Barts Health NHS Trust

Consultant Cardiac Surgeons 2015 - 2018: 16

Consultant Congenital Cardiothoracic Surgeons: 0

Consultant Thoracic Surgeons 2014: 4

Introduction

Department of Cardiothoracic Surgery, Barts Health NHS Trust

About the unit

Barts Health NHS Trust is one of the largest teaching hospital trusts in Britain serving over 2.5 million people. It is formed of 3 hospitals: The London Chest (founded in 1848, in Bethnal Green), St Bartholomew’s (founded in 1123, in the City of London) and the Royal London (founded in 1740, in Whitechapel). Prior to 2015, there were cardiac surgery units at both St Bartholomew’s Hospital and at The London Chest Hospital. There was also a separate cardiac surgery unit at University College London’s Heart Hospital.

In April 2015 The Barts Heart Centre was formed by the merger of three cardiac units: The Heart Hospital UCLH, The London Chest Hospital and St Bartholomews. The surgeons who previously worked at the legacy sites are now part of one team at Barts Heart Centre on the St Bartholomews Hospital site in a new purpose built unit.

Services provided

Adult Cardiac Surgery
Thoracic Surgery

Access

At both the London Chest and St Bartholomew’s Hospitals, cars are allowed to pull close to the main entrance where patients can be picked up or dropped off. There is wheelchair access. In addition there is ample parking on pay and display bays on Bonner Road and metered bays at West Smithfield.

Visiting hours

Wards are open to visitors between 9.30am – 8pm except during mealtimes (12.15 – 1.15pm and 6 – 7pm). There are no fixed hours for visiting patients on the ITU as long as this is arranged with the Sister in Charge.

Location

St Bartholomew’s Hospital,
West Smithfield, London EC1A 7BE,
The London Chest Hospital,
Bonner Road,
E2 9JX

Tel: Main switchboard: 020 7370 700

Trust Website: http://www.bartshealth.nhs.uk/

Cardiac Outcomes

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

Data for period April 2015 – March 2018.
Risk Adjusted In-Hospital Survival Rate

Data For Period April 2015 – March 2018
Risk Adjusted In-Hospital Survival Rate

Thoracic Outcomes

The Lung Cancer Clinical Outcomes Publication or LCCOP 2017 (2015 data).

LCCOP is a compulsory audit of surgery for lung cancer in NHS hospitals in England. It does not cover SCTS units in the devolved nations or Ireland.

Four outcomes are reported. These are the percentage of patients alive at 30, 90 days and one year after surgery, and the median length of stay before and after a lung cancer operation in this Trust. Survival data are adjusted to take into account some of the characteristics for the patient population being treated.

Beside these numbers are the combined figures for all Trusts in England that undertake lung cancer surgery within the NHS. We have also shown the resection rates for the Trusts who usually referred all or some of their patients to this surgical centre. The resection rate is the number of patients having lung cancer surgery, divided by the total number of lung cancer patients diagnosed by that hospital that year.

Surgeons operating in this hospital

	Number of lung cancer operations
*Wood Alan Jeffrey*	49
*Lau Kevin*	44
*Edmondson Stephen*	56
*Ambekar Shirish*	5

(this table shows the names of the surgeons who performed lung cancer surgery in this hospital in 2016, and the number of operations they performed that year)

Other thoracic surgery undertaken by this team

Thoracic surgery units also undertake surgery for other cancers within the chest such as thymoma or mesothelioma, collapsed lungs known as pneumothorax, major infections and to biopsy suspicious areas, among other surgery. The SCTS collects data on these other operations in the thoracic registry. Some data for this hospital for the 2016-17 audit year* is given below;

Data from the 2016-17 SCTS thoracic registry

	Cases Performed
Total thoracic surgery excluding endoscopy all case (excluding endoscopy)	732
Did this hospital perform radical surgery for mesothelioma in 2015-16?	yes
Did this hospital perform chest wall deformity (pectus) surgery in 2015-16?	yes

*note that the thoracic registry reports in financial years (1st April-31st March), while the LCCOP audit reports in calendar year.