- Stephen Westaby warns against releasing individual surgeons’ death rates
- Publication of data ‘shifts emphasis from patient care to self preservation’
- In June 2013, officials launched first ‘performance outcomes’ for doctors
- Information aims to show patients how well medics perform against peers
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Warning: Publishing individual surgeons’ death rates could lead to doctors turning away ‘high-risk’ cases, according to Stephen Westaby (pictured)
Publishing individual surgeons’ death rates could lead to doctors turning away ‘high-risk’ cases, according to a heart surgeon.
Stephen Westaby says that giving the public access to such data shifts the emphasis from ‘patient care to self preservation’.
In June last year, health officials launched the first ‘performance outcomes’ for doctors.
The information – central to Government plans for a more transparent NHS – aims to show patients how well consultants working in a number of specialities across England perform against their peers.
Patients can see the number of times a consultant has carried out a procedure, their mortality rates and whether or not they are performing within the ‘expected range’.
The initiative aims to ‘shine a light on variation and unacceptable practice’, NHS officials said at the time.
But writing in the British Medical Journal, Professor Westaby, a consultant cardiac surgeon at the John Radcliffe Hospital in Oxford, argues that most deaths are related to ‘team dynamics’ and hospital infrastructure rather than the competence of individual surgeons.
‘To the public, surgeon-specific mortality data (SSMD) reflect surgeons’ technical competence,’ he says.
‘Yet in reality team consistency and operating theatre practice supersede individual performance. Publication of SSMD diverts attention from deficiencies in NHS infrastructure.
‘An
understanding of why patients die allows something to be done about it;
attributing a pile of bodies to an individual surgeon does not.’
Publishing mortality data ‘has not improved patient choice, waiting lists, equipment, staffing or team consistency,’ he says.
Professor Westaby says that soon after surgeons’ death rates were published in parts of the US in the 1980s ‘risk-averse behaviour’ was ‘widely documented’.
He adds: ‘The answer was to avoid high-risk patients.’
Surgery: In June last year, health officials launched the first ‘performance outcomes’ for doctors (file picture)
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