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Last Updated: Thursday, 4 November, 2004, 11:31 GMT
Pledge on heart op failure data
Image of a surgeon operating
Surgeons will get star ratings
Patients must soon be able to check the success rate of individual heart surgeons before going under the knife, ministers have insisted.

The move is in response to the Bristol inquiry into the deaths of children who had heart surgery at the city's infirmary from 1988-1995.

All heart units in the country were told to send in data on individual surgeons to go public this April.

But data published so far does not give information about individual surgeons.

No one is shying away from having the discussion about their own results
Sir Bruce Keogh, president elect of the Society of Cardiothoracic Surgeons

Instead, the Society of Cardiothoracic Surgeons only published mortality data for aortic valve and heart bypass surgery that did not name individual surgeons.

The society has blamed the delay on IT hitches for the delay - but has also made it clear it has serious doubts about the fairness of making public data on individual surgeons.

The Department of Health has acknowledged the need to ensure data gives a fair reflection of a surgeons work - but has told the society that data on individual surgeons must be published.

Dr Roger Boyle, National Director for Heart Disease, said: "When the system is in full operation any surgeon or any hospital will be able to look day by day at their results and compare it immediately with the figures for the rest of the country."

The Society's audit of more than 82,000 adult patients from 2001 to 2003 found the death rate stood at 1.8%.

All surgeons were said to have achieved an acceptable standard with no surgeon having a mortality rate above 5.5% for the three years.

We want to get it right and we will not publish data that could be misleading.
Department of Health
At the time of the September publication, the reports author Sir Bruce Keogh said it would be "grossly irresponsible" to publish tables of individual surgeon performance as its data was not complete so risk could not be properly assessed.

"No one is shying away from having the discussion about their own results," he told the Health Service Journal.

"They are shying away from results being presented in such a way that's going to see them crucified because they take on cases that are high risk or difficult."

The concern is that if data does not take into account how sick the patient being operated on is, surgeons with the highest risk patients will come out unfairly looking bad.

This, in turn, might discourage surgeons from agreeing to take on the most complex cases with the lowest chance of success.

Sir Bruce said the April target had been over-ambitious, and that a system required to ensure fair comparisons could be made between surgeons was still not in place.

Heart specialist Professor Martin Cowie said: "Surgeons will say 'I'm sorry this patient is a higher risk than normal so I can't take on this patient because it will make the figures much worse.

"That's what's happening elsewhere in the world when they have introduces this system."

A Department of Health spokesperson said work was ongoing with the society to try to resolve their concerns.

She said: "We want to get it right and we will not publish data that could be misleading.

"We want to incorporate risk adjustment for more complex cases - we need to make sure this is taken into account. The figures need to be robust, and usable for patients."

Why heart surgeons are resisting the plans

Heart op death rate 'improving'
11 Sep 04  |  Health
Child death rate down at hospital
08 Oct 04  |  Bristol/Somerset


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