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Amplitude Clinical Outcomes

Surgeon performance data highlighted by the NHS

To provide greater transparency, last November the NHS released performance data for nearly 5,000 surgeons in England.

Information including mortality rates can be found by patients on the MyNHS website, yet the data might be “crude and misleading” according to some surgeons. However, critics have said that vital data has not been part of the released information.

Patients and professionals can use the MyNHS tool to compare the performance of consultants and NHS services, including statistics for mental health care, social care, and local hospital performance. Health Secretary Jeremy Hunt has stated: ‘Transparency is about patient outcomes, not process targets. It uses the power of a learning culture and of peer review, not blame.”

According to Sir Bruce Keogh, NHS England’s national medical director, surgeon’s minds will be more focused as a result of transparency. “Surgeons all feel a personal responsibility for their patients – they take it very seriously, they have their patients’ best interests at heart,” he said.

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The Francis inquiry that dealt with the Stafford Hospital failings was part of the movement towards greater transparency in the NHS, and MyNHS was a result of the government’s response to this.

Surgical Performance

MyNHS is designed to be easily accessible for patients, with consultant information being searchable by name, hospital and location. There is already a large amount of available data, however there have been added details to the MyNHS site including:

  • the type of procedure

  • head and neck surgery information

  • upper gastro-intestinal surgery and neurosurgery information

  • urogynaecology data

This data does have the potential to result in difficult cases being refused by consultants according to speciality surgeons.

Professor John MacFir, president of the Federation of Surgical Specialty Associations, stated: “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. There is now good anecdotal evidence that shows publishing this data has encouraged risk-averse behaviour, which is not in the interest of patients.” Prof MacFie went on to explain that only when an individual surgeon has concerns raised in accordance with their practice, then mortality rate data should be released. Data accuracy, risk adjustment by case, and low data volumes also caused data quality issues. “In reality very few deaths can be attributed to surgical error alone, and this data only attracts attention away from institutional failings,”

Dr Foster, a clinical data firm, up to 75% of procedures could be missing from the databases. Yet the Royal College of Surgeons have said that it is about being transparent with patients and Gill Humphrey, chairwoman of the Royal College of Surgeons Patient Liaison Group has stated: “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.”

Image labelled for reuse on Google Search Engine (3rd November 2015)

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