Three Yorkshire surgeons rebel over publishing mortality rates

Surgeons who refuse to publish data about how well they perform during operations will be named in coming days
Surgeons who refuse to publish data about how well they perform during operations will be named in coming days
Have your say

THREE surgeons from the region are among a group of consultants who have refused to publish information on the success of their operations.

The three all objected to the idea in principle and raised concerns that not enough had been done to reflect the level of risk involved in the operations when judging their outcome.

Patrick Kent, who is understood to operate at the Spire Hospital in Leeds, Rob Lonsdale, from Sheffield Teaching Hospitals, and Hull Royal Infirmary’s Peter McCollum and three others were the only heart and vascular surgeons out of 472 nationwide to opt out.

Officials said all six of the surgeons perform within the “expected range”.

Patients can now see the number of times a consultant has carried out a procedure, their mortality rate and whether or not they are performing within the expected range in tables being published online.

In the coming months, data will become available on 3,500 medics from 10 specialties and it is understood that it will eventually be rolled out to incorporate all surgical consultants.

A spokeswoman for the Royal College of Surgeons (RCS) said “fewer than 30” medics across the 10 fields covered did not agree that their data could be published but none of them had results that were considered to be significantly different from their colleagues.

Professor Sir Bruce Keogh, medical director for NHS England, said: “The NHS is on a journey with transparency. The more we shine lights into the corners of the NHS, the more you will see. That can be hard for NHS staff and policy makers. But it is the right thing to do.

“The data results show mortality levels. But in the majority of cases the issue is, how will an operation or procedure improve the quality of a patient’s life? Over time, the information that will be available will expand to include more indicators which reflect this important quality measure.”

The move has sparked much debate in the medical community, with some experts saying the data may not paint a true picture of performance.

Patients have been urged to be careful when weighing up how surgeons are performing using the new statistics.

The tables suggest one consultant has a death rate of 14.3 per cent which would be considered very high. The same individual has, however, performed the operation only seven times and one death has dramatically distorted the figure.

Professor Julian Scott, president of the Vascular Society, said: “When analysing this information it is vital to understand that many surgeons now operate jointly for complex cases such as AAA [abdominal aortic aneurysm] and this cannot be reflected in the current data as the operation is only assigned to one consultant.

“As a result, unit/hospital-level data may be a better guide to quality as it reflects the results of the surgical team far better.

“Surgeons in these tables should not be ranked by their mortality rate as there is a risk that they will be wrongly criticised and patients misled. Some are conducting extremely difficult surgery on very sick people so will have relatively high mortality rates.”

Questions over the way surgeons’ performance is measured and the figures are interpreted were raised during the recent suspension of children’s heart surgery at Leeds General Infirmary.

But the Government believes the move will help improve confidence and standards.

Health Secretary Jeremy Hunt said: “Publishing success rates in heart surgery has already led to one of the lowest mortality rates in Europe.

“These organisations have shown a real commitment to transparency in publishing this information. This will help patients choose their surgeon and surgeons to learn from each other and strive to improve.

“Transparency is key to becoming the world’s safest health system – not just by today’s standards but by the standards we all asp ire to.”

Patients can find the surgeon performance tables on the NHS Choices website.