Death rates too high at 16 NHS hospital trusts

Death rates too high at 16 NHS hospital trusts

Sixteen hospital trusts in England have higher numbers of patients dying than they should have, according to an authoritative annual guide to NHS performance.


All 16 had a higher-than-expected mortality rate in 2012-13 according to the Hospital Standardised Mortality Ratio (HSMR), which records the number of patients who die while still in hospital, according to the report from Dr Foster Intelligence, which analyses the performance of the NHS.


But overall the picture is improving. The 16 trusts with high death rates are four fewer than last year, while 28 trusts had lower-than-expected mortality rates, up from 25 last year. And hospital mortality has fallen by 30% over the past decade.


"These findings reveal overall that while the number of people who are dying in hospital has risen slightly since last year, it is still a much more improved picture than in the 10 years previously," said Roger Taylor, Dr Foster's director of research.


Of the 16 trusts with high mortality, 13 also emerged from Dr Foster's analysis as having higher-than-usual mortality according to at least two of the healthcare information firm's seven ways of measuring death rates. Only five of the 13 were among the 14 trusts that inspection teams led by Prof Sir Bruce Keogh, NHS England's medical director, investigated earlier this year, 11 of which were later put into "special measures" by NHS regulators to improve their performance.


Those five are: Blackpool teaching hospitals NHS foundation trust; Medway NHS foundation trust; North Cumbria university hospitals NHS trust; Northern Lincolnshire and Goole hospitals NHS foundation trust; and United Lincolnshire hospitals NHS trust. All of them except for the Blackpool trust were placed into special measures.


The 13 emerged as having high death rates on at least two of four measurements, including HSMR, deaths in low-risk conditions, deaths after surgery and site-based HSMR. Three trusts were rated as high for deaths in low-risk conditions, five for deaths after surgery and 10 for site-based HSMR.


In all 237,100 patients died in hospital last year, 4,400 more than in 2011-12. However, the figure was 5,300 lower than in 2010-11 and the second lowest total recorded in the last decade.


The disclosures come after months of focus on and action to tackle hospital death rates, inadequate care and lapses in patient safety triggered by the publication in February of Robert Francis QC's report into the Mid Staffordshire hospital trust care scandal.


Keogh stressed that mortality among hospital patients had improved significantly in recent years. "We have fewer hospital mortality outliers than before. In fact hospital mortality in general has fallen by 30% over the last decade," he said.


"We have had a real focus on mortality over the past year and this report highlights some encouraging signs of improvement. But there is no room for complacency. The provision of safe care must be our number-one priority," added Keogh.

By Denis Campbell

The Guardian, 6th December 2013

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