Chief medical officer's annual report confronts surgical safety

Sir Liam Donaldson called for 30-day survival rates - which have not been routinely assessed in England for six years - to be collected regularly and made part of "public reporting of surgical outcome". It was one of a series of measures to make surgery safer in his annual report, published on Monday.

The recommendation follows the publication of mortality rates for four hospital procedures that Department of Health interim director general of informatics and NHS medical director Sir Bruce Keogh said would aid patient choice. Other recommendations in the report include steps to tackle racial discrimination in medical recruitment.

Sir Liam's report called for a mentoring scheme for ethnic minority doctors, better training on equality and race awareness issues for selection panels, and more support for doctors raising concerns about racial discrimination.

He said that while many institutional barriers to ethnic minority doctors had been removed, there were still areas of concern.

Drives to improve health in teenagers and tackle increasing rates of oesophageal cancer are also proposed.

The National Patient Safety Agency received 129,416 reports of potential errors involving surgical procedures, varying from incorrect treatment or procedure to misplaced patient notes, during 2007.

Sir Liam said on 14 occasions in the last three years, burr holes had been drilled into the wrong side of a patient's head during brain surgery.

Urging the establishment of a clinical board for surgical safety, greater use of risk scores to estimate the risk to patients before an operation and routine use of the World Health Organisation's surgical safety checklist, he said: "Surgery for patients in this country is generally very safe, but we can and should make it even safer. Errors do still occur.

"Further improvements will need a more detailed understanding of how often errors occur, a change in culture and the use of innovative new tools."

King's Fund policy director Anna Dixon said the level of surgical and medical error was unacceptably high.

"Sir Liam is right to call for the NHS to collect and report more information on the outcomes of care, including safety critical indicators. But greater focus on safety is needed outside the operating theatre too." She said maternity services required similar measures.

Sir Liam's recommendations include a national summit to take stock of health programmes and services for teenagers.

HSJ's Outcome Measurement conference is in London on 24 September