A report by Dr Foster, the health information body, suggests that death rates are worryingly high in a number of NHS hospitals.
High death rates are generally taken to be a sign of poor quality care. Where the study is at its strongest is probably in indicating that there is a problem. However it tells us less about exactly what is going wrong.
The researchers at Dr Foster used 4 measures of mortality rates in hospitals. One was the hospital standardised mortality ratio (HSMR). This measures death rates for patients with any one of 56 conditions. These conditions are important because they account for the vast majority of hospital deaths, around 80%.
A second measure is known as the summary hospital-level mortality indicator (SHMI) which counts deaths from patients discharged within the previous 30 days.
There may of course be reasons for death rates being higher in one area than another, such as the age profile of the population, higher levels of poverty or the types of specialist care available in that hospital; specialist cancer hospitals might for instance expect higher death rates than more general hospitals.
However it is unlikely that those factors provide a sufficient explanation for Dr Foster’s figures. It is more likely that high death rates are a sign of poor quality care and the figures certainly need investigation.
NHS Hospital Trusts where death rates are higher than expected of any 2 of 4 standard measures were:
1. Aintree University Hospital (Liverpool).
2. Blackpool Teaching Hospitals.
3. Buckinghamshire Healthcare.
4. George Elliott Hospital (Nuneaton).
5. Hull and East Yorkshire Hospitals.
6. Medway (Kent).
7. North Cumbria.
8. North Lincolnshire and Goole Hospitals.
9. United Lincolnshire Hospitals.
10. University Hospital Birmingham.
11. Walsall Healthcare.
12. Western Sussex Hospitals.
Paul Sankey is a Senior Medical Negligence Solicitor at Slater and Gordon Lawyers in London.
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