The first round of individual surgeon’s performance data has been published today on NHS Choices.
Surgical outcomes data is available for two specialties: adult cardiac surgery and vascular surgery. A further five specialties will be published over the next week and three more will follow in the autumn.
The mortality rates for more than 3,000 surgeons on more than 20 different procedures will ultimately be published online in what NHS England’s medical director, Sir Bruce Keogh, calls “a major breakthrough in NHS transparency.”
“Surgeons deserve real credit for taking this voluntary leap. The public interest is clear, but there were valid and proper concerns about the dangers of misinterpretation and a great deal of work has been done to address them,” he said.
“The NHS is on a journey with transparency. The more we shine lights into corners of the NHS the more you will see. That can be hard for NHS staff and policy makers. But it is the right thing to do.”
Mortality rates for heart surgery have been published for many years as a result of the Bristol Royal Infirmary Inquiry, which found that babies undergoing heart surgery at the hospital in the mid-1980s had died unnecessarily, partly because performance rates were hard to come by.
“We know from our experience with heart surgery that putting this information into the public domain can help drive up standards. That means more patients surviving operations and there is no greater prize than that,” said Sir Bruce.
The measurements are based on national clinical audits and measure performance against a set of standards relating to survival rates, length of stay in hospital following a procedure and repeat operation rates, as well as the number of operations performed.
Over the past six months, surgeons have gathered and checked data based on the past three years of operations.
Professor Norman Williams, president of the Royal College of Surgeons, called it an historic moment for surgery and said he was proud of what surgeons had achieved.
“It has been a difficult and complex undertaking carried out in a short timescale, but we see this as the beginning of a new era for openness in medicine. It is early days, but it will change for the better the nature of the bond between patient and surgeon, which is based on both openness and trust,” he said.
“We must not deter surgeons from treating difficult cases for fear of being penalised.
"We hope patients understand and see that their outcomes do not depend on one individual, they depend on the entire team and the structure in which they work. That’s why the publication of data at a unit or team level is also vitally important.”
Under the Data Protection Act, consultants did not have to agree to their results being published. However, 98% of surgeons agreed to it and those who refused will be listed on the NHS Choices website.
Sir Bruce said he expected that over time more consultants would agree to the data being published.
“This is a major cultural change in the way the NHS works and we expect this to take time to bed-in,” he said.
Health secretary Jeremy Hunt also welcomed the publication as a step towards “a revolution in transparency.”
“These organisations have shown a real commitment to transparency in publishing this information. This will help patients choose their surgeon and surgeons to learn from each other and strive to improve,” he said.
“Transparency is key to becoming the world’s safest health system – not just by today’s standards, but by the standards we all aspire to.”
The specialties to follow over the next week are: bariatric; interventional cardiology; orthopaedics; endocrine and thyroid; and urology. Head and neck, bowel cancer, and upper GI will follow later in the year.
The mortality rates will be refreshed yearly and reporting of the data will be mandatory from 2014-15.