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Choice of hospital and surgical death-rates

April 17, 2011

‘Significant’ variation in death rates after bowel and rectal cancer surgery among hospitals in England.

The 30 day survival rate after bowel/rectal cancer surgery varies considerably among hospital trusts in England, even after taking account of factors likely to influence the risk of death, according to research published online in the journal Gut.

Doctors and other health-professionals will know what this means – choose your hospital and surgeon very, very carefully. They also know that the same variation applies across most of the NHS, for both hospitals and general practice and that it is often literally a matter of life and death. Of course it is much easier for those on the inside to find out where the great care is, and which places they’d never choose for themselves or their families.
A central part of Andrew Lansley’s changes for the NHS is transparency and publishing of information to expose variations in quality – both clinical outcomes and patient experience – to everyone and in a way that really empowers choice. Whilst this has been somewhat lost in the current shouting match about the role of GPs as commissioners, it is probably the most significant part of the Health Bill. What it means is that patients will be able to look at a list of all hospitals and surgeons who could operate on their cancer, see the risk of dying for each location and read what other patients have said about the surgeon and her team. Once that happens (and it will) concerns about who commissions care will be of far less importance – as patients, healthcare charities and the media will be able to rigorously hold to account both the providers of care and those who commission it.

…one trust had consistently significantly better outcomes and three had significantly worse outcomes than the population mean.

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