Surgeons' mortality rates are meaningless, say patient groups

Surgeons have been criticised by patients’ groups for the “meaningless” way in which they have released statistics about death rates following operations. 

Figures revealing the number of operations performed by 3,500 NHS surgeons over a three-year period, and subsequent death rates, are being released by their 10 professional specialist organisations

The data were meant to allow the public to make choices about their care. But campaigners said the information was too poorly presented to be useful to patients hoping to compare surgeons before undergoing treatment.

Figures revealing the number of operations performed by 3,500 NHS surgeons over a three-year period, and subsequent death rates, are being released by their 10 professional specialist organisations. The way the statistics are presented has been left up to the individual societies.

The first three sets of data to have been released so far have each been made available in different formats, with the latest, from the British Association of Endocrine and Thyroid Surgeons, requiring patients to know the name of surgeons before they can access the figures.

The statistics revealed that the average mortality rate among the country’s 125 thyroid surgeons was 0.1 per cent. Six surgeons did not provide data because they could not be contacted. But David Chadwick, who led the audit for the association, said the data would not give a complete picture of all thyroid surgery, as not all those carrying out such operations would be members of the organisation.

He defended the way the association had presented the data, saying patients could search by surgeon name or by hospital to see how they compared with other anonymised data. But it was not possible to compare all the surgeons at once, he said.

Campaigners who have been pushing for the release of mortality data expressed concerns following publication of figures by the British Cardiothoracic Society of Great Britain. Katherine Murphy, chief executive of the Patients’ Association, said the way the information was released did not fit with government promises to allow the public to make informed choices for elective surgery.

“The only reason for publishing this information should be so the public can use it,” she said. “Otherwise it is meaningless. Unless it is presented in a way that is meaningful, easily accessible and somewhere the public can find the information, rather than it being buried away, then patients are never going to have confidence in the information, and that the NHS is being more transparent. The public need to be able to use this information in the way they want, which is to choose one consultant over another.”

Some experts have raised concerns about the quality of the data made public so far, fearing that the release of raw mortality figures, as was done for vascular surgeons last week, could damage patient confidence. They argue that the figures must be adjusted to reflect the complexity of cases being taken on by surgeons, the age groups they treat and the performance of junior surgeons working as part of consultants’ teams.

Professor Sir Brian Jarman, who runs the Dr Foster Intelligence Unit at Imperial College London, said: “It has got to be done correctly, otherwise the information will get a bad name. It has got to be remembered that this is data for a consultant unit, so in many cases junior surgeons might be doing quite a lot of the work for training purposes. There is an enormous variation of case mix and if you don’t adjust for that then you discredit the whole system.”

Twenty surgeons nationwide have refused to have their figures published.