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NHS hospital cancer post-op death rates 'worryingly different'

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A study of post-operative death rates for one of the most common cancers has revealed “worrying” differences between NHS hospitals.

On average 6.7% of patients died within a month of undergoing surgery for bowel cancer in England between 1998 and 2006.

But a closer look at the period between 2003 and 2006 revealed wide variation between the worst and best performing centres.

The proportion of patients dying soon after surgery ranged from around 2% for Central Manchester University Hospitals Foundation Trust, to more than 15% for Burton Hospitals NS Foundation Trust.

Four other centres, Whittington Hospital Trust, Rotherham Foundation Trust, Northampton General Hospital Trust, and Colchester Hospital University Foundation Trust, had death rates above 10%.

Two more, Countess of Chester Hospital Foundation Trust and Shrewsbury and Telford Hospital Trust, had rates below 5% and much better than the national average.

The variations remained after adjustments to take account of patient populations, underlying health problems, and case loads.

At the international level, hospitals in England had a consistently worse record than those in some other countries, the study found.

In Scandinavia, Canada and the US, bowel cancer 30-day post-operative death rates ranged between 2.7% and 5.7%.

While acknowledging that it was difficult to make direct comparisons, the authors wrote: “This suggests that either the NHS may have fundamentally worse post-operative outcomes than some other comparable health services, or the operative risk of patients differs between countries.”

The findings, published in the journal Gut, were described as “worrying” by leading charity Cancer Research UK, which funded the study.

But the government’s “cancer tsar” Professor Mike Richards, who oversees cancer strategy at the Department of Health, insisted there were reasons to be optimistic about the long-term trend.

He pointed to new figures, not reported in the study, showing marked improvements among the poorest performing hospitals between 2007 and 2008 that had narrowed regional differences.

Death rates after surgery for bowel cancer were continuing to fall because of better training, new “keyhole surgery” procedures, and improved post-operative care.

“There’s good evidence that at a national level things are getting better,” said Prof Richards, speaking at a news conference in London.

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