The government needs to work closely with the medical profession if its plan to make key NHS data available to the public is to bring real benefits to patients, a leading GP has told Ministers.
Publishing GP practices’ prescribing data without considering the context of the local population “would make it impossible for people to interpret the information properly,” cautions Dr Laurence Buckman, chairman of the British Medical Association (BMA) GPs’ committee, responding to the government’s announcement that it is committed to publishing key data on the NHS.
The plan, set out in a letter from Prime Minister David Cameron to Cabinet colleagues in advance of the Open Public Services White Paper, “represents the most ambitious open data agenda of any government anywhere in the world,” according to the Cabinet Office.
For the health service, it commits the government to publishing the following data sets:
– data on comparative clinical outcomes of GP practices in England to be published by December 2011, following the lead of the NHS in London which has agreed a set of 22 indicators with local GPs;
– prescribing data by GP practice to be published by December 2011, as already outlined in the Growth Review;
– complaints data by NHS hospital so that patients can see what issues have affected others and take better decisions about which hospital suits them. This commitment will be met by October 2011;
– clinical audit data, detailing the performance of publicly-funded clinical teams in treating key healthcare conditions, to be published from April 2012. This service will be piloted in December 2011 using data from the latest National Lung Cancer Audit, commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP);
– data on staff satisfaction and engagement by NHS provider will be published from December 2011; and
– data on the quality of post-graduate medical education by provider from April 2012.
Dr Buckman agreed that greater transparency can drive up clinical standards and that it is important for patients to have access to good-quality information. However, he added: “measuring health outcomes is a very complex area, and so the government will need to work closely with the profession to ensure that it actually brings benefit to patients and the NHS.”
Moreover, he said, there are many factors which will affect one person’s health outcome, such as the other diseases which they may have, or what health care support or social care is available to them. “Any national audit would have to be sufficiently sophisticated to take this into account, otherwise we could end up with simplistic league tables which, without context, could mislead the public,” he warned.
And publishing GP practices’ prescribing data without the context of the demographic of the population would make it impossible for people to interpret the information properly, he went on. Similarly, comparing the clinical outcomes of GP practices would need to be done “in a way that is fair and compares like with like – rates and outcomes for chronic bronchitis, for example, can differ markedly depending on the lifestyle and even the occupations of the local population,” Dr Buckman noted.
He also stressed that information concerning health treatment and outcomes should also always form part of the discussion that a patient has with their doctor as part of their overall care.
– The “open data” agenda also commits the government to publishing key data on schools, criminal courts and transport. Its aim is “to provide the public with more information about the performance of services they use every day, and to help drive modern, personalised and sustainable public services. The new data are also expected to drive economic growth as they promote the creation of new services and applications,” says the Cabinet Office.
