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Last Updated: Monday, 14 February, 2005, 13:56 GMT
Pressure grows over surgeon data
Doctors fear mortality data could be misread
Pressure is mounting on surgeons to publish individual performance data after another hospital unveiled heart surgeon mortality information.

St George's Hospital in London put the data on its website, saying surgeons needed to be open as patients get more choice over where they are treated.

The risk-adjusted information showed some surgeons performing twice as well as others.

But doctor groups said they still had concerns about publishing such data.

Patients have been calling for more openness ever since the Bristol Royal Infirmary scandal when surgeons were found to have continued carrying out heart operations on children even though they had higher than average death rates.

We are concerned that simply publishing crude mortality figures will be misleading as they are dependent on many factors
British Medical Association spokeswoman

Heart surgeons are the most open as it is easier to measure outcomes but as yet national data is only broken down on a team by team basis.

However, a handful of hospitals have independently published individual information already and several more are considering it after requests under the Freedom of Information Act.

Patrick Magee, president of the Society of Cardiothoracic Surgeons, said it was "potentially unfortunate" that trusts had started releasing information as the risk-adjustment systems being used were not perfect.

He warned: "If the information is not properly interpreted patients could suffer.

"Surgeons could turn down high-risk patients."

St George's Hospital used a model called Euroscore, which took into account patient age and medical history.

Euroscore is also used by the Manchester Heart Centre and Papworth Hospital in Cambridge, which also publish individual data.

All five surgeons at St George's Hospital were within the acceptable level, although performance did vary.


Consultant cardiac surgeon Robin Kanagasabay, one of the surgeons listed, said the hospital were publishing the information as the NHS was becoming more open.

"We have had a very careful debate within St George's about this and I and my colleagues think we have got the right balance between presenting information in a way which is understandable, but which does not oversimplify."

And hospital chief executive Peter Homa said they may even go further.

"There is no reason in principle why we shouldn't be publishing similar information right across all areas of surgery."

Anthony Nally, of the Manchester Heart Centre, which has six heart surgeons, said: "More and more pressure is being put on surgeons to publish the data.

"From our point of view, we wanted to act before being forced to."

The Royal College of Surgeons said it supported the publication of individual data but added most hospitals were not in a position to do so at the moment.

A spokeswoman said: "Many clinicians do not have the time or the resources to collect and classify information properly.

"Variables such as case mix and operation risk must be allowed for so that one compares like with like.

"If this is not done there is a real risk that patients will be misled and surgical teams may be unfairly criticised."

The British Medical Association said it would be looking carefully at what the trusts which publish data are doing.

But a spokeswoman said: "We are concerned that simply publishing crude mortality figures will be misleading as they are dependent on many factors."

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14 Jan 05 |  Health
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11 Sep 04 |  Health

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