Editor’s blog Wednesday 18 August 2010: Dr Foster consults, and pieces and bits

Good morning. I hope the weather is good where you are.

Today we turn to an interesting press release from Dr Foster Intelligence, whose public sector share sale by the IC to the Health Secretary for £8 million we exclusively revealed last week.

Dr Foster Intelligence have moved into consulting mode. Now Tribal, KPMG, McKinseys, E&Y, Old Uncle Tom Cobblers and all can take heart: the consulting in question is about the methodology to be used in the next edition of the Dr Foster Hospitals Guide.

The press release states that "Dr Foster is publishing provisional methodologies for a wide range of indicators and asking for views from across the NHS. Dr Foster has always consulted with patients, patient groups and professionals over the Hospital Guide. This process continues but in addition, Dr Foster is engaging in a much broader debate about the Guide.

"This includes, for the first time, publishing provisional methodologies for indicators to be used in the Guide available pre-publication for comment and consultation. This includes potential new indicators in six areas including mortality, safety and clinical effectiveness". The six new indicators are:

a composite measure of adverse events (based on patient safety indicators originating from AHRQ );
failure to rescue (deaths in hospitals following surgery that could likely be avoided);
mortality in conditions amenable to healthcare (deaths where the person’s condition could have been treatable);
paediatrics (focusing on the clinical teams dealing with paediatric care);
pulmonary embolism (blood clots);  and
urology (focusing on clinical teams dealing with conditions associated with urological problems).

The consultation is being offered through HSJ, and can be found online here.

The move to greater openness on methodology is a shrewd one as we move to a decentralised NHS information age. Dr Foster have always attracted some critics whose motivation appears to be in no small element financial envy of the company's shrewd deals. Others have had genuine and valid concerns about methodology and transparency. This step is a good and timely move to address the latter category of concerns.

It would be reasonable to acknowledge that Dr Foster have played no small part in the NHS's slow progress to use information more meaningfully to assess the quality of healthcare it delivers or commissions. Nonetheless, there remains some considerable way to go.

Pieces and bits
The Guardian's Denis Campbell provides this useful summary of a new report from the Faculty Of Public Health detailing how public opinion on the need for firmer action on public health is ahead of politicians.

The survey of 1,400 people found a strong majority for the proposals for mandatory action. It is interesting, and if reproducible at scale (with the usual caveats about question bias), suggests truly interesting things about the in-touch-ness of the political classes.

Meanwhile, the Telegraph reveals the disturbing news that the German  clinical professional body may be unable to act against the registration to practice of proven incompetent Dr Daniel Ubani, whose fatal diamorphine overdosing of David Gray while working for out-of-hours provider Take Care Now is considered by a coroner to have constituted unlawfully killing.

The Telegraph also breathes fresh life into the brilliant US phrase "death panels", with this report about US consideration to limit use of Avastin for women with advanced breast cancer.

The clearly awesome Republican senator for Louisiana David Vitter is reported to have said the FDA decision amounted to rationing health care. What a shrewd fellow!

Senator Vitter's reported words are"I shudder at the thought of a government panel assigning a value to a day of a person’s life. It is sickening to think that care would be withheld from a patient simply because their life is not deemed valuable enough. I fear this is the beginning of a slippery slope leading to more and more rationing under the government takeover of health care that is being forced on the American people".

Insurance company rationing of healthcare because they do not deem a patient's life valuable enopugh would presumably be A-OK by Sen. Vitter. Fine for private enterprise; not OK for government. Intriguing thinking.