High death rates put a dozen trusts in spotlight

Hull and East Yorkshire Hospitals NHS Trust and Northern Lincolnshire and Goole Hospitals NHS Foundation Trust were among those where the number of patient deaths are above expected levels, the Dr Foster Hospital Guide found.

Patient safety is also being risked because hospitals are “full to bursting”, with many regularly breaching the 85 per cent limit in place to protect patients, it said.

Occupancy was running at 88 per cent midweek in 2011-2012, while averaging 90 per cent for 11 of the 12 months, excluding quiet periods including Christmas.

The report outlines concerns there could be another tragedy similar to that in which up to 1,200 patients died at two hospitals in Mid Staffordshire as a result of poor care as hospitals are increasingly focusing on cost rather than quality of care.

Each of the 12 trusts fell short on two of four mortality rate indicators – which include deaths after surgery and the deaths of patients who were admitted for minor ailments or “low-risk conditions”.

The authors say: “With the rising demand for care and falling revenues, there are concerns that trusts will focus more (or exclusively) on cost of care rather than quality of care.

“Because of this, there is a fear there could be another Mid Staffs. Hospital managers must ensure that they do not sacrifice one for the other.”

The report also suggests a shortage of senior doctors working out of hours could be linked to higher mortality rates at weekends.

Death rates at Northern Lincolnshire and Goole NHS Foundation Trust were found to be high using the Standard Hospital-Level Mortality Indicator (SHMI), a measure which indicates whether the numbers of deaths at a hospital and within 30 days of patients being discharged is higher or lower than expected, and the Hospital Standardised Mortality Ratio (HSMR), which does not include deaths after discharge but does include other factors such as palliative care and previous emergency admissions. Both were based on data from April 2011 to March 2012.

The trust said its own more up-to-date monitoring, using the Risk-Adjusted Mortality Index (RAMI), which produces an expected probability of death, showed death rates had fallen to within expected levels this year.

Medical director Dr Liz Scott said: “The RAMI figures are reassuring but we will not become complacent. Mortality rates remain an issue for the whole health community and, together with our commissioners and GPs, we are making sure that all possible factors are addressed.”

Dr Yvette Oade, Chief Medical Officer at Hull and East Yorkshire Hospitals NHS Trust, said: “We are really pleased to see that our continuous work to improve patient care is having a positive impact on HSMR which is much improved on last year.

“Our latest SHMI data sees us much improved on the Dr Foster figure and within the ‘as expected’ range.

“We accept we still have a lot of work to do but I would like to pay tribute to all of our staff who have worked so hard to make a difference to the care we offer.”