Individual trusts to publish surgeons’ data

The first tranche of consultant performance data is being made available via the NHS Choices website today, after legal clearance for the project was secured just hours before the proposed go-live time.

Two specialties will go live today, and a further five published over the coming week (see box below). A further three specialties go live in the autumn. Collectively, the ten will cover around 3,500 consultants.

Senior consultants said the data, which will be presented by the relevant professional bodies, would be of limited use to lay people in the early stages of the programme. They hope to address this in future iterations.

Ministers said publishing the data would drive better care and save lives.

“It is expected trusts will have this data available on their websites. They can either signpost to the data on the professional society websites or they can put their employees’ data up on their own website,” said Ben Bridgewater, who has led the team overseeing the project at Healthcare Quality Improvment Partnership. 

Professor Bridgewater, HQIP’s outcomes publication director, praised the “99 per cent” of consultants who had consented to their data being published, but added those who had not had “triggered a useful debate about data quality”.

He said none of the “under 50” consultants still withholding consent were under-performers; they were mainly objecting to publication on the grounds they were not satisfied with the quality of the data.

He added: “We are not at the end of this journey and we do know that there are issues around data quality and risk adjustment.”

Concerns were raised in the run-up to publication that poorly performing surgeons would use data protection laws to block their data being made public. 

While it remains unclear if this was the intention of some surgeons, the ones who have refused to publish are not in this group, Prof Bridgewater said.

Consultants warned that direct comparisons between surgeons were not possible in certain areas and that the data offered little value to patients in its present form.

However the names of senior surgeons with above average mortality rates were leaked ahead of publication to national newspapers.

Ian Martin, president of the Federation of Surgical Specialty Associations, said he supported the principle of transparency and that the programme would lead to service improvements in the long-term.   

However, he told HSJ: “The value [of the data in its current form] to patients… making an individual choice is really very small indeed, but it will allow them to form the basis of a discussion with their GP.”

He added that mortality rates in isolation could be very misleading and that there were some surgical specialties where there were not sufficiently robust mechanisms in place to make direct comparisons between consultants.

Mr Martin said: “In my area [head and neck surgery] there is no validated risk model for adjusting to allow you to make direct comparisons between outcomes for patients.”

NHS medical director Sir Bruce Keogh said: “This is a major breakthrough in NHS transparency. 

“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.”