning Committee, the Royal Belfast Hospital for Sick Children, the National Office of Clinical Audit (NOCA) in the Republic of Ireland, and HCA Healthcare.
NHS England commission and fund the Level 2 unit and ECMO data collections.
PICANet has support and approval from the Health Research Authority Confidentiality Advisory Group to process confidential patient information without consent for both non-research and research purposes under Regulation 5 of the Health Service (Control of Patient Information) Regulations 2002 (’section 251 support’ of the NHS Act 2006) for data collected in England and Wales. The references are: 21/CAG/0090 (non-research) and 21/CAG/0098 (research) and support is reviewed annually. Further details and assurances can be found in our Patient Privacy Notice and Fair Processing Statement.
PICANet clinical audit data has been granted an exemption from the National Data Opt-Out (in England) by the Health Research Authority Clinical Advisory Group for non-research activities (21/CAG/0090). This is because the absence of even one child’s data can lead to inaccurate conclusions. This means that if a National Data Opt-Out has been set, data can be entered into the PICANet web database.
PICANet apply the National Data Opt-Out to research activities (21/CAG/0098) including the processing and/or release of data for secondary uses, such as approved research projects, for data received from English hospitals.
The research database has ethical approval granted by the East Midlands – Derby Research Ethics Committee (ref. 23/EM/0189) and annual reports are provided to the committee.
The Understanding Practice in Clinical Audit and Registries (UPCARE) tool is a protocol to describe the key features of clinical audits and registries designed by HQIP. It has been designed to provide a “one-stop” summary of the key information about how clinical audits and registries have been designed and carried out. It is designed to help people understand the methods, evaluate the quality and robustness of the data, and find information and data that is most relevant to them.
The PICANet Team
Project Leadership
Professor Richard Feltbower, Principal Investigator Associate Professor Sarah Seaton, Principal Investigator |
Project Manager
Hannah Lever, Senior Project Manager |
Project Administration
Emily Evans, Audit and Research Assistant Rachel Shorthose, Study Administrator Georgina Tayler-Barrett, Project Officer |
Statisticians
Hannah Buckley, Senior Research Statistician Dr Chris Leahy, Research Statistician Dr Evrim Anik, Research Statistician |
Database and Data Management
Paul Micklethwaite, Senior Data Manager Lee Norman, Senior Database Developer Martin Perkins, Research Software Engineer Thomas Simpson, Database Developer Laura Stubbs, Data Manager |
Clinical
Dr Lyn Palmer, Research Nurse Dr Hari Krishnan, Clinical Advisor Lisa Mcllmurray, Research Nurse |