Skip to main content

NHS: Standards

Volume 489: debated on Friday 13 March 2009

To ask the Secretary of State for Health for which routine surgical operations information on outcomes is collected in the NHS; and whether his Department proposes to introduce further outcome measurement in other routine surgical operations. (260362)

There is no standard definition of ‘routine surgical operations’. The national health service collects information on surgical operations from a range of data sources, for example:

(i) There are limited clinical audit outcomes data on surgery for cancer (lung, head and neck, bowel, oesophago-gastric, mastectomy and breast re-construction), and heart disease (cardiac and paediatric surgery). Reports on these have been placed in the Library.

(ii) Hospital Episode Statistics (HES) is the national statistical records-based system for England for the care provided by NHS hospitals and for NHS hospital patients treated elsewhere. Each HES record—one for each period of care—contains clinical information about diagnoses and operation. There is no nationally agreed definition of ‘main procedure and intervention’. Each episode in HES has 24 procedure and intervention fields. The ‘main procedure and intervention’ should be the one that is the most resource intensive. Procedure and interventions are recorded using the latest version of the Office of Population, Censuses and Surveys: Classification of Interventions and Procedures, 4th Revision, OPCS-4.4 for 2008-09, and a copy of this has been placed in the Library.

The National Centre for Health Outcomes Development (NCHOD) has linked HES data with Office for National Statistics deaths data to develop indicators on deaths within 30-days of a coronary artery bypass graft and within 30-days of surgery for non-elective admissions (excluding diagnostic procedures and spells with cancer).

(iii) Patient Reported Outcome Measures—From 1 April 2009 all providers of NHS-funded care who are subject to the terms of the Standard NHS contract for acute services will be obliged to invite patients undergoing hip and knee replacements, groin hernia and varicose vein surgeries to complete patient reported outcome measures (PROMs) questionnaires.

The Department is actively exploring extending the use of PROMs into other clinical areas including long-term conditions. Any future decision to extend the use of PROMs will be based on a sound evidence base.

The Department is aware of a number of examples where local providers and regional networks are involved in other data collection exercises, including local PROMs collection, although there is no central register of these activities.

“High Quality Care for All” stressed quality as the organising principle of the NHS and the need for this to be supported by measurement. Therefore, the Department set out the vision for developing quality indicators across patient safety, effectiveness and patient experience including outcomes of care, PROMs and surgical outcomes, and using these to improve the quality of services in the NHS. This is described in “Measuring for Quality Improvement (MQI)—The Approach”. A copy of this document has been placed in the Library.