AUGIS statement on surgeon level outcome reporting for oesophago-gastric cancer

Last December the NHS Commissioning Board (now NHS England) announced that mortality rates and other outcomes of surgery will be published for a number of specialties by summer 2013. This included data for the outcomes of stomach and oesophageal cancer patients from the National Oesophago-Gastric Cancer Audit.
The Association of Upper Gastrointestinal Surgeons (AUGIS) of Great Britain and Ireland welcome this reporting of surgical-level outcomes. This will improve surgical performance and allow patients to find out more about the quality of care provided by hospitals and individual surgeons.

AUGIS intends to publish post-operative death rates for upper gastrointestinal surgeons working in English NHS Trusts who perform planned (elective) surgery for stomach and oesophageal cancer. The outcome measures assessed for this publication are the 30 day and 90 day mortality rate following a planned procedure. This mortality rate is the proportion of patients who undergo surgery who die from whatever cause within 30 days or 90 days of their operation. It is based on data submitted to the audit between April 2011 and March 2012.

This has been an extremely challenging project as we have been collecting consultant level data from an audit that was designed to look at all the aspects of care stomach and oesophageal cancer patients receive. As only one in three patients with these cancers undergo surgery to treat the disease, this data has had to be extracted and analysed separately. This information still requires extensive checking and so publication has been delayed until September.

Mr William Allum, President AUGIS, said “We are fully committed to this initiative but the analysis of surgical outcomes is complex with many pitfalls, and we are still sorting out data issues. We believe that the publication of erroneous data does not help anyone – especially patients facing surgery for stomach or oesophageal cancer. We are delaying the release of the data until September when we hope to have addressed concerns about its reliability.”



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