NHS Choices to publish death rates

The Department of Health (DH) is to publish death rates of patients undergoing major surgery at NHS hospitals in England, on the NHS Choices website from later this summer.

The aim of the move is to provide patients with information on the mortality rates of NHS trusts carrying out major surgical procedures such as hip and knee replacements.

According to the NHS it will be the first time anywhere in the world that a government has exposed the work of hospital surgeons, giving patients an opportunity to choose to be treated where their lives are least at risk, designed to aid the new ‘Free Choice’ initiative.

A DH spokesperson told EHI: “Publication of the figures will drive up standards by forcing trusts to improve performance or withdraw from medical specialties at which they do not excel. At this stage the published data will give results for hospital units, not individual surgeons.”

Eventually, the DH wants to use the statistics to let patients compare the performance of individual surgeons and GPs, though it is still unclear when this will take effect.

The DH’s medical director and interim director general of informatics, Sir Bruce Keogh, has asked the medical directors of every hospital and mental health trust in England to send in examples of the performance statistics they use internally to assess the quality of their clinical teams. The department will select about 50 for debate within the medical community.

Once any questionable statistics have been addressed, they will be published on the NHS Choices website, probably during the spring of next year.

"We hope to identify a series of measures that could be combined in a scorecard, which becomes a composite measure of quality for each specialty in each institution,” he said.

He added: "Some will say that the data is not good enough, but the only way we can improve it is by using it. We want people to submit to us what they think are useful measures of the quality of treatment and, if we agree, we will apply those measures across the board in the NHS.”

Plans to publish the data have been backed by the Royal College of Surgeons.

Bernard Ribeiro, president of the college, said: "This is going to happen and the college has to be the vehicle to make it happen. I have urged the government to use data about hospital units, not individual surgeons at this stage.

"Outside the field of cardiac surgery it is difficult to determine the outcome we should be measuring. Surgery is not just about whether patients live or die. It is also about mobility and quality of life."

Keogh said the desire for openness was being driven by the next stage of NHS reform: “…health commissioners need better data on the quality of hospitals’ performance; doctors need to demonstrate the quality of their work; and patients need information about quality to exercise choice about where to go for treatment,” he said.