Hospital Dr News

Surgeons call for improved data collection

Patients are being denied access to real choice in treatment because the medical profession and NHS are dragging their feet on providing reliable, independent and accessible information, says the Society for Cardiothoracic Surgery.

A report by the society, called Maintaining patients’ trust: modern medical professionalism, says data collection improves patient care and the practice of clinical outcome measurement is good value for money.

Access to reliable information protects and informs patients by explaining variance and preventing poor practice. Public reporting at hospital and individual surgeon level has resulted in a 50% improvement in risk adjusted mortality rates for cardiac surgery and has demonstrated that over 99% of cardiac surgeons are performing at a satisfactory level, the report says.

Despite the costs of data collection for cardiac surgery in England being £1.5m per annum, the report says resultant quality improvements have saved £5m in bed days for coronary artery bypass operations alone.

The society is urging the Department of Health to dramatically increase the tiny budget currently allocated to supporting clinical audits to enable more associations to follow suit.

The report also criticises the current approach to CPD saying this remains “vaguely defined and loosely organised”. Demonstrating effective CPD is important to continue to maintain the trust of patients, it says, and all surgeons should undergo an online education and assessment programme to ensure that CPD is up to date and relevant to current practise.

Mr Ben Bridgewater, lead author of the report and consultant cardiac surgeon at the University Hospital of South Manchester, said: “The NHS is littered with repeated failures of clinical governance and the medical profession must respond. Cardiac surgeons were forced to act after the Bristol inquiry and have subsequently proven that public accountability drives up standards of patient care while reducing costs as areas of substandard practice are resolved.

“Giving access to appropriate information will reassure the public and allow patients to make informed decisions about their care, but currently the NHS and the medical profession are failing to deliver.”

Responding to the report, health secretary Andrew Lansley said: “Cardiothoracic surgeons have led the way in demonstrating that a transparent NHS is a better and safer NHS. By opening up data and highlighting variation in standards, outcomes for patients needing cardio-thoracic surgery have improved substantially. We would like to see many more areas using data to improve outcomes. That’s why over the next year, we’ll make another £1.2 million available for more clinical audits, to provide more data to help us drive up clinical standards.”

The internet is rapidly changing public perceptions of access to information, and the report argues that medicine risks being left behind and losing trust if it doesn’t rise to meet this challenge. The society says that medicine needs to learn from broader consumer behaviour and take a more active role in the ‘information revolution’.

Professor David Taggart, the society’s president, said: “I don’t think there is a doctor in the land who hasn’t at some time felt they could do a better job for their patients but were limited in influence by the system they worked in. Independently published data is the best tool we now have for empowering clinicians in persuading those running and commissioning health services to make quality improvements in care and quickly identify when a service is in trouble. Nothing stimulates change like clear comparable and publicly accessible evidence.”

Along with the society’s findings, the report includes external contributions from Picker Institute Europe, an NHS Trust CEO, Deloitte UK and Sir Donald Irvine, a former president of GMC.

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