Objective

Following recommendations made by Sir Bruce Keogh's review of NHS care in July 2013 the UK Government mandated publication of named surgeon-specific outcome data (SSD) across nine surgical specialities. Aiming to improve transparency and raise NHS standards of care.Thoracic Surgeons remain exempt from publication of SSD however unit mortality and resection rates reflecting unit performance is collected nationally and published.Presenting the findings highlighting pitfalls in NCLA data collection

Methods

The data sent to the unit lead was vetted by lung cancer audit database manager to identify patients on the trust system and operating surgeon. This data was sent to individual surgeons to validate and highlight missing patients. The final data was collated and verified by the audit lead and submitted to LCCOP. The surgeons analysed database data compared against personal logbooks.

Results

The process revealed a number of coding errors resulting in an underestimation of Consultant operative activity by 10-15% for the year of 2013. Furthermore 13% of Lung cancer resections were omitted from NLCA. Careful analysis also revealed a number of errors in Consultant - Patient attribution within the trust system.

Conclusion

Our analysis highlights the difficulties of maintaining data quality using current approaches to data collection which relies on MDT coordinators. We note the NLCA may have potentially under reported UHL resection rates for 2013. These discrepancies raise concerns of misleading data and a failure of meaningful transparency. A central single point data entry which feeds into the national database will obviate these pitfalls and lead to robust outcome reporting.