Demand for overhaul in wake of hospital report

A massive overhaul in the way hospitals are inspected was demanded yesterday, as a new report revealed that nine trusts rated excellent or good by the official health regulator were failing when it came to patient safety.

The latest Hospital Guide from the Dr Foster organisation rates hospitals according to "safety indicators" such as deaths, errors in surgery, infection rates and staff levels. It identified 27 trusts with unusually high mortality rates and said more than a third were found to be "failing to investigate unexpected deaths or cases of serious harm on their wards".

Items such as swabs and drill bits were left inside patients after surgery in 209 cases, and surgeons operated on the wrong part of a body at least 82 times. As many as 5,024 patients died after being admitted for "low-risk" conditions, of whom 848 were under 65. The fact that nine of the 12 worst performing trusts in the new league table were recently judged by the Care Quality Commission watchdog to be "good" or "excellent" led to a debate yesterday over the current inspection system.

"Clearly there needs to be a massive overhaul in the way that the inspection regime is working," said the shadow health minister, Stephen O'Brien. "The failed system of self-assessment can't carry on. We need above all to stop the tick-box targets."

And Norman Lamb, the Lib Dem health spokesman, called for a public inquiry. "The case is overwhelming, and we appear to have a system which seems to be able to deliver 'paper-safety' but not real 'patient safety'," he said. Katherine Murphy, director of the Patients Association, added: "What confidence can we have in a system that claims hospitals are excellent or good when in fact they are consistently under-performing?"

The lowest score in the guide went to Basildon and Thurrock University Hospitals NHS Foundation Trust, which had a taskforce ordered in last week to sort out a series of failings. Monitor, the body that regulates foundation trusts, stepped in after a report criticised poor hygiene, standards of care and a death rate of about a third higher than the national average.

Yesterday, Baroness Young, head of the Care Quality Commission, said some of the Dr Foster data was "very legitimate" but some was "quite alarmist", insisting other trusts would not need the same taskforce response as Basildon. "We do a comprehensive programme of monitoring, on a much more detailed level," she said.