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“Significant variation" of patient benefit across NHS providers

“Significant variation" of patient benefit across NHS providers


The best and worst hospitals in the UK for patient health improvement after common surgeries have been revealed in a map by the Health and Social Care Information Centre (HSCIC).

The map, published for the first time, shows significant variation across NHS providers on perceived patient health gain from hip, knee, varicose vein and groin hernia procedures. 

The results were gathered from the annual Patient Reported Outcome Measures (PROMs) programme. 

Hip replacement

Nationally about 87% of respondents recorded an improvement in general health after a hip replacement in 2011/12. 

Three providers (Hillingdon Hospitals NHS Foundation Trust (FT), Walsall Healthcare NHS Trust and Royal Liverpool and Broadgreen University Hospitals NHS Trust) had significantly worse scores than the England average. Nine providers were negative outliers in 2010/11. 

Patients believed that two providers gave a significantly better service than the rest of the country, Dorset County Hospital NHS Foundation Trust and The Horder Centre – St John’s Road. 

Knee replacements

And for knee replacements, 78% of patients said their health had improved after surgery. 

Again, three providers had significantly worse scores than the average. These were Sandwell and West Birmingham Hospitals NHS Trust, the Royal National Orthopaedic Hospital NHS Trust and South London Healthcare NHS Trust. 

No providers were positive outliners, compared to one in 2010/11. 

Groin hernia

For groin hernia surgery the South Warwickshire NHS FT was the first positive outlier since the information was first collected in 2009. Just 49% of patients in England said their health had improved after surgery. 

Varicose vein

And for varicose vein surgery there were no outliers and 52% of respondents said their health had improved. 

An HSISC statement said: “Healthcare providers which are 'outliers' have been identified by a statistical model as having outcomes significantly different from the national average. A 'positive outlier' has a significantly better outcome than expected; a 'negative outlier' significantly worse. 

“The outlier model is based on statistical theory and is not a declaration of the provider doing anything 'wrong' or 'right'; in particular there is a roughly 1 in 500 chance that a provider would be identified by the model as an outlier merely because of random variation amongst the patients they treat.” 

HSCIC chair Kingsley Manning said: “By making our published data available in a variety of formats for patients, care users, the public, clinicians, policymakers and others the HSCIC can play a powerful role in improving health and social care outcomes.”

The map is available to view here


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