Author: Ms Lyndsay Pearce, NELA Chair
The Royal College of Anaesthetists established the National Emergency Laparotomy Audit (NELA) 10 years ago to monitor, benchmark and drive improvement in the care of patients undergoing emergency laparotomy across NHS hospitals in England and Wales (Northern Ireland included in Year 11).
The audit aims to use real-world comparative data to highlight variation, share good practices, and prompt systems-level and local quality improvement.
We published the tenth NELA report on 9 October 2025 and reported on 23,560 patients who underwent emergency laparotomy between 1 April 2023 and 23 April 2024. The report reflects on trends, gains and enduring gaps in care at a particularly challenging time for the NHS. We’ve all seen hospitals regularly feature in the national news with queues of ambulances outside emergency departments.