St George’s Hospital in Tooting has published mortality rates for cardiac surgery on its internet site.

As well as raw data on deaths following three kinds of heart operation, the Trust is also publishing risk-adjusted information which takes account of the complexity and severity of the illness of the patient.

While a few other hospitals publish some of their cardiac mortality data, St George’s is the first in London to do so. It is publishing both ‘raw’ and risk-adjusted mortality figures, as well as the numbers of complications following surgery.

The exact graphs and tables are as follows:

  • ‘raw’ data on mortality following coronary artery bypass graft (CABG), mitral valve replacement and aortic valve replacement for the hospital from 2002, 2003 and 2004.
  • Risk-adjusted mortality in graph form following coronary artery bypass graft for 2002, 2003 and 2004.
  • The rate of seven different types of complication following both all cardiac surgery and coronary artery bypass graft.
  • Risk-adjusted mortality in graph form for the Trust’s five cardiac surgeons as individuals.

The publication follows careful internal discussion between surgeons, staff and managers. Consultant cardiac surgeon Robin Kanagasabay, one of the individual surgeons whose mortality rates are published today says:

“We’re doing this for several reasons. First, as surgeons we know that openness is the future in the NHS. What the Bristol and other cases have shown is that the public want to know, and should know how hospitals and individual surgeons are performing.

“There has been a huge debate about this within the medical profession and amongst cardiac surgeons in particular. The serious and important concern is that the publication of raw data for individual surgeons could be an incentive to take on only the easiest and least severe cases.

“The other important problem is that it is so easy to misunderstand and misinterpret this information. If misrepresented or misunderstood it could have serious consequences, ironically for those surgeons who carry out the most difficult operations on the most ill patients.

“We have had a very careful debate within St George’s about this and I and my colleagues think we have got the right balance between presenting information in a way which is understandable, but which does not oversimplify.

“In some ways this publication is a pilot project for us. It may be that we can publish more detailed information about cardiac care at St George’s in the near future and we are discussing those possibilities.”

As well as cardiac surgery, St George’s plans to go further by publishing similar information on a much wider range of operations. St George’s University Hospitals NHS Foundation Trust Chief Executive Peter Homa says:

“We think we can go further. Cardiac surgery is on the leading edge of this debate, but surgeons from other specialties want to get involved too. There is no reason in principle why we shouldn’t be publishing similar information right across all areas of surgery.

“What underpins this is a programme of very regular and careful audit of surgical mortality and complication. Like other NHS hospitals, we are constantly checking mortality rates to pick up potential problems and deal with them.”

Notes to editors

1. For further information please contact Tim Jones, Head of Communications, on 0208 725 2717.

2. Cardiac surgery mortality rates at St George’s.

3. The website fully explains the process of collecting mortality data, and the methodology used in risk-adjustment. St George’s uses a statistical method known as ‘Euroscore’ which has been extensively tested and is used in other hospitals and academic work around the world.