Urological Surgery Q and A with Mark Speakman
Urological Surgery Learn about urological surgery in the UK and what surgical information is available to the public.
In England, the public now has access to 'surgeon identifiable data'? What is this?
It's data that shows how many operations individual surgeons, countrywide, have performed, together with some outcome data.
NHS England has made it compulsory for each surgical speciality to publish individual surgeon identifiable data for at least one procedure. For example, at the BAUS, we have been publishing individual surgeon identifiable data for nephrectomies — the removal of the kidney, predominantly required for kidney cancer patients — for three years.
Why is that important?
As an organisation we want to promote the highest standards in our practice through training; but we also want to achieve it by research and improving clinical outcomes. And there is good evidence that higher volumes of operations equals better outcomes for patients. In other words, surgeons are more likely to get better outcomes for their patients if they perform a particular operation regularly rather than just twice or three times a year. So by collecting this data we're ticking those last two boxes, as this information can be used in research; plus we're improving standards by allowing the public — and our colleagues — to see it. Already, there have been small numbers of surgeons who have looked at the data and said: 'I'm probably not performing this operation enough. I'm going to stop.' Then another centre that does perform more of it can take on their work. We are the first country in the world to publish identifiable data for all surgeons countrywide.
Is BAUS collecting data on any other operations currently?
Yes. From the middle of September the public will be able to log on to the NHS Choices website and see data for female stress urinary incontinence surgery and for patients who have had major surgery for kidney stones, a technically challenging operation. They can also link back to our website for further information. This year, we are collecting data about operations for prostate, kidney and bladder cancer, plus a rarer but complex operation called urethroplasty, where a damaged urethra needs to be reconstructed.
Has any of the data surprised you?
We found that if you have your kidney removed in this country, your chance of dying is 0.45 per cent. In other words, just under one in 200. That compares favourably with centres of so-called excellence around the world.
What is the 'average patient profile'?
It's a concept we are trying to develop because, plainly, not all patients are the same — so their surgical outcomes will be different, too. For example, some patients may be more likely to experience complications during a nephrectomy if they are older, or more frail, or anaemic, or if they have more complex tumours.