Measuring Surgeons Performance

Topics covered: Ridouts professional advice

Sir David Nicholson, the head of the NHS says performance data on individual surgeons should start being published from next summer. Data on heart surgeons is already available, but Sir David Nicholson said he wanted to see other specialities, including vascular and orthopaedic surgeons follow suit.

Sir David said providing such data would allow surgeons to compare their performance with other surgeons which would put pressure on them to improve. He said the evidence showed that patients did not always use such detailed information.

Professor Sir Ian Kennedy first called for the publication of surgery-specific data in 2001, who chaired the inquiry into the excessive number of babies who died undergoing heart surgery in Bristol. Since then, only heart surgeons have published data down to an individual level.

Many doctors are cautious about widening publication of data as there is a fear that it may give a misleading impression. Those doctors that take on the most difficult and complex cases may look to be performing worse, when in fact they could be the leading specialists in their field.

Sir David acknowledged this could be a problem, but said it had to start happening at some point and the accuracy of data would improve in time. Dr Mark Porter, chairman of the British Medical Association, said “there is still more to be done to ensure that data about consultants’ performance is meaningful. Basic mortality figures alone could mislead patients because they fail to take into account other factors that might have contributed to the death of a patient”.

The announcement about individual data on surgeons formed part of the planning guidance for 2013-14 published by the NHS Commissioning Board. The board is in charge of overseeing the new GP-led clinical commissioning groups that will take charge of the NHS budget from April. The Commissioning Board is also to set up a group to examine the potential for the NHS in England to provide some services, such as day surgery, at the weekend.

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