09 March 2016
Hospital Under Weekly Review Following High Death Rate Concerns
One of England’s best-known hospitals has been ordered to report weekly on the results of its adult heart operations after it was revealed that too many patients were dying both during and after surgery.
The Guardian newspaper reported that the Care Quality Commission (CQC) visited the Queen Elizabeth hospital in Birmingham in December last year after it was alerted to the high death rate of patients who had undergone open-heart surgery.
The paper suggests there may have been as many as 17 deaths over the last three years that could have been prevented.
CQC inspectors considered closing down the unit responsible for the operations following the inspection in December, but decided instead to allow it to continue on the condition it provided weekly reports on its results.
University hospitals Birmingham NHS foundation Trust now has to report its heart surgery results to the CQC by midday every Wednesday, while an independent Royal College of Surgeons team decide what improvements are needed. The CQC says it will monitor the unit for the “foreseeable future.”
Professor Sir Mike Richards, the chief inspector of hospitals at the CQC said: “Our inspectors found significant concerns particularly with regard to the safety, effectiveness and responsiveness of the service”.
“Following our inspection we have told the trust to take immediate action, with regard to the service and have been monitoring individual patient safety and outcome data on a weekly basis.”
Data from the Society for Cardiothoracic Surgeons revealed that between April 2011 and March 2014, the hospital’s cardiac surgical unit had an above average death rate.
Over those three years, figures show that the unit operated on 1,713 patients who had a survival rate of 95.54 per cent, taking into account factors such as the patient’s age and state of health. Of these, 77 patients died.
The trust has said the figures are misleading and the “cluster of deaths” related to a surgeon who was dismissed following an internal inquiry which found that 15 of his patients had died over a 14-month period and he had allegedly been misreporting mortality data of bypass patients.
In a statement the trust said it had "taken action as early as June 2013 when internal data identified a cluster of deaths between September 2011 and September 2012 related to one surgeon".
The CQC has said it will publish a full report on heart surgery at the Queen Elizabeth hospital shortly.
The situation at the Queen Elizabeth hospital in Birmingham is reminiscent of the scandal involving the tragic deaths of 29 babies at the Bristol Royal Infirmary in the late 1980s and early 1990s.
The subsequent Kennedy report into the scandal, which found that the deaths of up to 35 babies under the age could have been prevented, ensured heart surgery data was collected and shared. It is these systems, established following the publication of the report, that have identified exactly the same issue at the Queen Elizabeth hospital in Birmingham, 15 years later.
Unfortunately, despite the collection and sharing of heart surgery data amongst surgeons, there is clearly much more that needs to be done before patients and the general public can truly rely on the information and decide whether they will be in safe hands. Put simply, there have been too many deaths in Birmingham and the sooner the CQC report is published, the sooner the public will be made aware of what improvements are needed.
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