Poor care puts high-risk patients in greater danger

Only half of high-risk patients receive the level of good care they are entitled to

Patients at the highest risk of death who undergo surgery in NHS hospitals are being put in even greater danger by the poor standard of care.

Only half of high-risk patients – the elderly or those with multiple illnesses – received good care in UK hospitals, according to the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).

"People die because we do not give them the level of care they are entitled to expect," said Bertie Leigh, chairman.

There are around 20,000 to 25,000 deaths a year following surgery in hospitals across the UK, a rate of less than 1 per cent. But among high-risk patients death rates are 10 to 15 times higher.

These patients represent one in 10 of the total having surgery but eight out of 10 of the deaths. Too many patients were being returned to general wards after surgery, rather than to critical care units and too few were being assessed before surgery. Fewer than one in 10 had risk of death explicitly stated on their consent form.

The report examined the care of 19,000 patients treated in 300 hospitals but did not include an assessment of the quality of the surgery itself.

George Findlay, NCEPOD clinical co-ordinator, said: "There appears to be a serious lack of awareness of the degree of mortality risk to patients. If we don't identify the risks how can we provide the best care?"