Marchbank Adrian

GMC: 3296709

Hospital(s): Plymouth Hospitals NHS Trust

Special Interests: Adult Cardiac Surgery, Thoracic Surgery

I am a consultant cardiothoracic surgeon in a busy teaching hospital with an interest in surgery for lung cancer, chest wall injury, arterial revascularisation, mitral valve repair and off-pump coronary artery surgery. I have responsibilities for data collection and audit, I am the previous Lead Clinician for lung cancer, am previous Chairman of the Lung Cancer MDT Support Group, I acted as liaison between Plymouth Hospitals NHS Trust and the Hyperbaric Medicine Centre. I have had a research fellow whom I supervised studying local vascular effects following exposure to hyperbaric oxygen and sternal wound vascularity. I am the Lead for the Cardiac MDT, and the lead cardiothoracic surgeon for surgical care practitioners (SCP). I started the programme to locally train SCPs, and am the Lead Peninsula Clinical Supervisor for SCP training. I am an Associate Lecturer at the University of Plymouth. I was Chief Investigator for ANTICS Trial, and Principal Investigator for the PulmiCC and SMART Trials. In May 2012 I was appointed Caldicott Guardian for the Plymouth University Hospitals NHS Trust, and in April 2015 was co-opted onto the UK Council of Caldicott Guardians.

Training Attended

I trained in London and Oxford, and was appointed to a consultant position in Plymouth in 2000.

Qualifications & Accreditations

BSc 1985

MBBS 1988

FRCS 1992

FRCS (CTh)(MacCormack Medal) 1998

Risk-adjusted in-hospital survival rate

This graph shows the “in hospital” survival rate of patients who are operated on by the individual surgeon/unit you have selected. “In hospital” means time the patient is in the hospital where they have had their operation. It does not include any time that patients may have spent in other hospitals, either before or after their heart operation.

The data has been through a complex methodology, including the variations in patient risk factors in order to give you a comparative base from which to work from. This means that the survival rates take into account the type and risk of patients being operated on for each surgeon/unit. This is known as risk adjusted survival.

The vertical axis shows the GMC number of the surgeon or the Hospital identifier. In brackets is the total number of patients operated on by the surgeon/unit and the percentage of patients for whom the survival is known. The horizontal axis is the percentage survival. The dashed vertical line shows the risk adjusted survival rate for the UK as a whole. The solid black horizontal line represents the surgeon/unit. What is important here is that the horizontal line crosses the vertical dashed line. If this occurs, it means that the surgeon/unit are within the expected outcomes given the case-mix and risk factors of the patients they operate on.

The icons that sit on the horizontal line should give you more information about your surgeon/team.

For example

The open square is the survival rate with no risk adjustments:
The X is the predicted survival with adjustments
The solid dot is the survival probability after the methodology has been applied.

  • If the solid dot is red it means survival is worse than expected
  • If the solid dot is black it means that it is within limits
  • If the solid dot is green it means that there is significantly higher survival than expected

There is a lot of information on these plots, but the takeaway message is that if the solid black line crosses the dashed vertical line then the survival rate for the surgeon/unit is within expectations and that there is no reason for any concern.

A more detailed explanation about these graphs and methodology can be found here: Graph Explanations