Records of the RCOG Clinical Effectiveness Support Unit, 1996-2006

Records relating to the activities of the RCOG Clinical Effectiveness Support Unit (CESU), including administrative records of the work of the RCOG Audit Unit in Manchester and the establishment and governance of CESU(1997-2003), papers relating to the development of guidelines on induced abortion (1998-2001), antenatal care (1998-2000), infertility (1996-1998), sterilisation (1996-1998), menorrhagia (1996-1998), electronic fetal monitoring (1999-2001) and induction of labour (1999-2001), records of the National Sentinel Caesarean Section Audit (1998-2002), and papers of the National Maternity Audit on Antenatal Choice (2004-2006), comprising meeting papers, published reports, papers of the VALUE and MISTLETOE studies, peer reviews and audit papers.

The Clinical Effectiveness Support Unit (CESU) was established in June 1999 after the Clinical Audit Unit (based in Manchester) was disbanded. After a review, the Royal College of Obstetricians and Gynaecologists (RCOG) re-organised its activities in the areas of audit, guidelines and clinical governance. CESU was set up to take over some of the College’s core activities such as the Audit Committee and the Scientific Advisory Committee (SAC), as well as externally funded projects such as the National Evidence-based guidelines. CESU answered directly to the newly formed Clinical Effectiveness and Standards Board (CESB), which oversaw the production of guidelines. The RCOG wished to continue its audit activities, as well as developing its ongoing clinical effectiveness and governance programme.

A department manager, a director of CESU and a clinical research fellow were appointed, with secretarial/administrative support as appropriate. These core staff members were supplemented on an ad hoc basis for externally funded projects. The CESU team was based at the RCOG and, for its initial work, drew on the expertise established within the College’s existing staffing structures, such as the original RCOG Clinical Audit Unit, as well as other appropriate external national bodies such as the Guideline Development Groups (GDGs). These were composed of representative groups of professional and consumer stakeholders, with potential members nominated from professional organisations, societies, Royal Colleges and patient/carer groups. The principal role of all members of the GDGs was to use their varied skills and knowledge to inform the development of guidelines.

The major aims of CESU were the development, promotion and support of clinical governance issues in obstetrics and gynaecology. Its objectives included; the production of at least two national evidence-based guidelines, national audits in obstetrics and gynaecology, co-ordination and support of the clinical effectiveness programme within the College, liaison with the relevant related activities (including the Confidential enquiries into infant and maternal deaths, CESDI and CEMD) and consideration of further developments, particularly accreditation of services and consumer issues.

CESU produced two types of guidelines:

1.)National Evidence-based guidelines which were funded initially by the Department of Health and then by the National Institute for Clinical Excellence (NICE) once created, to cover all aspects of a particular area of clinical practice e.g. infertility, electronic fetal monitoring and induction of labour. 2.)Green –Top Guidelines funded by the College, which comprised brief evidence-based statements on topical and controversial issues to assist clinicians in their decision-making about appropriate health care.

Also,three college standing committees were serviced by CESU; the Clinical Effectiveness and Standards Board (CESB) the Guidelines and Audit Committee (GAC), the Scientific Advisory Committee (SAC) plus the Steering Committee of the National-Evidence-based guidelines.

With the establishment of NICE (in 1999) as a Special Health Authority for England and Wales, and the Department of Health funding for National Evidence-based guidelines transferring to that body, it became evident that the College would not be able to continue to take forward the guidelines component of its work and this aspect was taken over by NICE. NICE funded most of the work of CESU from this point. When NICE decided subsequently to concentrate its funding on a small number of collaborating centres, the RCOG, the Royal College of Midwives (RCM) the Royal College of Paediatrics and Child Health (RCPCH) and the Faculty of Family Planning and Reproductive Health Care (FFPRHC) put forward an application to establish the National Collaborating Centre for Women’s and Children’s Health (NCC-WCH) which was accepted by the NICE Board in February 2001.

CESU handed over to the NCC-WCH with effect from 1st April 2001 and the College, in liaison with the partners, was understood to be responsible for staff contracts and financial services. The externally funded component of CESU transferred to the NCC-WCH and the College’s core activities fell under the remit of the newly established Standards department, which was renamed as the Clinical Governance and Standards department within a year, to reflect its broadened activities. NCC-WCH then absorbed all of CESU’s ongoing projects.

By subject

Permission is required from RCOG senior management via the College Archivist for access to College records less than twenty years old.

Copyright of the RCOG

Transferred to semi-current storage by the Administration and Clinical Governance Departments between December 2001 and April 2006, and accessioned following reviews of the files between November 2009 and April 2011.

Related material held at the RCOG may be found at the following references:

RCOG/B7/G Records of the RCOG Audit Unit, Manchester

RCOG/P5 Guideline publications produced by the working groups