Heart Surgeons Reveal Death Rates

Over 200 heart surgeons have made their survival rates public, more than twice as many as when the publication scheme launched last year. Some 70% of UK surgeons now put their results on the Healthcare Commission watchdog website where they can be accessed by patients-to-be.

Data for 2005-2006 shows all 39 heart units have satisfactory survival rates. And that was after the data was put through an even more stringent testing method this year, the watchdog said.

This new model allows patients to view how units have performed against recent standards in the UK, as well as giving an idea of their performance against European standards. The figures cover the two most common heart procedures.

The survival rate for heart bypass operations – of which there were 20,773 such procedures last year – was 98.4%. Just over 98% of patients also survived the second most common heart procedure – aortic valve replacement surgery. This is a slight improvement on rates for the year previous.

Some 2.6 million people have heart disease, with more than 30,000 requiring surgery each year. The push to release data on outcomes followed the scandal at the Bristol Royal Infirmary in which surgeons with higher than average death rates continued to operate on children.

But while there has been much support for the publication of data on individual surgeons, some have opposed it, arguing that it would lead to more pressure for good results and consequently discourage doctors from operating on higher risk patients.

The watchdog has sought to alleviate these fears by using a testing method which takes into account factors such as patient’s age and severity of illness, in order to produce a risk-adjusted result that does not penalise surgeons who take on difficult cases.

However a spokesman at the commission also noted that the benefits of publishing individual data remained “open to debate”. “Successful surgery relies on a number of experts working together,” said David Burrows. But he said the fact that increasing number of individuals were releasing their results proved “many heart surgeons are on board and believe in what we are trying to do”.

The chairman of the Healthcare Commission, Sir Ian Kennedy, said it was time for other medical disciplines to follow suit and publish their data in an equally transparent way. “We’ve made a start with heart surgery; others should follow,” he said. “Our target must be to give greater information and confidence to any who have to undergo operations of any kind.”

Heart operation data is however seen as unusually easy to analyse as most surgery in this field consists of a handful of operations. All of these carry a risk of death and figures for the death rate are easy to collect.

But the NHS Confederation also said it hoped other specialisms would follow the lead. “By adopting this approach clinicians and trusts can continue to drive up standards,” said its chief executive, Dr Gill Morgan.