19.11.14
Surgeons’ performance data published in NHS league tables
Performance data of 5,000 consultant surgeons has been published on the new MyNHS website to increase transparency.
Critics say the data is “crude” and can be misleading as it does not include essential information such as duration of hospital stay and returns to theatre.
This year’s publication, which covers 10 specialty areas of surgery, gives patients another route to find out more about an individual surgeon’s practice and the outcomes for their patients after an operation.
The consultant outcomes data, based on national clinical audits, is a way of measuring performance against a set of professional standards such as survival rates, length of stay in hospital following a procedure and repeat operation rates, as well as the number of operations performed.
In general, the data show that most surgeons are performing operations and procedures to the high standards expected by their own professional association.
But, for a second year, a handful of surgeons appear as ‘outliers’.
NHS England’s medical director Professor Sir Bruce Keogh, who has championed transparency in the NHS, said the website will drive up standards.
“This represents another major step forward on the transparency journey,” he said. “It will help drive up standards, and we are committed to expanding publication into other areas. The results demonstrate that surgery in this country is as good as anywhere in the western world and, in some specialities, it is better.
“The surgical community in this country deserves a great deal of credit for being a world leader in this area.”
The Royal College of Surgeons stated that where there is a concern, the specialty association is working closely with the individual and hospital trust in order to understand the reasons behind their data and where necessary ensure support is in place so that patients are receiving a high standard of care.
Clare Marx, president of the Royal College of Surgeons (RCS), said: “Patients and surgeons should have honest and open conversations about the likely outcome of their surgery and best treatment options available. Publishing consultant outcomes is just one step for ensuring that dialogue and trust is present.
“This is by no means a quick process. Year on year we will develop our methods for collecting and analysing data so that we are continually improving the quality of care and the outcomes we deliver for our patients.”
The College added that greater transparency in the NHS and honest conversations with patients are at the heart of improving patient care. Consultant outcomes data is just one way in which the RCS is committed to ensuring that patients receive information and a high quality of care.
In a speech today, health secretary Jeremy Hunt is expected to say: “Transparency is about patient outcomes, not process targets. It uses the power of a learning culture and of peer review, not blame.
“Healthcare globally has been slow to develop the kind of safety culture based on openness and transparency that has become normal in the airline, oil and nuclear industries. The NHS is now blazing a trail across the world as the first major health economy to adopt this kind of culture.”
But Professor John MacFie, president of the Federation of Surgical Specialty Associations, said: “The publication of individual surgeons’ performance data is crude and can be misleading, and does not include essential information such as duration of hospital stay and returns to theatre.”
Gill Humphrey, chair of the RCS Patient Liaison Group, added that to patients, the patient-surgeon relationship is very important and consultant outcomes can help build a relationship of trust and openness.
“Patients can be active participants in their care and use consultant outcomes information to help have an informed conversation with their surgeon and discuss the likely outcome and recovery process from their procedure,” she added.
However, earlier this week, it was revealed that around 2,500 consultants have not published their figures. The RCS said that all doctors can and do discuss outcomes with patients and “to suggest that we would need to be forced to be open is utterly misleading”.
But NHS England is looking into ways of forcing surgeons into revealing their figures. Prof Sir Bruce Keogh said: “We are looking now at a series of inducements, penalties to force that [publishing death rates].”
He added that the move was necessary to help improve and maintain the quality of care.
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