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Surgical outcomes

Greater information for patients about their surgeons

Nearly 4,000 surgeons have started to publish their individual surgical results. The innovative move will drive forward improvements in care and enable patients to understand far more about the nature of a surgeon’s work and their recovery after an operation.

For the first time, patients and the public will be able to read information which gives details of a surgeon’s performance by looking at the outcomes of particular procedures or operations such as a hip replacement or surgery for obesity.

The measurements, based on national clinical audits, are a way of measuring performance against a set of professional standards relating to survival rates, length of stay in hospital following a procedure and repeat operation rates, as well as the number of operations performed.

Over a period of only six months, and in the largest clinical undertaking of its kind, thousands of surgeons have prepared and checked data based on the results of NHS operations carried out over the past three years.

The exercise has found that the overwhelming majority of surgeons are performing operations and procedures to a high standard set by their own professional surgical specialties. Fewer than ten surgeons currently appear as ‘outliers’ where their results are significantly different from others and where further investigation to understand these data is needed.

The initiative means that people undergoing certain surgical procedures can look up their surgeon and unit on the NHS Choices website and see how many similar operations they have performed in the past year, and how they compare with others on a number of different measures or ‘indicators.’

Until June only heart surgery patients had been able to analyse surgical data in this way. The Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) has published information on heart bypass surgery mortality rates by surgeon and units since 2005.

However, there is an ongoing drive for greater transparency within the NHS to improve standards and safety and reinforce trust in clinicians. As part of this, the Department of Health asked nine other specialties to share their data publicly. Nine involve surgeons, and one involves cardiologists.

From June 28, individual specialities are releasing information, with the others to follow.

Each specialty does a very different type of work, so the measures for each vary. Individual specialties present the data in different ways too.

The new approach is intended to empower patients by giving them accurate data about the quality of their care. It allows them to benchmark surgeons against acceptable standards and make comparisons between units. In this way, patients can make informed decisions about their surgery and who performs it.

It is believed that, by revealing what others have achieved in their clinical area, surgeons are more likely to reflect on their practice and be inspired to improve.

You can read more about the ten specialties, represented procedures, their expected publication dates and how they are presenting their data below:

Adult cardiac surgery
List of procedures Specialist Society
Isolated first time coronary artery bypass graft (CABG) Society for Cardiothoracic Surgery (SCTS)
Isolated first time aortic valve surgery
Vascular surgery
List of procedures Specialist Society
Elective infra renal AAA repairs Vascular Society of Great Britain and Ireland (VSGBI)
Carotid endarterectomy
Thyroid and endocrine surgery
List of procedures Specialist Society
Thyroidectomy only British Association of Endocrine and Thyroid Surgeons (BAETS)
Interventional cardiology
List of procedures Specialist Society
British Cardiovascular Intevention Society (BCIS)
Orthopaedic surgery
List of procedures Specialist Society
Total hip replacement British Orthopaedic Association (BOA)
Total knee replacement
Bariatric surgery
List of procedures Specialist Society
Laparoscopic British Obesity & Metabolic Surgery Society (BOMSS)
ASA Grade
Gastric band
Roux-en Y gastric bypass
Sleeve gastrectomy
Duodenal switch
Duodenal switch + sleeve
Bilio-pancreatic diversion
Revisional gastric band
Gastric balloon
Urological surgery
List of procedures Specialist Society
Nephrectomy British Association of Urological Surgeons (BAUS)
Colorectal surgery
List of procedures Specialist Society
Major bowel resection for curative and palliative patients The Association of Coloproctology of Great Britain and Ireland (ACPGBI)

Head and neck surgery
Surgical resections on Specialist Society
Oral cavity British Association of Head and Neck Oncology (BAHNO)
Oropharynx Expected date of publication: Autumn 2013
Major salivary gland
Upper gastro-intestinal surgery
List of procedures Specialist Society
Oesophagectomy for curative patients Association of Upper Gastrointestinal Surgeons (AUGIS)
Gastrectomy for curative patients Expected date of publication: Autumn 2013