Which surgeon is right for me?

Which surgeon is right for me? Understanding how surgeons monitor their 'end results' to improve the quality of treatments


Mr Andrew Chambler, Consultant Orthopaedic Surgeon, talks about his commitment to the gathering of outcome data and how, in turn, this improves the quality of treatments offered to patients.

The first thought in a surgeons’ mind when treating a patient is, “keep the patient safe.” The first thought in a patients’ mind is, “will the surgery work?”

We have a responsibility to our patients to understand the outcome of our surgical interventions. Codman (a famous American surgeon, born in 1869, and known for his pioneering use of process-and-outcome measures) understood this over a 100 years ago and asked, “If not, why not?” when looking at his results. This heralded the era of patient outcome-and-satisfaction analysis to improve the quality of treatments.

Factors associated with the variation in the outcome for patients following surgery have been a topic of major interest to the medical community for some time. Now patients can access this data, to make an informed decision, when choosing a surgeon.

During my shoulder and elbow fellowship, under Prof Carr in Oxford, I was involved in the creation of a clinical-audit programme that surgeons could use to follow up their patients’ outcome after surgery. I have used this prospective collection of functional outcome-and-satisfaction rates during my entire Consultant career with over 4,000 patients entered during a 15 year period. The data stretches over a number of hospitals within which I have worked, as a consultant orthopaedic surgeon with dedicated teams, to create solid foundations for treatment advancement.

The results allow an honest and transparent view of what my patients are likely to achieve after surgery, with evidence from over 3,000 surgical procedures. This provides a confident insight into the quality of life to which they will return following surgery and appropriate rehabilitation. I believe this achieves an effective, informed consent process for patients.

All orthopaedic surgeons should be able to provide this data as it shows care and interest in what they are doing for their patients. As a patient, you should be able to see these results before making a decision about which surgeon you would like to see.

A vital aspect of this is taking into account the patient’s perspective of their treatment. Patient-reported outcome measures (PROMs) were officially adopted by NHS providers in 2009. Every patient that receives care from me is assessed before and after their treatment. This data allows my team to pinpoint any vulnerability in the patient pathway, resulting in a system that is continually improving.

Ultimately, this results in better patient care. In a sample of 2,876 patients, we found that over 99% of my patients said that they did not regret having their operation, while 93% said that they were pleased with the results so far.

Continuous entry of results allows this to be a live record of the current practice at Circle Bath Hospital in terms of overall figures as well as individual types of operations.


Andrew Chambler is a member of the Shoulder and Elbow Unit at Circle Bath Hospital alongside consultant orthopaedic surgeons Simon Gregg-Smith, Gavin Jennings, Alex Cowey and Umer Butt.

He currently operates as an orthopaedic surgeon, specialising in shoulder and elbow surgery. He brings over 15 years of medical expertise, having extensive medical experience in the public and private sector. Oxford fellowship trained, he has been awarded travelling fellowships in America and Europe by the British Elbow & Shoulder Society.

Andrew is one of a number of leading surgeons in his field. He has committed himself to further the understanding of advanced-arthroscopic techniques and joint replacements; a pursuit he first began while working at Yeovil District Hospital Foundation Trust.



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