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Death rates for doctors to be published online


28 June 2013

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NHS England are to begin the staged publication of mortality rates for individual hospital consultants in ten specialties, in a major breakthrough for NHS transparency.
 
It is leading a drive to give patients more information about their treatment, helping the NHS drive up and maintain the quality of care.
 
The data – covering around 3,500 consultants – will appear on the NHS Choices website and will cover a range of operations and procedures.
 

NHS England are to begin the staged publication of mortality rates for individual hospital consultants in ten specialties, in a major breakthrough for NHS transparency.
 
It is leading a drive to give patients more information about their treatment, helping the NHS drive up and maintain the quality of care.
 
The data – covering around 3,500 consultants – will appear on the NHS Choices website and will cover a range of operations and procedures.
 
Using national clinical audit data, it will show the number of times a consultant has carried out a procedure, mortality rates and whether clinical outcomes for each consultant are within expected limits. The specialist societies that have produced the data will also include additional indicators where appropriate to their specialty.
 
Outside of cardiac surgery, it is the first time that the performance of individual surgeons can be viewed openly online. It is also the first time globally that this level of performance information has been published.
 
Two specialties will go live today, with a further five specialties going live over the next seven days. An additional three specialties will go live with their data in Autumn this year.
 
The overall results are expected to reassure patients, with mortality rates for almost all surgeons being within the expected range.
 
Professor Sir Bruce Keogh, National Medical Director of NHS England, said: “This is a major breakthrough in NHS transparency.
 
"We know from our experience with heart surgery that putting this information into the public domain can help drive up standards.  That means more patients surviving operations and there is no greater prize than that.
 
"Surgeons deserve real credit for taking this voluntary leap. The public interest is clear but there were valid and proper concerns about the dangers of misinterpretation and a great deal of work has been done to address them.
 
"The NHS is on a journey with transparency.  The more we shine lights into 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.”
 
Sir Bruce added: “There will inevitably be a small number of outliers, which is where the consultant’s data is outside an expected range. It is really important that people understand that somebody could be an outlier because they take on difficult cases. It doesn’t necessarily mean there is a performance issue. Where someone is an outlier, it is important that expert colleagues review the data so that the issues are properly understood by all.”
 
The publication of consultant-level outcomes has been managed by the Healthcare Quality Improvement Partnership (HQIP), which runs the National Clinical Audit and Patient Outcomes Programme for NHS England. HQIP worked with the relevant specialist societies and audit project teams to bring the results together.
 
The reporting of the data was led by HQIP Outcomes Publication Director Professor Ben Bridgewater – a practicing heart surgeon who leads the successful cardiac consultant-level reporting which paved the way for this work.
 
Professor Bridgewater commented: "Ultimately there is one patient and one responsible consultant. This means the public can now know about the care given by each doctor and be reassured an early warning system is in place to identify and deal with any problems. A number of extra new safety checks have been created as natural by-products of putting this work in train, and this will only improve as processes are refined. In terms of geographical coverage and specialties covered, this is truly groundbreaking."
 
The Secretary of State Jeremy Hunt said:
 
“We need to see a revolution in transparency in the NHS – publishing this data will not only drive better care for patients, it could literally save lives.  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 aspire to.”
 
To date, around 99 percent of consultants have agreed or not objected to information regarding their practice being published. Consultants and their reasons for opting out of publication will be listed on the NHS Choices website.
 
The data will be available via www.nhs.uk/consultantdata. It will initially be refreshed annually and reporting of data in this way will be mandatory from 2014/15.
 
By summer this year, acute Trusts will be expected to link to the information on NHS Choices from their own websites.

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