Consultant Outcomes Publication (COP) is an NHS England initiative, managed by HQIP (Healthcare Quality Improvement Partnership), to publish quality measures at the level of individual consultant doctor using National Clinical Audit and administrative data. The data is published on NHS choices website (http://www.nhs.uk/service-search/performance/Consultants#view-the-data).
The information published so far includes how many times each participating consultant has performed certain procedures and what their mortality rate is for those procedures. The data shows where the clinical outcomes for each consultant sit against the national average. The data is risk adjusted to ensure outcomes are calculated as if all consultants operated on the ‘average’ patient.
COP began in 2013. The medical specialties included in COP 2014 includes Adult Cardiac surgery, Bariatric surgery, Colorectal surgery, Head and neck surgery, Interventional Cardiology, Thyroid and Endocrine surgery, Orthopaedic surgery, Upper GI surgery, Urological surgery, Vascular surgery, Lung cancer, Urogynaecology and Neurosurgery.
The aim of COP is to drive up the quality of care in the NHS and improve transparency.
Prof Sir Bruce Keogh, National Medical Director of NHS England, said: ‘We know from our experience with heart surgery that putting this information into the public domain can help drive up standards. That means more patients surviving operations and there is no greater prize than that’.
The reporting of the data was led by Prof Ben Bridgewater from the Healthcare Quality Improvement Partnership (HQIP). Prof Bridgewater is a practising heart surgeon who leads the successful cardiac consultant-level reporting which paved the way for this work.
Prof Bridgewater said: ‘Ultimately there is one patient and one responsible consultant. This means the public can now know about the care given by each doctor and be reassured an early warning system is in place to identify and deal with any problems
Due to data protection legislation, consultants had to agree to have results from their operations published and around 98% have. The names of those consultants who have not agreed to have data published and the trusts they work in can be seen on NHS choices website.
Some surgeons object to the principle of attributing surgical results to an individual when those results are dependent on effective teamwork between surgeon, anaesthetist, theatre and ward nurses and physiotherapists. Prof Sir Bruce Keogh counters that the patient enters the agreement for surgery with the surgeon and someone has to be accountable for the team’s outcomes.
What will the NHS do where consultants have high mortality rates?
Any hospital or consultant identified as an outlier will be investigated and action taken to improve data quality and/or patient care.