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Surgeons' death rates published

Performance data for around 5,000 surgeons revealing how many patients have died in their care over the past year will be made public by NHS England today.

The league tables were launched for the first time last year but have been extended to cover 13 surgery areas and an extra 1,000 consultant surgeons for 2014.

The data will show the mortality rate of patients who have undergone a specific operation, such as cardiac surgery, under an individual doctor and whether they are within expected limits.

NHS England said the mortality rates for "almost all surgeons" are "within the expected range".

The data is being published on new website MyNHS where patients can compare critical data about hospitals and the professionals who will be treating them.

In a speech today, Health Secretary Jeremy Hunt is expected to say: "Transparency is about patient outcomes, not process targets. It uses the power of a learning culture and of peer review, not blame.

"Healthcare globally has been slow to develop the kind of safety culture based on openness and transparency that has become normal in the airline, oil and nuclear industries. The NHS is now blazing a trail across the world as the first major health economy to adopt this kind of culture."

NHS England's medical director Professor Sir Bruce Keogh who has championed better transparency in the NHS, said the website will help to drive up standards.

"This represents another major step forward on the transparency journey," he said.

"It will help drive up standards, and we are committed to expanding publication into other areas.

"The results demonstrate that surgery in this country is as good as anywhere in the western world and, in some specialities, it is better.

"The surgical community in this country deserves a great deal of credit for being a world leader in this area."

At the weekend Sir Bruce said penalties will be enforced against hospital consultants who refuse to publish patient death rates, with around 2,500 believed to not be taking part in the initiative.

He told the Sunday Times said: "We are looking now at a series of inducements, penalties to force that (publishing death rates)."

He added: "We will lose some surgeons. We will, and have as a consequence of this endeavour."

But critics said the move to publish surgeon's performance data is "crude and misleading".

John MacFie, president of the Federation of Surgical Speciality Associations, which represents surgeons, said: "There is now good anecdotal evidence that shows publishing this data has encouraged risk-averse behaviour, which is not in the interest of patients.

"I believe that the data should only be published after any concerns in a surgeon's performance have been investigated.

"In reality very few deaths can be attributed to surgical error alone, and this data only attracts attention away from institutional failings. Put simply, hospitals should not be allowing surgeons to practice unless they can demonstrate their practice is safe."

Work to compile the data has again been led by the Healthcare Quality Improvement Partnership (HQIP), which manages the National Clinical Audit programme on behalf of NHS England.

The website will go live today and the public will be able to access the 'consultant outcomes data' from 6am.

Reacting to the MyNHS launch, Katherine Murphy, chief executive of the Patients Association, said: " We welcome the openness, transparency and the commitment of the Secretary of State for Health to publish data on health and social care performance.

"We hope that the drive to publish data in 2015 for long-awaited clinical outcomes for all specialties will be seen through. This will go a long way to giving patients and the public the information that they desperately need in order to make informed, empowered decisions about where they go for care and treatment.

"Hopefully to follow quickly afterwards will be performance information on individual hospital wards, departments, consultants and teams. Once this data is out in the open, we can be hopeful that standards and access to services will improve."

Responding to criticism, Sir Bruce told BBC Breakfast: "The publication of these results is simply the end result of a long process. Surgeons individually agonise over how they can do better, they agonise when things go wrong.

"They share their performances with colleagues at case conferences, particularly where they've had difficulties, they have annual appraisals at their hospital where they discuss how they're performing, so we have a number of mechanisms in place that precede publication.

"I think you've got to start somewhere so at this stage the figures are in many cases relatively crude but it's better to start somewhere and improve them."

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