Patients’ damning verdict on NHS care lottery

More than 10,000 patients treated at both NHS and private hospitals in the region have recorded how they feel after going under the knife for four common procedures – hip and knee replacements, varicose vein surgery and hernia operations.

Results analysed for the first time by the Yorkshire Post reveal significant variations both in outcomes of surgery and in wider measures of how patients feel about their general health.

They also show people in more deprived areas tend to be operated on only when their conditions have deteriorated more, leaving them worse off after surgery.

Ministers have already announced that outcomes of NHS care measured by patients will be given a key role in how services are funded in future.

One leading expert today calls on NHS bosses to use information in Patient Reported Outcome Measures (PROMS) to demand explanations now from hospitals over their performance.

Figures show 96 per cent of patients nationally said hip conditions improved after surgery in the 20 months to last November. At the privately-run Spire Hospital in Hull, 98 per cent of patients reported improvements, falling to 90 per cent of those treated in Bradford’s hospitals.

For knee surgery, 92 per cent of patients nationally reported improvements, ranging from 96 per cent of those treated at the privately-operated Claremont Hospital in Sheffield to 84 per cent in Bradford.

Among patients treated for varicose veins, 93 per cent treated in Chesterfield reported improvements falling to 80 per cent of patients at the Wakefield-based Mid Yorkshire trust. The national average was 84 per cent.

Hip patients from north Lincolnshire and knee patients from Wakefield had the most severe symptoms before surgery. Those from North Yorkshire had fewer problems before both operations.

People from Barnsley reported the smallest improvements after knee and hip replacements – probably because they tend to have more severe symptoms prior to surgery.

Those with the most gains from hip surgery were treated at the Spire Hospital in Hull. Knee patients had the most gains in Calderdale and Huddersfield.

Patients reported fewer improvements on wider measures covering their general health in the months after surgery. Seven in eight hip patients nationally said their health was better, four in five knee patients reported better health and only half of varicose vein and groin hernia patients felt generally better.

Prof John Appleby, chief economist of the health think tank the King’s Fund, said patients would be empowered by the information telling them how their hospitals performed and variations in the quality of care.

“What you want to know about when you go into hospital is will my health improve and by how much and it’s information that’s not really been collected before,” he said.

“It will tell us the extent to which patients report the benefits of surgery, we will see differences between hospitals and, as the data builds, the differences between surgeons.”

He said it was a concern patients in deprived areas were being treated later. “There shouldn’t be these differences – people should have equal access to healthcare and that doesn’t seem to be the case,” he said.

David Stout, of the Primary Care Trust Network, said the information was “potentially very powerful”. He added: “We need to ask did the operation do what we wanted it to do, did the lives of patients improve?”

A Department of Health spokeswoman said: “This experimental data will help the NHS build a fuller picture on quality of care.

“PROMS give patients a voice on the status of their health before and after surgery, providing vital insight into their views on the effectiveness of the care they receive.”

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