NNUH is top performer nationally for lifesaving procedure

The first publication of NHS hospital survival rates today reveals the Norfolk and Norwich University Hospital has the best mortality rates nationally for emergency Abdominal Aortic Aneurysm (AAA) repair.

The national website NHS Choices has today published hospital survival rates for three of the most common operations. It is the first time this information has been made available to the public and the NHS is the first national health provider in the world to do this.

Each hospital in England is rated on the number of deaths in hospital within 30 days of surgery over the three years from 2004 – 2007. The figures are adjusted to take account of factors including age and sex of patients, areas of deprivation and co-morbidity.

Mr Matthew Armon, Norfolk and Norwich University Hospital consultant vascular surgeon, said: “We are delighted to see that our mortality rate for abdominal aortic aneurysm repair is amongst the best in the country. This is a reflection on the skill of the entire vascular team – surgeons, anaesthetists, theatre staff and vascular nurses. We are one of the highest volume centres for AAA surgery in the country and this data supports the view that high volumes lead to better results.”

Two months ago the Healthcare Commission revealed patients rate the quality of care offered by the Norfolk and Norwich University Hospitals NHS Foundation Trust as the best in the country out of all district general hospitals.

The findings came from the Healthcare Commission national patient survey. The 2007 survey is compared to similar survey questions in 2006, 2005, 2004 and 2002. A total of 534 adult in-patients at NNUH were surveyed in autumn 2007 for the latest survey.

The Norfolk and Norwich came 11th overall out of 165 trusts nationally for providing a high quality of care but the 10 trusts who performed better are all small, single-specialty trusts. The 1000-bed Norfolk and Norwich is the highest-scoring general, multi-specialty hospital in the country. 

NHS Medical Director Sir Bruce Keogh said: “The publication of this data on the NHS Choices website is a good advance for the NHS in the way it shares information with the public. Data on outcomes takes time to collect, analyse and make sure that it is adjusted to take account of the different types of patients which different surgeons treat.

“These days, people expect and want to know much more, and it is our job as clinicians to share what we know on how we perform. Over the next year we will be working hard to make this data available for many more operations. I am working with the medical directors of every hospital to see how we can improve and produce more performance data. “

“I am very pleased that today’s new indicators show that our hospitals are doing a good job in the areas we have published. It is important for the public to have confidence where it is due and also to be alerted where there may be a problem”.

Health Minister Ben Bradshaw said: “Providing the public with the information about survival rates on the NHS website is bold and necessary in this information age. It is something that people need and want to know if they are going to make an informed choice about where to have operations. “

“When I asked for this information to be provided, I didn’t know what it would show. There was always the chance that it could show worrying variations in survival rates. It is only by producing this level of data that we can ever know. What it has showed in this case is that our hospitals are doing a good job in the operations that we so far have the data for. We will keep pushing for more and more procedures to be published, and make the NHS a byword for openness. And when problems are discovered as a result of this, then we will know and be able to identify the causes and tackle it.”


1. An AAA is a widening of the aorta, the main artery that runs from the heart to the abdomen. If the aneurysm (excessive localised swelling of the wall of the artery) is large it can run the risk of rupture which will need operating on. Surgery usually involves the surgeon making a large incision in the abdomen, opening up the weakened area of the aorta and bypassing it with a tube of synthetic material.

2. For each of these, the overall rating is presented as a response to the question “Is the mortality rate for this treatment better or worse than expected, for the types of cases treated?” For each Trust one of the following answers is given:

a. The mortality rate is better than the expected range.
b. The mortality rate is within the expected range.
c. The mortality rate is worse than the expected range.

3. Hospitals which performed better than the expected range were as follows:

a. For AAA (emergency): Norfolk and Norwich University Hospitals NHS Foundation Trust
b For AAA (elective): Newcastle Upon Tyne Hospitals NHS Foundation Trust, University Hospitals of Leicester NHS Trust, Worcestershire Acute Hospitals NHS Trust
c. For Hip replacement (elective, planned): No hospitals in this category
d. For Knee replacement (elective, planned): East Kent NHS Trust

4. These indicators are derived from Hospital Episode Statistics (HES) and are based on deaths in hospital within 30 days of the given procedure over a three-year period (November 2004 – November 2007). Deaths after discharge from hospital or more than 30 days after the procedure are not counted. The indicators are adjusted for a number of factors, including age, sex, deprivation, and co-morbidity.

5. The NHS is the first public health service in the world to publish survival rates on a national basis. Publication is in the most accessible way possible, on the official NHS website, where the public can compare and rate hospitals on a wide range of clinical and non-clinical indicators.

The Norfolk and Norwich University Hospitals NHS Foundation Trust falls within the expected range for the other three categories of operations.

Thursday 10th of July 2008 11:00:12 AM