London NHS trust publishes cardiac death rates online

St George’s Hospital, in Tooting, London, has started publishing mortality data online for its cardiology department, along with details about complications and data for individual surgeons.

The data is collected on a monthly basis from patient records, and is audited by a clinically-qualified database manager and in cardiology department meetings. Data adjusted for risk through the Euroscore system is also uploaded, so that prospective patients can see how the likelihood of mortality in each case squares with results. Comprehensive information on how to interpret the data is also available.

Robin Kanagasabay, one of the surgeons whose mortality data is listed on the website, said: "We’re doing this for several reasons. First, as surgeons we know that openness is the future in the NHS. What the Bristol and other cases have shown is that the public want to know, and should know how hospitals and individual surgeons are performing.

"There has been a huge debate about this within the medical profession and amongst cardiac surgeons in particular. The serious and important concern is that the publication of raw data for individual surgeons could be an incentive to take on only the easiest and least severe cases."

St. George’s claims it is the first hospital in London to do this, and has uploaded both raw and adjusted data from 2002-4.

However, some have expressed concerns that publicising cardiology mortality data could be counter-productive. A spokesperson for the British Medical Association told BBC News Online that they were concerned that the data could be misunderstood: "We are concerned that simply publishing crude mortality figures will be misleading as they are dependent on many factors."

And Sir Bruce Keogh, president-elect of the Society of Cardiothoracic Surgeons, told the Daily Telegraph: "It is right and proper that surgeons are made accountable but this has to be done in a meaningful way. We are morally obliged to protect the public from misinformation which is what this is.

"The last thing we want to happen is for surgeons to turn down certain operations to preserve their record. That is what happened in New York and we should learn from it and prevent it happening over here."

Currently, the data only partly covers heart operations. However, St. George’s is planning to expand publication of mortality rates to other disciplines. Peter Homa, trust chief executive, said: "Surgeons from other specialties want to get involved too. There is no reason in principle why we shouldn’t be publishing similar information right across all areas of surgery."

The information is available on St. George’s Healthcare NHS Trust’s website here.