Saturday, 10 September 2011


Is this video, from Consumer Reports in the USA, a vision of the future for the UK? I suppose it should be - you just cannot argue against it. The Bristol Heart Surgery scandal and the endeavours of Sarah Boseley at the Guardian led to the eventual publication of individual surgeons' results. Today however, 6 years after the first publication of institutional results and the efforts of the then President of the Society of CT surgeons and the current medical director of the NHS, Sir Bruce Keogh, we are no further forward.

The Care Quality Commission is to stop hosting the survival outcomes for British Heart surgery on its website. The results on the website are now 2 and abit years out of date. No other surgical specialty publishes any outcomes routinely.  The only outcome measured by centres and collated by the Society of Cardiothoracic Surgery of Great Britain and Ireland is still only death despite the fact that a devastating stroke is a recognised complication of heart surgery.  I personally would prefer the publication of the results of institutions rather than those of individual surgeons. So many outcomes are dependant on the efforts of a team - system failures are often the cause of poor outcomes - see MidStaffs.
Maybe the lack of progress is not surprising. Publication of outcomes is only meaningful if there is a genuine opportunity for patients to choose easily between institutions. Vested interests against competition and a democratic deficit ensure that the situation is unlikely to change any soon.