Keywords
Citation
(2013), "England - Surgeons can opt out of NHS tables rating their performance", International Journal of Health Care Quality Assurance, Vol. 26 No. 8. https://doi.org/10.1108/IJHCQA.06226haa.008
Publisher
:Emerald Group Publishing Limited
England - Surgeons can opt out of NHS tables rating their performance
Article Type:
News and views
From:
International Journal of Health Care Quality Assurance, Volume 26, Issue 8
Keywords: Performance management for surgeons, NHS league tables and publication of date, Patient choice and healthcare forum
NHS England has conceded that consultants can legally refuse to hand over performance data.
The value of the NHS league table for surgeons has been cast into doubt after it emerged that consultants can opt out of the system that rates their individual performance.
NHS England conceded that consultants could legally refuse to hand over performance data, including how many people die in their operating theatres, under the Data Protection Act.
About 4 per cent of consultants across the country have opted out of providing performance data to the league tables due to be published by all NHS trusts..
The new ratings system was heralded last year as a “revolution for patients by the NHS commissioning board, the new independent quango in charge of the health service.
The league tables are supposed to cover consultant-level data for survival rates and quality of care in 10 specialities including cardiac, vascular and orthopaedic surgery, measured against national standards, and what their patients say about them.
A spokeswoman for NHS England said: “Around 96 per cent of consultants across 10 specialities who have responded have opted in to the publication of data about their performance, which patients should have the right to see.
“We urge all consultants to think very carefully about the effect on their patients and their colleagues if they choose to opt out on the basis of legislation designed to protect personal data.
The spokeswoman added that the new performance rankings heralded “a new level of openness. But she added: “There is some way to go before the NHS is as transparent as it should be.
The reform is also seen by Government ministers as key to driving patient choice in the NHS, although doctors have been resistant to such changes in the past. Only after the outcry from the Bristol childrens heart surgery scandal and years of campaigning did surgeons make public their survival rates for heart bypass operations and aortic valve replacement surgery.
The NHS England spokeswoman said she was optimistic that those surgeons who had opted out of the new league tables would change their minds. “The experience with the publication of cardiac data strongly suggests that consultant surgeons who do feel uncomfortable quickly come on board when they see the enormous benefits publication brings to their patients and to themselves, she said.
A Department of Health spokesman said: “If there are legal grounds for individual doctors opting out, any patient and their family would be entitled to ask why and may prefer their operation to be carried out by someone who was prepared to be fully transparent.
The first of the new ratings of consultants will be published by the University Hospital of South Manchester. It will begin by publishing data on its cardiologists and cardiothoracic surgeons before extending the rankings.
UHSM cardiac surgeon Ben Bridgewater said: “Most doctors have always welcomed transparency. The problem in the past has been about credibly and fairly producing the metrics and reporting them in real time so doctors, and now patients, can review performance.
“In cardiac and thoracic surgery, we surgeons have been pushing for weaknesses to be improved so that we can give our patients the best possible service and outcome. After all, at the end of the day its our names above the bed.
Dr Paul Flynn, chair of the British Medical Associations consultants committee, said: ““Publishing data for individual consultants is complex. Some consultants may take on higher-risk cases that would lead to raised mortality rates. Some patients will have multiple health problems which can increase the likelihood of complications.
“It is critical that any information provided is accurate and in context. If not, it will be misleading and cause unnecessary anxiety to patients.
For more information: http://www.guardian.co.uk