22 March 2011

Nigeria: Doctors Warn About 'Club Culture' Costing Lives

The NHS needs to undergo a major culture change to drive up standards and save hundreds of lives, according to a new report.

Leading heart surgeons said other disciplines should follow their lead and collect the data on deaths and other treatment outcomes to give patients a clearer picture of where to go for the best results.

Cardiac specialists have been collecting mortality data since the Kennedy inquiry into the Bristol babies scandal in 2001. It found babies who died after heart surgery may have survived if a more skilled surgeon had been used.

This had led to a dramatic improvement in survival rates with a 50 per cent drop in death rates in the UK in recent years.

Experts agree making data available to the public on individual doctors does push up standards, but some medics have been reluctant to expose 'weak links' in the service, according to Sir Donald Irvine, former president of the General Medical Counci.

He wrote in the report: 'The generally good public standing of doctors has tended to obscure the fact that over a long period of time the profession, perversely, has been prepared to tolerate some very poor practice from a minority of its members through a misplaced sense of collegiality and dated ideas of professional autonomy.'

Ben Bridgewater, lead author of the report and consultant cardiac surgeon at the University Hospital of South Manchester, said change was necessary across the NHS.

'This data improves the quality of care for patients, and better quality care actually comes at a lower cost to the NHS.

'Society is also changing, people are looking for all sorts of information, and they will demand more of this type of information in the future.

'The profession needs to start responding to that in order to keep its level of trust with patients.'

He added: 'The NHS is littered with repeated failures of clinical governance and the medical profession must respond.

'Cardiac surgeons were forced to act after the Bristol inquiry and have subsequently proven that public accountability drives up standards of patient care while reducing costs as areas of substandard practice are resolved.'

Other information collected from heart surgery includes whether people stay too long in hospital, how many patients develop major wound infections, and the number of post-operative strokes.

In the future, data will include how many patients end up back in hospital after their operation.

As well as improvements in death rates, the data collected and analysed by surgeons has revealed that more than 99 per cent are performing at a satisfactory level.

The report said: 'We believe these improvements have been a result of intense scrutiny on mortality rates, which has forced the development of highly skilled and focused multi-disciplinary teams.'

The experts said such data collection had 'helped us to appreciate the need for a change in the culture of our professionalism, to try to see our surgery more through the patient's eyes, and so place the care of patients unequivocally first in everything we do'.

The report comes as Health Secretary Andrew Lansley announces £1.2 million of funding to improve data collection across the health service.

The study, Maintaining Patients' Trust: Modern Medical Professionalism, estimates that the cost of data collection for cardiac surgery in England is £1.5 million a year - 0.6 per cent of total spend on cardiac surgery.

But this has led to a £5 million saving in bed days for coronary artery bypass operations alone, the report said.

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