1. Promoting quality for better health services Surgeon-level outcomes Where next? Ben Bridgewater HQIP Director of Outcomes Publication Rebecca Cosgriff HQIP Outcomes Publication Project Manager

2. Outline Background Looking ahead Group discussion

3. Background In December 2012 NHS England asked HQIP to manage the publication of procedure numbers and survival rates from ten national clinical audits by summer 2013 Time from Outcomes Publication team appointment to publication = 3 months!

4. Background Adult cardiac surgeryOrthopaedic surgery Bariatric surgeryThyroid and Endocrine surgery Colorectal surgeryUpper gastro-intestinal surgery Head and Neck surgeryUrological surgery Interventional cardiologyVascular surgery The ten specialties

5. Publishing consultant data: Aims Improve the quality of care Help patients make informed decisions Improve monitoring and governance Reassure that the standard of clinical practice is being actively monitored Provide evidence for Revalidation

6. Case study Hawthorne Works electric factory wanted to know if workers performed better with higher or lower levels of light What do you think happened when the factory lights were turned up? What do you think happened when the factory lights were turned down?

7. Case study ActionResult Lights turned upProductivity improved Lights turned downProductivity improved Experiment endsProductivity returns to normal The act of measuring results independently triggered an increase in productivity (The Hawthorne Effect)

8. Challenges Timescales Professional buy-in (consultant vs. team) Dataset issues (e.g. No GMC code) Validation Risk adjustment Presentation format Communications Multiple stakeholders

9. Consent Legal advice = Best practice to seek consent ~3,500 consultants in total High response/consent rate brings public interest clause into effect Outcome –82% response rate with >99% of respondents consenting –21 non consenting names and rationale published on NHS Choices

10. Publishing consultant-level data All ten audits have now published Hub page: www.nhs.uk/consultantdatawww.nhs.uk/consultantdata 21 non consenters; none outliers <10 outliers in total –Reassurance that standard of care is high

11. What information is available?

12. Where next?

13. Nationally –Minimum requirements for reporting More outcomes measures, regional searches, patient input etc. –More audits –Integrated reporting via NHS Choices –Longer data collection/validation timeframes –Consent unlikely to be a requirement

14. Where next? Local requirements –Use of data for revalidation –Resources/time for data entry and validation –Participation in all Offer 2 audits –Dialogue with HQIP

15. Any questions?

16. Discussion Number 2s: Move tables! On your tables –Introduce yourselves –Discuss for 15 minutes: Have you used the consultant-level analysis locally? If yes, how? If no, why not? –Appoint a spokesperson and a secretary to feed back your best answer for each point