8th National Audit Project (NAP8) being undertaken by the Royal College of Anaesthetists (UK) in collaboration with the College of Anaesthesiologists of Ireland. The RCoA National Audit Projects have been running for almost 20 years, involve nearly every NHS hospital in the UK and produce internationally recognised reports which focus on rare complications of anaesthesia. NAPs typically generate recommendations with the ultimate goal of improving clinical practice and most importantly patient outcomes and safety.
NAP8 is examining major complications of regional anaesthesia (both neuraxial and peripheral techniques) as well as perioperative nerve injury under general anaesthesia, a topic which is also of significant importance across all surgical as well as some medical and allied health specialties. Perioperative nerve injury, whether due to regional anaesthesia or positioning or pressure related injury whilst under general anaesthesia, is relatively uncommon but the consequences for patients can be catastrophic, affecting function, rehabilitation, and long-term quality of life. Contemporary evidence to guide informed consent discussions amongst patients, anaesthetists and surgeons is lacking and NAP8 aims to provide answers to these gaps in the literature. The project will hopefully launch in late May 2026.
A key issue with NAP8 is that significant peripheral nerve injuries are often only identified after the patient has left the care of the anaesthetist, typically presenting during post-operative review, outpatient follow up or rehabilitation. Each hospital taking part will have a local co-ordinator who will promote the project amongst local surgeons, physicians and other allied healthcare professionals and the success of NAP8 will rely on the active engagement of these colleagues.
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