NHS England faces running into further consultant opposition after it emerged it wants to impose stricter publishing guidelines on royal colleges for next year’s consultant performance data.
Sir Bruce Keogh, NHS England national medical director, said today that colleges had made a good start but “there is a lot of room for improvement” after they began publishing performance data for 3,500 consultants, including death rates.
News of the tighter guidelines follows criticism from patient groups and experts that data published so far by some of the 10 specialty groups has not allowed patients to draw meaningful comparisons between surgeons.
HSJ understands the more uniform structure for future publications will be mandated via the NHS contract while guidelines will be drawn up on how the data should be presented.
It is understood NHS England wants the revised format to clearly show consultants’ risk-adjusted mortality rates to make comparisons more meaningful.
However, clinicians told HSJ it was hard to gauge risk in some specialties. One senior surgeon said: “In some areas, such as cardiac, it is relatively straightforward to make meaningful comparisons.
“But in other areas there are lots of confounding variables and there are no validated risk models for adjusting to allow you to make direct comparisons between outcomes for patients.”
A spokesman for the Healthcare Quality Improvement Partnership, which has been leading the project for NHS England, said it was determined to keep the clinicians on board.
He said: “It was always the understanding that this would be contractual from next year. The buy-in of clinicians is central to this project and close collaboration with the societies remains essential.
“HQIP will be gathering feedback from a wide range of stakeholders before putting together a report for NHS England in the coming months which should help set the direction of travel for future data publications.”
The National Vascular Registry was first to publish data last Friday – a move which culminated in accusations that the media has seriously misrepresented its data after the Daily Mail compared surgeons on their crude death rates rather than risk adjusted rates.
On Monday the British Orthopaediac Assocation and the British Cardiovascular Intervention Society both published data in a format which only allowed patients to look up one named surgeon at a time.
While comparisons could be made with a national average, it was not possible for them to compare with the performance of other consultants in their area.