Tuesday, June 12, 2007
The philosophy underpinning the NHS in England is one of patients exercising informed choice. To help them to do this, vast amounts of information are being placed on web sites. A recent example is a new NHS website proving outcomes of paediatric cardiac surgery. Intrigued by this development, I tried to think how it might help me if I was unfortunate to have had a child needing surgery. Not much, unfortunately. The most recent data relate to procedures undertaken in 2004/5, over two years ago. Such a delay is inevitable, given the need to wait until one year survival can be calculated and the data processed. However, in many centres both surgeons and techniques may have changed. Twenty of the procedures listed were undertaken fewer than twenty times in the entire country and even the most common procedure was undertaken an average of less than 28 times a year in each of the sixteen centres, so the numbers in any one centre will be very small and the observed differences are likely to be statistically insignificant due to chance variation. Furthermore, none of the figures are adjusted for risk, an important consideration as many of these children will have other problems. I am sure that those making these data available have the best of intentions but if, as is suggested, they are intended to help parents make choices, then some guidance from government ministers as to how precisely they are meant to do so would be helpful.