The health inspectorate plans to publish information about the death rates of individual heart surgeons in April, a year after a Guardian inquiry cast doubt on the reliability of some data collected by hospitals.
Sir Ian Kennedy, chairman of the Healthcare Commission, intends to make the results available on an official website in four months. They will allow patients to choose a surgeon on the basis of his or her success rate for similar operations.
But the publication of individual death rates is still resisted by some surgeons. About 10 units are fully on board, which means the website will launch with full data from less than a third of heart surgeons.
The move was foreshadowed by Alan Milburn when he was health secretary in 2002. He promised after the Bristol babies heart scandal that the information would become freely available by 2004. But he also accepted representations from the Society for Cardiothoracic Surgeons that the figures should be adjusted to reflect the relative risk of each operation, to avoid penalising surgeons taking on the most difficult cases.
The society struggled to reach agreement on assessing risk and published death rates for hospitals, not individual surgeons. The Guardian used the Freedom of Information Act to apply for the mortality scores of cardiothoracic consultants at 36 NHS trusts performing these operations. Some provided risk-adjusted data, but others could only give the raw scores.
After the Guardian published this information in March, John Reid, Mr Milburn's successor as health secretary, promised to make full risk-adjusted data available by September. But this deadline also came and went.
The biggest problem has been persuading surgeons and chief executives to submit complete data on heart operations to the central cardiac audit database. Some surgeons do not believe the information should be made public and say that it will make surgeons more likely to turn down risky cases. Chief executives are not always enthusiastic about spending money on data collection rather than treatment.
The society went to the Healthcare Commission for help. Sir Ian sent a warning to chief executives and surgeons: "Unfortunately both the Healthcare Commission and the society are aware of significant problems with the quality of data in some hospitals, which preclude ... risk adjustment. A recent article in the Guardian ... exposed several shortcomings in the data. For example, some hospitals did not record that an operation was carried out by a locum rather than the substantive post-holder."
He warned trusts that the commission intended to carry out checks to ensure the data reflected the number of operations performed as recorded in the Department of Health's statistics.
