Health secretary suspends reconfiguration of children’s heart surgery in EnglandBMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3856 (Published 13 June 2013) Cite this as: BMJ 2013;346:f3856
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Plans to concentrate children’s heart surgery in seven of 10 units in England and to close the other three have been suspended after an independent panel commissioned by the health secretary, Jeremy Hunt, concluded they were based on “a flawed analysis.” 1
Similar plans to publish data on maternity indicators (induction of labour rates, instrumental delivery rate, Caesarean Section rates, emergency readmission rates, etc) based on Hospital Episode Statistics (HES) have been voiced by the Royal College of Obstetricians and Gynecologists (RCOG)2 despite published grave concerns about the quality of HES data.3 In fact a preliminary internal publication of this data last year by the RCOG was unable to provide basic data from HES, such as parity, for 30% of the maternities. This has huge implications for risk adjustment which the RCOG claimed to have performed before publication.
The publication of poor quality data by the RCOG would then lay some maternities unjustly open to scrutiny by the public and the press because they would be classed as outliers. The RCOG justification has been we had to begin somewhere and that individual units had to take ownership of the raw data. However HES data is extracted and so it is impossible for clinicians to have any ownership over it at all
We wonder therefore if the RCOG should be publishing risk adjusted raw data after collection from individual units rather than using HES data. In the light of the children’s surgery experience we do feel that it can't just be a case of publish and be damned by our college.
Consultant Obstetrician and Gynaecologist
Guy’s and St Thomas’ NHS Foundation Trust
King’s College London
1. Health secretary suspends reconfiguration of children’s heart surgery in England. BMJ 2013;346:f3856
2. Electronic response to Chappell L et al. Understanding patterns in maternity care in NHS and getting it right BMJ 2013 http://www.bmj.com/content/346/bmj.f2812
3. Understanding patterns in maternity care in NHS and getting it right. Chappell L et al 2013;346:f2812
Competing interests: No competing interests