NHS England is committed to making more information available about how services and professionals are performing. The aim is to drive up the quality of care in the NHS and help people choose the treatment that suits them best.
This initiative is a central part of NHS England’s ambition to ensure every patient gets high quality care, and to build improved services for the future.
On NHS Choices you’ll find links to information about individual consultants in a number of clinical areas. You can look at their results for a range of operations and treatments to help you make decisions about your care.
Prof 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.’
The reporting of the data was led by Prof Ben Bridgewater from the Healthcare Quality Improvement Partnership (HQIP). Prof Bridgewater is a practising heart surgeon who leads the successful cardiac consultant-level reporting which paved the way for this work.
Prof Bridgewater said: ‘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 data show where the clinical outcomes for each consultant sit against the national average. Where results differ significantly from the national average, there may well be good reason, and you can discuss this with your GP and/or surgeon.
The information available for each type of treatment varies, but in all cases you can see how many times each consultant has performed a particular procedure.
You may wish to discuss the data with your GP before choosing where to be treated, or with your consultant before your operation. Find out more about choosing a consultant
Publication begins on Friday 28 June with most results due to be available by 5 July. Click on the NHS Choices website for more details.
This initiative applies to England only, although some specialties have also chosen to publish data they hold for Scotland and Wales. The NHS plans to make much more information available in future.
Due to data protection legislation, consultants had to agree to have results from their operations published and around 98% have. Results that are not published are still analysed and acted upon as necessary by the NHS. The names of those consultants who have not agreed to have data published and the trusts they work in can be seen here.
The information published so far includes how many times each participating consultant has performed certain procedures and what their mortality rate is for those procedures. You can see whether or not the data for each consultant is within or outside the expected range. Consultants who fall outside the expected range are sometimes referred to as ‘outliers’.
You can use this data to decide which consultant to choose for your care. However, there are some important issues to bear in mind when looking at the data.
For instance, the vast majority of the data has been through a process known as ‘risk adjustment’. This is a way of accounting for the different mix of patients operated on by a particular consultant’s team. Using risk adjustment, outcomes are calculated as if all consultants operated on the ‘average’ patient. This means that consultants who take on particularly poorly, high-risk patients or carry out the most complicated procedures don’t appear to have an unfairly high mortality rate.
However, not all the data can be ‘averaged out’ in this way. Specific reasons for this are outlined in the introductory text for each set of results. Where risk-adjusted data is not available, actual (also called ‘crude’) clinical outcomes are shown. If the data is not risk-adjusted, a consultant may have a higher mortality rate simply because he or she takes on more difficult cases.
If you have questions or concerns having viewed specific results, please discuss these with your GP or consultant.
Any hospital or consultant identified as an outlier will be investigated and action taken to improve data quality and/or patient care.
At present, data is only available for the 10 specialties listed on this page. The majority of these sets of results will be published by July 1 2013, and remaining sets by September 2013. Not all consultants who work in these specialties are included in the data published so far. A consultant may not appear because:
This is the first time that data on individual consultants have been published on this scale. A number of approaches are being tested to see which methods work best, so that these can be used more consistently in future.
Each specialty has been asked to publish data showing, for each consultant, how many times they have performed a procedure and what their mortality rate is for that procedure.
Each specialty has decided which procedures to include, and what measure of mortality to show, based upon what is most relevant to their patients and what data are collected.
Some specialties have published additional information. In future all specialties should publish more data as the process evolves.
The results published to date were selected because relevant data was already being collected for these procedures and specialties. It is likely the programme will be extended from 2014 when data for other conditions can be collected and analysed in a similar way.
The data comes from national clinical audits which continuously review medical practice to check that it is safe and seek ways to improve it. These audits are managed by ‘audit providers’ (usually academic institutions such as a university or royal college) which work with the specialist association. A specialist association is an independent, membership organisation, which represents a particular medical specialty.