Public risk-adjusted outcome reporting for cancer surgery to drive centralisation
Where you have your cancer operation strongly affects whether you survive it. Publishing each hospital's adjusted results would push complex surgery towards the centres that do it well.
National mandatory reporting of risk-adjusted 90-day mortality, major complications, margin status, lymph node yield and volume for major cancer operations (oesophagectomy, pancreatectomy, gastrectomy, cystectomy, hepatectomy, lung resection), published by hospital and, for high-volume procedures, by surgeon, with minimum volume thresholds for commissioning. The volume-outcome relationship in complex cancer surgery is among the most robust findings in health services research; the Netherlands, Denmark and parts of England have centralised and improved mortality. Public reporting plus commissioning thresholds is a policy lever that requires no new science and little money.
- Surgery and radiotherapy cure most, get least · Surgery and radiotherapy cure more people than drugs do, but attract a fraction of the research investment.
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
Pages like this
not linked directly; found by shared links- IdeaAn independent evaluation unit for surgical robots and AI, paid on evidence
Shares A video-based surgical quality registry linking assessed skill to cancer outcomes, Mandatory staged registries for new surgical techniques before wide adoption, Surgery and radiotherapy cure most, get least.
- IdeaRapid diagnostic centres for people with vague but worrying symptoms
Shares Fragmented care and guideline gaps, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
- IdeaDedicated cohorts for patients with performance status 2 in first-line trials
Shares Oesophageal cancer, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
- IdeaAutomatic palliative care referral triggered by diagnosis, not by decline
Shares Fragmented care and guideline gaps, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
- TechnologyEnhanced recovery (ERAS) and perioperative nutrition
Shares Fragmented care and guideline gaps, Surgery and radiotherapy cure most, get least, Bladder & urothelial cancer, Oesophageal cancer.
- TermEndoscopy (EGD, EUS, ERCP)
Shares Bladder & urothelial cancer, Oesophageal cancer, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
- TechnologyImmunonutrition before cancer surgery
Shares Surgery and radiotherapy cure most, get least, Oesophageal cancer, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
- TargetEpCAM
Shares Bladder & urothelial cancer, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.