News that the government has launched an investigation into high death rates in 14 NHS hospitals is welcome. The decision follows the investigation into poor patient care in Mid Staffordshire NHS Trust.
It will be important to find out why more patients die in some hospitals than in others. In the meantime here is my guess as to some of the key factors, based on the experience of our specialist Clinical Negligence team.
1. The failure to follow early warnings systems.
Most hospitals operate a ‘MEWS’ system. This is an early warning system based on nursing observations – pulse, temperature, heart rate etc – designed to alert nursing and then medical staff to patients deteriorating. In a number of our recent cases patients have died or suffered serious complications from septic shock including strokes and Amputations.
2. Low levels of staff at the weekend
We already know that death rates are higher at weekends than during the week. The reason is clear. Paying staff to work at weekends is expensive. Hospitals cut costs by reducing staff levels at weekends. Some do so more than others. Patients die as a result. A large number of our cases arise because of poor weekend care.
3. Varying standards of surgery
Some hospitals are simply better equipped than others and have more specialist staff. This is not necessarily the hospital’s fault. Much as we love our hospitals to be local, a local district hospital is unlikely to offer the specialist skills found at a teaching hospital. Even the teaching hospitals may not offer the same level of care as is offered by some of our centres of excellence (such as the Royal National Orthopaedic Hospital, Moorfields Eye Hospital, the Royal Marsden Hospital (Cancer) and others).
It will be important to learn from the Inquiry’s findings. It will be interesting to see what it says about the 3 factors I have suggested.
The hospital trusts being investigated are:
Colchester Hospital University NHS Foundation Trust
Tameside Hospital NHS Foundation Trust
Blackpool Teaching Hospitals NHS Foundation Trust
Basildon and Thurrock University Hospitals NHS Foundation Trust
East Lancashire Hospitals NHS Trust
North Cumbria University Hospitals NHS Trust
United Lincolnshire Hospitals Trust
George Eliot Hospital NHS Trust
Buckinghamshire Healthcare NHS Trust
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust
Dudley Group NHS Foundation Trust
Sherwood Forest Hospitals NHS Foundation Trust
Medway Foundation Trust
Burton NHS Foundation Trust
Read more about Medical Negligence.