Patients reassured over hospital safety

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Date: 22 May 2013

Time: 22:17

Patients reassured over hospital safety

Story posted/last updated: 29 November 2012

Dr Dave Rosser, Medical Director, University Hospitals NHS Foundation Trust, said: “I would like to reassure patients that our hospitals are extremely safe places to be treated and to have surgery.

“The Trust monitors its death rates on a daily, weekly and monthly basis and it refutes the mortality rates and death rates after surgery produced by Dr Foster.

“The figures do not accurately reflect the quality of care given at the Queen Elizabeth Hospital Birmingham. We believe there is a risk that figures like these could cause unnecessary confusion and distress amongst patients and are a distraction to concentrating on providing the best in care for our patients.

“The methodology for reaching their hypothetical figure is fundamentally flawed and misleading to the public. We treated over 90,000 inpatients in 2009-2010, 1,299 of whom died in our hospitals last year. Dr Foster’s methodology inflates the number of deaths, by such factors as attributing one death to multiple hospitals. These adjustments would take the number of deaths to 1,409. However Dr Foster has calculated our mortality rates based on 1,507 deaths (i.e. 208 deaths more than actually occurred). The Trust has been working with the Imperial College Dr Foster Unit, who are currently unable to explain how they have attributed 102 of those deaths to the Trust.

“The Dr Foster ‘deaths after surgery’ indicator is destructive and unhelpful. For example, many patients come to the Queen Elizabeth Hospital Birmingham’s regional liver unit with oesophageal varices, a condition often associated with alcoholic liver disease. More than 50% of patients die from this condition worldwide, even in the very best hospitals. As a specialist liver unit, in the majority of cases, doctors at the QEHB will carry out a procedure to try to save a patient’s life. However, the way this indicator is constructed, those patients who will die, despite the intervention, will still contribute to a high score on this indicator.

“We note that Newcastle-Upon-Tyne Hospitals NHS Foundation Trust have raised similar concerns about the indicator. They have a similarly large specialist liver unit and a similar score to QEHB.

“This indicator could put significant pressure on medical staff not to carry out procedures that would potentially save the lives of high-risk patients because they would be counted as unexpected deaths. For staff at QEHB the only consideration is doing what is in the best interests of the patient.

“We take any death of a patient in our hospitals very seriously and have a very robust and sophisticated system in place for monitoring them.

“The Trust independently asked one of the world’s most-renowned hospitals, The Cleveland Clinic in the United States, to review our mortality data and they reported no cause for concern.

“The Care Quality Commission, which regulates clinical standards across NHS hospitals, is also satisfied that there are no causes for concern regarding our mortality rates or deaths after surgery.

“The Hospital Standardised Mortality Rates methodology currently used by Dr Foster, to determine unexpected death rates, has been the subject of much debate nationally over the last few months. Following a Government directive, a new measure for hospital mortality has been nationally agreed and is due to be introduced from April 2011.

“The Trust did not complete the Dr Foster questionnaire for the Hospital Guide as it spends nearly £1m each year on employing staff to provide information mandated by numerous statutory bodies, which monitor and regulate care quality. The Trust felt it was not good use of public money and resource to fill in the detailed survey when a significant proportion of the information required by Dr Foster was already publicly available. This is line with the Trust’s policy of reducing costs wherever possible.”