Patient outcomes continue to become ever more visible in the NHS with ongoing drives to demonstrate transparency in our delivery of healthcare. This article reviews unit-level data publication using Hospital Episode Statistics data in all units undertaking head and neck cancer surgery in England. This includes 10,589 patients who underwent major head and neck cancer surgery between 2006 and 2011. Interestingly the authors used an in-hospital mortality measure in contrast to the commonly accepted 30-day mortality used elsewhere. Data such as an overall in-hospital mortality rate of 3.05% and myocardial infarction rate of 4% is provided. The important issue of variability between units is explored and the demonstration of distinction between units performing ‘intermediate’ numbers of major surgeries (16-25 a year) as opposed to high volumes is not unexpected given work in other areas (cardiothoracics and vascular). Summarising this paper is no mean feat owing to the breadth of issues discussed and illustrated; I urge you to read and consider for yourself how the future of head and neck cancer care is likely to develop and be monitored.

A national analysis of the outcome of major head and neck cancer surgery: implications for surgeon-level data publication.
Nouraei S, Middleton SE, Hudovsky A, et al.
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Andy Hall

FRCS (ORL-HNS), North Thames, ST7 Northwick Park Hospital, London, UK.

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