18 June 2013

Health care professionals in colorectal surgery support outcome reporting but raise concerns about flaws in data collection and presentation.

The Association of Coloproctology of Great Britain and Ireland (ACPGBI) represents the 1300 medical and nursing professionals in the UK that treat patients with Bowel Cancer, Crohn’s Disease, Ulcerative Colitis, Diverticular Disease, Faecal Incontinence and Anal disease – including haemorrhoids, perianal abscess and fissure.  In England there are 560 consultant members, most of who are involved in the treatment of patients with colorectal cancer. The ACPGBI welcomes the intention of the NHS Commissioning Board to see publication of surgical outcome data as set out in Offer 2 of the publication Everyone Counts: Planning for Patients 2013/4.  ACPGBI recognises that open reporting of surgical outcomes is associated with improvements in surgical performance, which has been demonstrated by other specialties, most notably Cardiac Surgery. Graham Williams, President ACPGBI has made the following statement; “Colorectal Surgeons are committed to measurement and critical analysis of surgical outcomes and open reporting of their results is a logical extension of this.  Although the Association of Coloproctology supports surgeon specific outcome reporting we are concerned about:

• The possible inaccuracy of the data
• The small sample size involved that can lead to incorrect conclusions concerning an individual surgeon, causing confusion and worry to patients and their relatives.
• The danger that good surgeons, wrongly categorised as 'poor performers', will be placed in an unacceptable position.

The ACP has always been consistent in driving forward support for the improvement of standards in colorectal surgery and has been at the forefront of training surgeons in techniques in cancer surgery.  We will continue to work with clinical teams and key stakeholders including the Royal Colleges, DH and the public in this regard”. Surgeon Specific Outcome Reporting For Colorectal Cancer Surgery – 125kb Surgeon Specific Outcome Reporting Delay in Publication to Autumn 2013 – 116kb A Patient’s Guide to Surgeon Outcome Reporting in Colorectal Cancer – 120kb

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