What if you could choose your surgeon based on survival rates of his previous patients.
Health Secretary Jeremy Hunt has confirmed the latest government initiative which will enable patients to compare the survival rates for different surgeons before they select who they wish to treat them.
It is believed that the release of such information, due in the summer, will mean that standards in the NHS are raised which, in turn, will help save lives.
A similar scheme which releases the survival rates for heart surgeons is said to have led to a significant improvement in the care and treatment given to patients.
Surgeons throughout England and Wales from 10 different specialties including vascular surgery and orthopaedic surgery will have their survival rates published and patients will then be able to select who they wish to treat them based on those rates.
It is intended that the scheme will be rolled out across many other areas of NHS care in due course, meaning a patient may eventually be able to chose which GP will offer them the best care and treatment.
It is further believed that if there is more transparency in the NHS, this will ultimately lead to more effective healthcare being offered, with better outcomes, greater accountability and efficiency resulting from this.
It cannot be denied that knowing openly about a surgeon’s competencies can offer benefits to patients. We only have to look at the case of Dr Robert Jones, who worked at the Royal Cornwall Hospital to see an example of this. Concerns had been raised about his clinical competency since 2000 and eight reviews had been carried out into his work before he was eventually suspended. Perhaps if people had been made aware of this, they would not have chosen to be treated by him and concerns would have been raised much sooner than they were.
Furthermore, surely having negative results published will force more surgeons to improve the standard of care that they offer? After all, a bad reputation is often hard to leave behind.
But what about the negative impact that this new initiative may have? Many questions must be asked about the effect of this scheme on the day-to-day management of the NHS and the impact that it could have on both the surgeons and their patients.
For example, if a patient is a high risk surgical candidate, possibly either due to respiratory concerns, obesity or a pre-morbid condition, will this make the surgeon less eager to treat them? If there is a risk that a patient may die after surgery, is there a chance that a surgeon would not want to take that risk merely because it could affect his published survival rates. The patient could then be denied surgery based not on any clinical reason, but on a surgeon’s need to improve his statistics.
We would hope that no surgeon would refuse to treat solely on the impact it could have on his reputation but perhaps it is an issue that needs to be considered further?
And what if a surgeon with a high survival rate becomes ‘popular’ with patients who all want him to manage their care. Will he then have to decline to treat certain patients simply due to lack of available time he has in surgery? Or will patients have to choose between either being treated by a surgeon with a less successful survival rate or waiting longer for their surgery so that they can be treated by their choice of surgeon? Could this impact on their overall treatment and recovery?
Also, if a patient dies following surgery, should that be solely attributed only to the surgeon or should we look at all aspects of the patient’s care? It could be that the surgery was carried out perfectly well, but due to a lack of facilities the patient developed post-operative complications. Should that affect the surgeons rates when, for all intents and purposes, his actions were not the driving factor in the patient’s death? Perhaps the scheme should be rolled out throughout the NHS, to include nurses, clinicians and Consultants?
At present, everything is a gamble. We don’t know how successful our surgeons have been at treating their patients. But instead, we simply go ahead with the surgery on the understanding that your surgeon is competent in his area of expertise. That is, of course, until something goes horrifically wrong.
Clearly, the success of this new government initiative can only be measured when the scheme is rolled out this summer. However, it cannot be denied that any scheme which forces surgeons to deliver a better standard of care can only be a positive step in raising standards within the NHS.
If you would like further information or think that you may have been the victim of negligent surgical care please call Suzanne Gallagher on 0207 880 4407.