Fiona Dalton, CEO

Chief executive's blog - 12 October 2015

Internationally healthcare is very bad at measuring outcomes - by which I mean the difference that we make to patients' lives.

It sounds deceptively simple, but outcomes are actually surprisingly hard to measure. It's much easier for us to measure how long a patient has to wait for their treatment, or whether a patient felt well cared for in hospital, than to measure whether our intervention actually made any difference to their life.

Nationally, the specialty of cardiac surgery has led the way in terms of properly achieving this - and measuring survival rates whilst properly taking into account different levels of risk and comorbidities.

Cardiac surgery in Southampton has an excellent reputation, and last month I received a letter from the National Institute for Cardiovascular Outcomes Research which confirms that this reputation is justified. They formally told us that we are a statistically significant outlier (in a good way!) for our cardiac surgical outcomes.

In their analysis, each hospital trust received a percentage score based on how ill patients were, how high-risk their procedures were and how many survived, with the national average at 2.3% deaths.

If the number was lower, it showed a better than average survival rate - and University Hospital Southampton NHS Foundation Trust's was 1.4%.

You can read the press release here.

I have noticed that whenever I speak to any of the cardiac surgeons about their ongoing excellent results, I always hear the same response - "it's not just us, it's really a team effort, and the post-operative care in intensive care and on the wards makes all the difference". I love this response – it’s a credit to the individuals concerned and a sign of a great team.

We have some other good examples of outcomes – including vascular surgery, children’s and adults' intensive care and major trauma. But it’s much more difficult to measure outcomes effectively in some other specialties, particularly if we try to focus on what makes a real difference to patients.

I have however seen good progress on this in UHS. In particular I've seen great examples from both orthopaedics and the therapies asking patients before and after treatment to rate their quality of life, and ability to be mobile and live independently.

The overriding goal of so much health and social care policy right now is to support and enable patients to live independently at home wherever possible – and I think this is often a good measure of a successful outcome.

We support patients to live independently at home in so many ways - including through elective surgery (for example, improving patients' sight and mobility makes a real difference) or through excellent responses to health crises (for example, both the national stroke and fractured hip audits now measure the proportion of patients who are able to return to live at home).

These are just a few examples - but overall I strongly believe that we in the acute hospital sector need to become better at measuring the real difference that we make to patients' lives, across every specialty.

Fiona Dalton


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