NHS surgeons with the highest death rates named

NHS surgeons with the highest death rates named


Several hospitals said the mortality rates of their surgeons fell within the expected range when risk factors such as complexity of a patient’s health and age were taken into account. One surgeon’s figures reveal that nearly one in three people he treated for a particular type of operation ended up dying.


The data, which relates to doctors who perform vascular surgery, involving blood vessels, is due to be published on an NHS website today. It shows only the rates of more than 450 surgeons who have agreed to have their data made public. Six surgeons refused, leading to suggestions that their death rates may be even higher.


Jeremy Hunt, the Health Secretary, hailed the publication of the data as “a revolution in transparency in the NHS”. “Publishing this data will not only drive better care for patients, it could literally save lives,” he said.


Prof Sir Bruce Keogh, national medical director of NHS England, added: “Putting this information into the public domain can help drive up standards. That means more patients surviving operations.” Prof Norman Williams, president of the Royal College of Surgeons, hailed “an historic moment for surgery”. The information published today will be followed by data on a further 3,500 surgeons carrying out nine specialties in coming days and weeks on the NHS Choices website.

But a number of surgeons have refused to give consent for their mortality rates to be published. The names of those doctors will eventually be published


Doctors welcomed the data but pointed out that those who appeared to have the worst outcomes might be taking on high-risk cases that others turned down. The first figures published will cover 458 vascular surgeons who carried out operations on more than 21,000 NHS patients in the five years ending last December. Just six such surgeons refused consent to publish the data.


Their patients underwent planned surgery for an infrarenal abdominal aortic aneurism (AAA) — a life-threatening condition where a bulge forms in the main blood vessel leading from the heart to the lower half of the body. It can be fatal if it ruptures. The condition most commonly occurs in those aged 65 and over.


The average mortality rate for patients following surgery was 2.2 per cent — but some surgeons had rates up to 14 times higher. The highest mortality rate was for Simon Payne, a surgeon at Portsmouth Hospitals NHS Trust. His death rate was 31.3 per cent based on 16 operations. At Sherwood Forest Hospitals NHS Foundation Trust Irfan Akhtar had a rate of 22 per cent after performing nine procedures.


At Sheffield Teaching Hospitals NHS Foundation Trust, Philip Chan had a rate of 18.2 per cent, after carrying out 11 operations. At City Hospitals Sunderland NHS Foundation Trust, Ben Banerjee had a rate of 14.3 per cent after 7 operations. The doctors on the list carried out an average of 32 operations in a year. Many of the highest mortality rates were among surgeons carrying out fewer than 20.


Surgeons with the highest mortality rates said they could be branded as poor when in fact they were taking on the most high-risk cases. Prof Julian Scott, president of the Vascular Society, said: “Some are conducting extremely difficult surgery on very sick people so will have relatively high mortality rates.”


The Vascular Society said that when the data was risk-adjusted, with numbers of procedures taken into account, no surgeon had outcomes which differed from the national average “by more than would be expected from random fluctuations”.


The Sherwood Forest trust said it no longer carried out the procedures. It said the apparently high mortality rates reflected the small numbers of patients operated on, all of whom had complex procedures. The Portsmouth trust said it has a mortality rate of zero per cent for aneurysm surgery over the past year. A spokesman said Mr Payne should not have been included, because he stopped carrying out such surgery in 2011.


The Sheffield trust said the report made clear that all its surgeons’ mortality rates fell within the expected range when risk factors were taken into account.


The Sunderland trust said surgeons had widely different patient numbers and populations to deal with — some more healthy than others.




By Laura Donnelly


The Telegraph, 28th June 2013









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