Consultant Treatment Outcomes
All patients want the best possible clinical outcomes from their treatment and care in the NHS. At King’s, this is what we aim for each and every day. We are extremely proud that our clinicians rank among the best in the world and we are delighted to share with our patients and the public some of the results that our consultants are able to achieve.
Our consultants, along with many other clinicians within King’s and across the NHS, contribute data to a range of different national registries and clinical audit projects. This allows us to compare our care and clinical outcomes and ensure that we are achieving the best possible results. The data has been collected, analysed and reported by a range of national specialist societies, and is made available to the public via NHS Choices.
The Healthcare Quality Improvement Partnership has provided some Frequently Asked Questions.
Results are published individually by the societies for each area and are all linked from www.nhs.uk along with further information about the project.
Looking at the data: a health warning!
King’s is sometimes unique in the care we provide and the patients to whom we provide it.
For example, King’s is a Major Trauma Centre for South East London and the South East. Many of these patients are critically ill and, when they are cared for by our neurosurgery teams or orthopaedic teams, the severity of their injuries means that they are much more likely to die than less-sick patients cared for by other hospitals.
Our most experienced surgeons will care for our most critically ill patients. The data may sometimes make it appear that these surgeons have poorer outcomes than other surgeons when, in truth, the results reflect the severity of the patients’ illnesses rather than the quality of care.
Where we know that something about our patients or the data itself may affect the results, we have tried to explain this below.
Adult cardiac surgery
Our Cardiothoracic surgery unit cares for many elderly and high-risk patients with heart valve disease who have been referred here from other hospitals. We also care for a large number of critically ill patients referred through our large Cardiac Arrest Centre and, because of our close collaboration with the world renowned liver unit at King's, we also see a higher number of patients who have both heart and liver disease.
King’s is a one of the busiest Heart Attack Centres in the country with an excellent reputation and we have now been designated as a Cardiac Arrest Centre, which means that our consultants care for extremely sick patients who have been resuscitated out of the hospital by paramedics after suffering a heart attack. They are, therefore, extremely skilled at dealing with the most complex and highest risk patients.
We currently submit 90-95% of the required data to the National Joint Registry. In the past, however, our participation rate has been lower and therefore the data reflects only part of the workload of the Orthopaedic Unit at King’s.
Thyroid and endocrine surgery
We have not submitted data to the British Association of Endocrine and Thyroid Surgeons’ audit. Future submission is currently under consideration.
We have experienced some problems with submitting data to the British Association of Urological Surgeons audit and not all required data has been submitted.
We see patients with renal cancer who cannot be treated in their local hospital due to the seriousness of their illness, including those who may need renal dialysis at King’s after renal surgery. Some patients come to King’s because the severity of their illness means that they need the support of our specialist liver surgeons. Surgery is often much more difficult for these patients, and the post-operative complications and length of stay are likely to be longer than for other patients, and their long-term prognosis can be very much worse. In addition, King’s offers a range of novel and highly specialist treatments that would not normally be available. This also means that it is very difficult to compare our outcomes with those of other hospitals.
In summary, we do not think that this audit reflects the full reality of the complex work that we do but we are delighted to share our results and to continue to provide excellent care for our patients.
King’s is home to one of London’s ‘hyper-acute’ stroke units, which also cares for patients with transient ischaemic attacks (TIAs) that are at high risk of stroke. Our surgeons perform the largest number of carotid operations in London to try to restore blood supply to the brain, with very low complication rates and excellent patient outcomes.