Healthcare ratings explained
We have access to more information on NHS performance than ever, and now it’s easy to look up your surgeon or GP practice, reports Sarah Brealey.
If you’re having surgery or a procedure, you’ll probably want to gather as much information as possible beforehand. Finding data on your consultant and hospital hasn’t always been easy, though.
Heart surgeons were the first to publish their performance data, in a move pioneered by Sir Bruce Keogh, but it could still prove difficult to sift through. This data has now been compiled in a patient-friendly format, available on the My NHS website. It extends to 12 other specialisms, including interventional cardiology (such as angioplasty) and vascular surgery (such as abdominal aortic aneurysm repair).
Publishing these figures, which include a rating of consultant performance, including their patient mortality rate and how many times they’ve done a particular procedure, “can help drive up standards [which] means more patients surviving operations,” said Sir Bruce, who is Medical Director of NHS England, and a former cardiac surgeon and President of the Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS).
When the initial figures on 5,000 consultants were published, only three were “outside the expected range based on the national average” (NHS England calls these ‘outliers’).
I think it will give reassurance to patients
Professor Peter Weissberg
However, the figures shouldn’t be treated as a ‘league table’. “This is good for openness, for transparency, and it will help to drive up standards,” said Mike Knapton, our Associate Medical Director and a GP in Cambridge. “It’s a useful tool as long as it’s interpreted in the right way – it wouldn’t be correct to view these figures as a league table of the best and worst.”
The available data is risk-adjusted – in other words, it takes into account factors such as the age of each patient and how unwell they were to begin with.
The My NHS tool is a measure you can use to help you choose. When you are referred by your GP to a specialist, you have the legal right to choose which hospital to go to for your first outpatient appointment and which consultant-led team will be in charge of your treatment. Information on hospital quality has also been published on My NHS.
Benefits of transparency
The BHF welcomes the move. Professor Peter Weissberg, the BHF’s Medical Director and Honorary Consultant Cardiologist to Addenbrooke’s Hospital, said: “What this shows is that there is a high standard across the NHS. In that way, I think it will give reassurance to patients.”
Although the My NHS site only covers England, in some cases you can find data for other parts of the UK. Heart surgeon data comes from the SCTS, and you can access UK-wide data for individual surgeons at its website.
Stewart Craig, Cardiothoracic Surgeon at the Golden Jubilee National Hospital in Scotland, is one of those whose figures are available through the SCTS website. “There is lots of information out there for people to see,” he says. “I think people will feel reassured when they see the data.”
The publication has also been welcomed by the Royal College of Surgeons. However, in January, the SCTS wrote to NHS England expressing the concerns of some of its members, that publication “results in risk-averse behaviour”. Surgeons may be less willing to operate on patients with a higher risk of death, for fear of damaging their ratings, regardless of whether the operation could be of overall benefit to the patient.
The SCTS says it does not want to change anything straight away or scrap all individual data. It suggests instead that people should be presented with a whole department’s data first, with an explanation of how it works as a team, before a breakdown of the individual surgeon’s results are revealed.
GP surgeries compared
Patients in England can compare GP surgeries for the first time, thanks to data published by the Care Quality Commission (CQC). Surgeries are put into one of six bands. The majority of England’s 7,661 practices are in the lowest-risk category (Band 6), but 11 per cent have been rated as highest risk (Band 1), based on the proportion of measures where the practice scores badly.
The 37 measures cover a wide range of issues, and some are based on the national GP patient survey, including the proportion of patients who said they were happy with the practice and how easy it was to get an appointment. Others include proportion of eligible patients receiving a flu vaccine, the proportion of patients with atrial fibrillation on medication to reduce risk of stroke, and dementia diagnosis rates.
The CQC says GP data is not a judgement but a way to prioritise surgery inspections, which then provide a fuller picture. Elevated risk “does not necessarily mean that people using the practice are at risk”. If you’re concerned about your practice’s rating, there is more information in the individual practice reports, or you can chat to your GP.
How to use My NHS
Go to My NHS website. From the eight options, click on the area you’re interested in, such as ‘Consultants’.
Although the consultant data was launched back in November, the My NHS site is still in development (beta) and it’s not always obvious how to get the best results from it. It helps if you’re familiar with medical terms for specialties, as these aren’t always explained.
In some areas, such as interventional cardiology, a large number of consultants are listed as “data not available” (though there is an option to exclude these from your search). This may be because the procedures done by a consultant are not covered by the national clinical audit for that specialty (all the My NHS data comes from existing national clinical audits).
Alternatively, if they haven’t carried out many procedures, data will be excluded, as it may not be reliable. If you’re interested in a specific consultant, you can type in their name without a location. You can search for either their surname or first name, but it must not be abbreviated. For example, ‘Andrew Parry’ will bring up a result, whereas ‘Andy Parry’ does not. You should leave out any additional titles, such as Professor.
The location search isn’t perfect. For example, type ‘London’ in the location box and you’ll see London Fields in the West Midlands, London Minstead in Hampshire, but only one option in the capital – the postcode EC3M. But select it, and you’ll see results for most London hospitals.