Consultant Outcomes Publication Anieakan Assangha, NHS Choices 12 May 2015

The story so far Bristol public inquiry report 2001 Named hospital cardiac surgery mortality publication 2005 Individual cardiac surgeon data publication 2013 2014/15 Publication of consultant outcomes data from 10 specialties, linked from NHS Choices to specialty association websites Publication of consultant outcomes data from 12 specialties on NHS Choices and MyNHS Consultant directory launched on NHS Choices 2007 NHS Choices launch MyNHS launch Has the publication of cardiac surgery outcome data been associated with changes in practice in northwest England: an analysis of 25730 patients undergoing CABG surgery under 30 surgeons over eight years

MyNHS (www.nhs.uk/mynhs) NHS Choices (www.nhs.uk) Comprehensive general health and social care information and data about conditions, treatments and services Aimed at those with direct or indirect health or care needs in England Vision to transform NHS Choices A single place where health and care organisations and the public can compare the performance of services Aimed at informed patients and service users, providers, commissioners Led by Department of Health and partners into a modern digital service that is user-centred, outcomes-focused and creates value and impact for the health and care system

NHS Choices Audience NHS Choices is Europe’s largest health site receiving and average of 42 million visits per month NHS Choices presentation is primary focussed on users on choice journey/ information seeking. For example, 400,000 visits per month to Hospital departments and services pages The site (which is a Beta site and therefore by definition a test site which will evolve following feedback) as a whole,   

My NHS Audience 133,000 consultant searches 19/11/14 to 15/02/15 Dec 2014 Jan 2015 133,000 consultant searches 19/11/14 to 15/02/15

Principles of presentation Tried and tested mode of presentation (Kings Fund research, Choices user testing) Allows audience to easily access, understand and compare complex information Ability to refer people onto the primary publication easily – embedded links, links at bottom of page

Choice audience – information categories

Choice user journey   Information on choice and consultants is available for users http://www.nhs.uk/choiceintheNHS/Yourchoices/consultant-choice/Pages/choosing-a-consultant.aspx A user looking for a consultant using our on site directory http://www.nhs.uk/Service-Search/Hospital/LocationSearch/7/Consultants A user looking for a consultant using google -  would be directed to http://www.nhs.uk/Services/hospitals/Services/Service/Team/DefaultView.aspx?id=194963   A user looking for information on a specific specialty e.g. http://www.nhs.uk/Service-Search/Orthopaedics/London/Results/14/-0.085/51.511/728/13136?distance=25

What users want to know Users were presented with a scenario which involved a hypothetical referral to see a consultant. Broadly, prioritised by number of mentions, here is what they would like to know if making a choice: More mentions Qualifications/where they studied/trained Proximity/location/where they practise Patient experience/feedback Experience (number of procedures performed, years practising) Track record/success rates Role/speciality Waiting times Fitness to practice (any disciplinary issues) Gender Photo (want to see) Biog Hospital rating/reputation of institution Fewer mentions Mentioned by individual users: Consultant name, languages spoken, areas of interest, performance in context (comparison), personal interests, surgery times, contact details, case studies   1 2 3 4 5 6 7 8 9 10 11 Title Proximity/location/Where they practise Qualifications/where they studied/trained Experience (inc number of procedures performed, years practising) Patient experience/feedback Track record/success rates Waiting times Role/speciality Hospital rating/Reputation of hospital Fitness to practice Photo Biog Consultant name Language spoken Areas of interest To be able to compare Personal interests Surgery times Contact details Case studies Gender

Public and patient participation and website feedback Three main categories: Requests for further information on published data ‘Would like to see data on whether procedure was emergency or elective’ Requests for more specialties ‘Would like to see data about non-surgical consultant outcomes’ Functionality/ general queries ‘Would like detailed information about when new scorecards will be published; not just coming soon’ Additional data topics Would like to see data about complaints made by patient, relative or advocate Would like to see data on whether procedure was emergency or elective Would like to see PROMs - whether the patient believes the procedure has benefitted them Would like to see same level of information on MyNHS as speciality websites Would like to see data about type of procedure/surgery Would like to see time to discharge from hospital Would like to see 2 week re-admittance rates Would like to see incontinence and erectile function rates post surgery Complexity of operations Would like to see data about number of misdiagnoses Would like to see rate of all adverse outcomes including incomplete removals or recurrence of the cancer Would like to see averages for alternative treatments New scorecards Would like to see data about ophthalmic consultants Would like to see data on spinal surgical outcomes Would like to see data about gynaecology to support patient choice Would like detailed information about when new scorecards will be published - not just "coming soon" Would like to see data about angioplasty Would like to see data about non-surgical consultant outcomes Would like to see data about neo-natal consultants Would like to see data about prostatectomies Would like to see data about foot operations Independent sector Does data include independent sector and if so, how is this data captured? Does the data only account for NHS activity only or does it include PMI or self-pay activity? Mortality How does this data convey whether patients have chosen to die with dignity in hospitals under care of surgeon? Consultant search Unable to find consultant by name Unable to find data by location and name Location search and name search do not yield the same results Would like location search to display consultants working in a particular hopsital only Indicator description Would like to understand whether the consultant performed the procedure or whether they oversaw other individuals who carried out the procedure Missing consultants If consultant has chosen not to have their data displayed, this should be indicated on the site Additional professionals Would like to see data about registrars, locums and hospital grade physicians included

Consultant profile Users expect to see a Consultant CV/profile page – something that appears comprehensive, authoritative and reassuring “Area of text explaining who they are, what they've done, background info, specialty. Hobbies and interests.” “Picture if they were willing.” “Text explaining career path.” User stumbled across UCLH’s profile page for Dr Johan Witt in the symptom scenario. This type of profile page received fairly positive feedback: https://www.uclh.nhs.uk/OurServices/Consultants/Pages/MrJohanWitt.aspx “Something like the BACP website.” “Photo, biog describing himself.” ‘Find a therapist’ on the BACP website, powered by: http://www.itsgoodtotalk.org.uk/therapists/in/1d17b5/london-south-east/london/kenneth-currie