The history and achievements of the National Confidential Enquiry into Perioperative Deaths.

The National Confidential Enquiry into Perioperative Deaths started in 1989 as a direct development of a Confidential Enquiry in the United Kingdom in 1984. Different samples from the 20,000 deaths in hospital within 30 days of a surgical operation are selected each year. Questionnaires about these are examined by groups of anaesthetists and surgeons, and lessons about the quality of perioperative care are derived. Causation is not emphasized but examples of potential for improvement are sought. Changes of consultant practice, increase in medical audit, improvement in physiological monitoring, appropriate matching of specialist experience to patients' medical conditions and increased awareness of the need for critical care areas are believed to have been influenced by this unique enquiry.