[an error occurred while processing this directive]
BBC News
watch One-Minute World News
Last Updated: Thursday, 27 April 2006, 01:18 GMT 02:18 UK
Heart op survival rates unveiled
Surgeons
Some doctors fear mortality data could be misread
Hospital heart surgery survival rates are being published for the first time.

The Healthcare Commission has produced a website listing the performances of 30 hospitals with heart units.

But it stops short of providing full performance details for all individual surgeons, because some of them opposed such a move.

Patient groups said the data was too vague. The three hospitals with heart units which failed to provide figures have until June to do so.

Some 2.6m people have heart disease, with more than 30,000 requiring surgery each year.

This is an important move in increasing information available to patients and the public about clinical outcomes
Sir Ian Kennedy, of the Healthcare Commission

The Healthcare Commission gave details of survival rates for all cardiac surgery and also individually for coronary artery bypass graft and aortic valve replacement surgery - the two most common types of heart operations - for units in England and Wales.

In all cases, a range was given for the expected survival rates once risk factors such as illness, type of operation and age were taken into account.

In all the units, and in the cases of 17 hospitals where individual surgeon data was given, performance was as good or better than expected.

The overall, survival rate from April 2004 to March 2005 was 96.6% - well above the expected range of 93.7% and 94.5%.

Demand

The government has been pushing doctors to publish the data ever since the Bristol Royal Infirmary scandal.

Patients demanded more openness after surgeons at the hospital were found to have continued carrying out heart operations on children even though they had higher than average death rates.

Heart surgery is considered one of the easiest specialities to produce performance data as outcomes are easier to measure than many other procedures.

The Society of Cardiothoracic Surgeons published data for some operations in 2004 and a number of trusts have unveiled mortality rates either voluntarily or after challenges under the Freedom of Information Act.

There is the potential for confusion now we have some areas having individual data and others just units
Simon Williams, of the Patients Association

Healthcare Commission chairman Sir Ian Kennedy said: "This is an important move in increasing information available to patients and the public about clinical outcomes."

The commission said the publication could eventually lead to individual data being released on all surgeons. It raised the possibility of other specialisms following suit.

But Sir Bruce Keogh, president of the Society for Cardiothoracic Surgeons, said some surgeons were still against publishing individual data, believing it will lead to more pressure for good results and consequently discouraging surgeons from operating on higher risk patients.

He added: "I believe we will overcome these concerns."

Informed

Simon Williams, of the Patients Association, said: "Having information on a unit by unit basis is too vague for patients. They need to know what the performance of their surgeon and team is.

"There is the potential for confusion now we have some areas having individual data and others just units."

And he added: "It is also important that the three trusts which have not provided information follow suit."

Michaela Willis, who lost her son Daniel in 1993 at the Bristol Royal Infirmary, told the BBC the data would provide an important safeguard.

But she said the new figures showed there was currently very little variation between units.

The three hospitals which failed to provide the Healthcare Commission with the data - St Mary's in London, Leicester's Glenfield and Morriston in Swansea - cited complications compiling risk-adjusted information.

Dr Mike Knapton, of the British Heart Foundation, said the website "should enable patients to make more informed decisions".

The table below shows the survival rate for first-time patients being treated for coronary artery bypass and aortic valve replacement operations.

The range columns represent the expected survival rates, taking into account the health of the patients being treated.

HEART OP SURVIVAL RATES
Based on first-time patient treatments
Coronary artery (Bypass) and Aortic valve replacement (AVR)
Hospital Bypass expected range Bypass actual AVR expected range AVR actual
Bart's & The London 93.6-97.4% 98.5% 84.9-98.9% 97.2%
Birmingham QE 93-98.3% 98.4% 84.4-99.5% 97.2%
Blackpool Victoria 94.5-99% 98.6% 84.4-100% 97.5%
Brighton Royal Sussex 93.7-99.2% 96.9% 81.7-100% 95.2%
Bristol Royal Inf 94.7-98.3% 98.9% 85.7-99.6% 95.3%
Cardiff Univ 92.5-98.2% 98.9% 80.2-100% 100%
Coventry Walsgrave 92.3-98.1% 98.5% 81.6-100% 94.9%
Guy's & St Thomas' 93.6-97.8% 97.9% 85.1-98.9% 99.3%
Hammersmith 90.4-97.6% 97.8% 79.4-100% 100%
Hull Castle Hill 95-99% 98.5% 78.2-100% 97.4%
Leeds Gen 94.2-98.3% 98.1% 86.2-100% 98%
Leicester Glenfield n/a n/a n/a n/a
Liverpool Cardio 93.9-97.7% 97.3% 87.2-99.1% 98.1%
London Bridge 91.9-100% 98.9% 75-100% 96.2%
London Harefield 94.4-99.3% 98.1% 80.2-100% 97.9%
London Heart 93.6-98.6% 98% 83.9-100% 95.6%
London King's 87.9-100% 94.7% 59.1-100% 100%
London St George's 94.4-98.7% 99% 86.5-100% 100%
London St Mary's n/a n/a n/a n/a
Manchester Royal 94.2-99.1% 98.7% 82.5-100% 95.2%
Manchester Wythenshawe 93.5-98.3% 99.1% 85.5-99.6% 96.9%
Middlesbrough JCU 93.5-98% 98.8% 87.3-100% 99.1%
Newcastle Freeman 93.6-98.2% 98.7% 83.9-99.5% 93.6%
Nottingham City 92.6-99.1% 98.9% 84.6-100% 100%
Oxford John Radcliffe 92.6-97.9% 97.3% 84.9-98.8% 96.9%
Papworth 92.2-96.9% 97.4% 88.9-98.9% 97.7%
Plymouth Derriford 93.7-98.6% 98.2% 84.7-100% 95.8%
Royal Brompton 94.9-99.2% 99.3% 84.1-99.5% 98.2%
Sheffield Northern 93-98.3% 97.4% 83.9-100% 100%
Southampton Gen 88.9-97.2% 99.2% 79-100% 97.1%
Stoke North Staffs 94.5-98.6% 98.6% 81.4-100% 100%
Swansea Morriston n/a n/a n/a n/a
Wolverhampton New Cross 92.5-99.8% 97.7% 68.5-100% 100%
Source: Healthcare Commission (2004/5)




BBC NEWS: VIDEO AND AUDIO
What one heart patient thought of the performance list



SEE ALSO:
Q&A: Heart surgery data
27 Apr 06 |  Health
The hopes and fears of surgeons
27 Apr 06 |  Health
Death data 'cuts risky surgery'
14 Jan 05 |  Health
Heart op death rate 'improving'
11 Sep 04 |  Health


RELATED INTERNET LINKS:
The BBC is not responsible for the content of external internet sites


PRODUCTS AND SERVICES

Americas Africa Europe Middle East South Asia Asia Pacific