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NHS Plans for Surgeon League Tables

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18 Dec 2012

On 6 December 2012, the BBC reported that the NHS medical director in England plans to publish individual surgeons' results within two years. This was followed by an article on 18 December 2012, stating that performance data on individual surgeons should start being published from next summer.

Sir Bruce Keogh believes this will force clinicians to focus on their performance and seek help when surgical practice falls below acceptable standards.

The Health Secretary Jeremy Hunt fully supports the plan to publish individual surgeons' results.

Responding to this, President of The Royal College of Surgeons of Edinburgh, Mr Ian Ritchie said:

IanRitchie"The Royal College of Surgeons of Edinburgh fully supports transparency in relation to surgical outcomes. However, while we fully endorse moves to identify and address poor surgical performance, we are concerned that any attempt to publish individual surgeons' results in a form that can be interpreted easily, is fraught with difficulty. 

"With over 19,000 Fellows and Members in some 100 countries across the world and with over 40% of our membership in England, the College is well placed to understand the issues involved in Sir Bruce Keogh's plan to establish a surgeons' league table in England.  

"Within surgical specialties, there is a significant variance in the procedures performed and, depending on the nature and complexity of a procedure, a marked difference in the potential outcomes.  The College therefore believes that if individual surgeons' results are to be made public they must be carefully risk adjusted so that surgeons are not deterred from operating on sick patients, where surgery is in their best interests, even if there is a much greater risk of morbidity or even mortality.

"Developing better ways to measure and publish outcomes, and offering support in investigating and resolving problems, are areas in which The Royal College of Surgeons of Edinburgh is keenly interested. Indeed, we are in the early stages of discussions with stakeholder groups as to how we can best support these areas. The College therefore welcomes Sir Bruce Keogh's commitment to patient safety and transparency within surgery; however we have to question whether a surgeons' league table is indeed the best method through which to achieve this important aim."

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