Fresh details about how rankings of individual consultants on metrics such as how many patients die in their theatres each year will be devised have been shared with HSJ.
The Healthcare Quality Improvement Partnership, which is overseeing the project for the NHS Commissioning Board, told HSJ it had identified ten specific clinical audits or registers which it will base the ratings on.
The proposals, labelled “incredibly challenging” by surgeons, mean that from June patients will be able to check surgeons’ performance in ten specialist areas across a range of metrics and clinical quality measures, such as survival rates, via the NHS Choices website.
The ten areas identified by the commissioning board included adult cardiac; orthopaedic and vascular surgery.
HQIP said rankings for these areas would be based on the national adult cardiac surgery audit; the national joint registry and the UK audit of vascular surgical services and carotid endarterectomy respectively (see table for a full list).
The body told HSJ more surgical areas would be included following the intitial roll out.
Professor Ben Bridgewater, a consultant cardiac surgeon at the University Hospital of South Manchester seconded to HQIP to support the work, said: “This is ground-breaking work; as such it is incredibly challenging for the projects involved.
“But reactions have been positive and we are confident ten robust and meaningful sets of results will be produced.
“We are working closely, alongside our colleagues at the Royal College of Surgeons, to ensure each project is fully supported.”
The British Medical Association warned the proposals, first announced in the commission board’s planning guidance in December, could lead to league tables which could be misinterpreted.
A HQIP spokesman said it was “extremely unlikely” the information would be presented as a league table or in a way which represented a simple ranking. However, patients will be able to use the data to benchmark consultants against set standards.
He said: “We need to be absolutely certain surgeons are treated fairly and we do not end up with crude league table.
“However, patients will be able to see where individual consultants’ fall in relation to the other consultants in that group, so they will be able to draw meaningful conclusions.”
The commissioning board’s 2013-14 planning guidance Everyone counts: Planning for patients 2013/14. said: “HQIP will develop methodologies for casemix comparison and, in conjunction with NHS Choices, publish activity, clinical quality measures and survival rates from national clinical audits for every consultant [practising in certain areas] by summer 2013.”
What clinical audit or registry consultants will be ranked against
|Speciality||Clinical audit or registry||Specialist society|
|Adult cardiac surgery||National Adult Cardiac||The Society for Cardiothoracic Surgery|
|Bariatric surgery||National Bariatric Surgery Register||The British Obesity & Metabolic Surgery Society|
|Colorectal surgery||National Bowel Cancer Audit Programme||The Association of Coloproctology of Great Britain and Ireland|
|Head and neck surgery||National Head and Neck Cancer Audit||The British Association of Head & Neck Oncologists|
|Interventional cardiology||Adult Coronary Interventions||The British Cardiovascular Intervention Society|
|Orthopaedic surgery||National Joint Registry||The British Orthopaedic Association|
|Thyroid and endocrine surgery||BAETS national audit||British Association of Endocrine and Thyroid Surgeons|
|Upper gastro-intestinal surgery||National Oesophago-Gastric Cancer Audit||Association of Upper Gastrointestinal Surgeons|
|Urological surgery||BAUS cancer registry||British Association of Urological Surgery|
|Vascular surgery||UK Audit of Vascular Surgical Services & Carotid Endarterectomy||The Vascular Society|