By Daily Mail Reporter
Last updated at 12:52 PM on 21st March 2011


  • Report found medical profession has tolerated poor practice due to misplaced sense of collegiality
Transparency: Heart surgeons say doctors in all fields should make mortality data public as it has been shown to boost survival rates

Transparency: Heart surgeons say doctors in all fields should make mortality data public as it has been shown to boost survival rates

The NHS needs to undergo a major culture change to drive up standards and save hundreds of lives, according to a new report.

Leading heart surgeons said other disciplines should follow their lead and collect the data on deaths and other treatment outcomes to give patients a clearer picture of where to go for the best results.

Cardiac specialists have been collecting mortality data since the Kennedy inquiry into the Bristol babies scandal in 2001. It found babies who died after heart surgery may have survived if a more skilled surgeon had been used.

This had led to a dramatic improvement in survival rates with a 50 per cent drop in death rates in the UK in recent years.

Experts agree making data available to the public on individual doctors does push up standards, but some medics have been reluctant to expose 'weak links' in the service, according to Sir Donald Irvine, former president of the General Medical Counci.

He wrote in the report: 'The generally good public standing of doctors has tended to obscure the fact that over a long period of time the profession, perversely, has been prepared to tolerate some very poor practice from a minority of its members through a misplaced sense of collegiality and dated ideas of professional autonomy.'

Ben Bridgewater, lead author of the report and consultant cardiac surgeon at the University Hospital of South Manchester, said change was necessary across the NHS.

'This data improves the quality of care for patients, and better quality care actually comes at a lower cost to the NHS.

'Society is also changing, people are looking for all sorts of information, and they will demand more of this type of information in the future.

'The profession needs to start responding to that in order to keep its level of trust with patients.'

He added: 'The NHS is littered with repeated failures of clinical governance and the medical profession must respond.

'Cardiac surgeons were forced to act after the Bristol inquiry and have subsequently proven that public accountability drives up standards of patient care while reducing costs as areas of substandard practice are resolved.'

Other information collected from heart surgery includes whether people stay too long in hospital, how many patients develop major wound infections, and the number of post-operative strokes.

In the future, data will include how many patients end up back in hospital after their operation.

As well as improvements in death rates, the data collected and analysed by surgeons has revealed that more than 99 per cent are performing at a satisfactory level.

The report said: 'We believe these improvements have been a result of intense scrutiny on mortality rates, which has forced the development of highly skilled and focused multi-disciplinary teams.'

The experts said such data collection had 'helped us to appreciate the need for a change in the culture of our professionalism, to try to see our surgery more through the patient's eyes, and so place the care of patients unequivocally first in everything we do'.

The report comes as Health Secretary Andrew Lansley announces 1.2 million of funding to improve data collection across the health service.

The study, Maintaining Patients' Trust: Modern Medical Professionalism, estimates that the cost of data collection for cardiac surgery in England is 1.5 million a year - 0.6 per cent of total spend on cardiac surgery.

But this has led to a 5 million saving in bed days for coronary artery bypass operations alone, the report said.

A 'traffic light system' also allows performance data for individual surgeons to be quickly analysed, allowing swift action if necessary.

Mr Lansley said: 'The publication of useful information goes to the heart of our modernisation plans.

'Cardiothoracic surgeons have led the way in demonstrating that a transparent NHS is a better and safer NHS.

'By opening up data and highlighting variation in standards, outcomes for patients needing cardiothoracic surgery have improved substantially. We would like to see many more areas using data to improve outcomes.'

Professor David Taggart, president of the Society for Cardiothoracic Surgery, said: 'I don't think there is a doctor in the land who hasn't at some time felt they could do a better job for their patients but were limited in influence by the system they worked in.

'Independently published data is the best tool we now have for empowering clinicians in persuading those running and commissioning health services to make quality improvements in care and quickly identify when a service is in trouble.'

John Black, president of the Royal College of Surgeons, said: 'Cardiac surgery has been the trailblazer in this field and what they have learned over the past decade is making it far easier for those following to get audits up and running quickly.'

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From this article's headline, I thought DM meant that spending too much time in late-night nightclubs was affecting doctors' performance.

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Surgeons are in a way similar to any tradesperson...there are good ones and cowboys...if you are the unlucky one......

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i am 75 years old and need hospital treatment but,after reading many reports about the way elderly people are left,i will not go anywhere near one,i will take my problems to the end of my days.

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Re: ....Mr Langley should get around to publishing some of his own department data, such as the survey showing record high satisfaction rates within the NHS as well. I think you are being cynical here, lol, :) I understand what you mean. There has been a tendency to promote rosy views of the NHS, I may be wrong but here Langley sounds genuinely interested in patient care. Patient care is so bad that I am desperately hoping that the re-organisation of the NHS will expose poor nursing and doctor care, as it is costly to the government in terms of litigation and disability care.

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Re:Im sorry but after 30 years of unfortunately having to attend hospital in three major town and city's, my experience is they do not check previous medical records, don't listen to what you say, give out far to many tablets and hope it might be the correct diagnosis. I know the odd good one's makes up for the rest, but agree standard's need to get better, soon. I agree with you entirely as you can see from my comments. Such care creates a nocebo effect and kills the patients and the NHS off. I hope we can expect better in our future care. It cannot get any worse. Things have to change.

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Sir Donald Irvine, former president of the General Medical Council. --- Does he know about the scandal at the hospital opposite parliament? This scandal had occurred even after the NHS had 'learned lessons' from 'Bristol inquiry' and 'shipman inquiry' even after I had quoted the fifth report of shipman inquiry in the court about the protection for the whistleblowers. From my experience as a whistleblower in the past 5 1/2 years it seems certain to me that these scandals will occur again and again and again in the NHS.

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