Report highlights concerns over 'alarmingly high' death rates at 'full to bursting' hospitals

 

The death rate at 12 NHS hospital trusts in England registered as ‘alarmingly high’ last year, according to an influential report.

The Dr Foster Hospital Guide found that patient safety is also being risked because hospitals are “full to bursting” with many regularly breaching the 85% limit set in place to protect patients.

Figures shows that in 2011-2012 occupancy was running at 88% in midweek, while averaging 90% for 11 of the 12 months, excluding quiet periods including Christmas.

The Guardian, which has seen the report in full, added that the national level was over 85% for 230 of the 365 days of last year, and over 90% for 19.

Dr Andrew Goddard, the director of the medical workforce unit at the Royal College of Physicians, which represents hospital doctors, told the Guardian: “If you ask any doctor in this country they would say that the system is straining to burst; particularly in winter, but now it's increasingly happening the rest of the year.

“Hospitals always seem to be full.”

The report outlines concerns that there could be “another Mid Staffs” as hospitals are increasingly focusing on cost of care 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”.

“These measures are to be used as a warning sign that poor-quality care may be leading to a higher-than-expected mortality,” the report states.

The authors continue: “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 that there could be another Mid Staffs.

“Hospital managers must ensure that they do not sacrifice one for the other.”

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

However, University Hospitals Birmingham NHS Foundation Trust (UHB) - one of the 12 trusts named as having higher death rates in two categories - raised concerns about the validity of the Dr Foster indicators.

Dr Dave Rosser, medical director at the trust, said: “The HSMR (Hospital Standardised Mortality Ratio) is widely considered to be unsuitable for use as a comparative indicator between hospitals.

“Dr Foster frequently changes the methodology of the HSMR which, in our opinion, further reduces its credibility as a comparator.”

He continued: “In our opinion, the mortality indicator relating to conditions of low clinical risk is deeply flawed.

“To illustrate, one of the patients identified by Dr Foster to be in this category was a patient admitted into one of UHB's specialist services with a condition called toxic epidermal necrolysis, which is known to have a mortality in excess of 50%.

“Under Dr Foster's methodology, this condition is classified as an allergy and therefore treated as 'low clinical risk'. There are many similar examples.”

The report, which measures mortality indicators at 145 acute hospitals in England, also found that death rates at three hospitals have been consistently high for three years running.

Buckinghamshire Healthcare NHS Trust, The Dudley Group NHS Foundation Trust and George Eliot Hospital Trust in Nuneaton had high mortality rates three years in a row.

Authors of the report alerted authorities to problems at the Mid Staffordshire NHS Foundation Trust - where the deaths rates were also high for a number of years.

At present, Robert Francis QC is finalising details of the report into the public inquiry concerning the serious failings at Mid Staffordshire NHS Foundation Trust.

Kevin McGee, chief executive at George Eliot, said the trust commissioned an external review of its historically high mortality rates last year.

He said: “It is important we acknowledge the HSMR data from the latest Dr Foster Hospital Guide as showing a time when figures were unacceptably high.

“However, we're very keen to focus on the future, where we will aim to maintain consistently low mortality rates coupled with high standards of care.

“We are obviously pleased with the improvements in mortality rates seen so far this year and it is testament to the efforts of all our staff, but we are still some distance from where we want to be.

“We always knew this wasn't going to be a quick fix; this is very much a journey, both for the trust and the wider health economy.”

A spokesman for the Dudley Group said: “We take mortality indicators very seriously and this is one of a number of tools we use to assure ourselves of the quality of our care.

“Current independent analyses show that the trust is not an outlier for mortality. Indeed, recent reports suggest a significant and sustained improvement.”

The Buckinghamshire Healthcare NHS Trust strongly denied that it had a higher than expected mortality rate and questioned whether the hospital guide reflected new ways of operating.

Medical Director Graz Luzzi said: “The title says it all. This is a hospital guide, but our care is also delivered at home, in the community and in a hospice. To be effective it is important to compare like with like.

“Hospice beds are obviously not the same, and the mortality rates between the two will be hugely different. Most hospitals in England don't run hospices, but new integrated acute and community health care trusts do.”

The Trust said the HSMR formula was developed for acute non-specialist trusts only and cannot accurately measure the mortality rate of Buckinghamshire Healthcare since its integration with the community hospitals and hospice.“

:: The 12 hospital trusts where the number of deaths are higher than expected in two of the four mortality indicators are: Aintree University Hospital NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Buckinghamshire Healthcare NHS Trust, George Eliot Hospital NHS Trust, Hull and East Yorkshire Hospitals NHS Trust, Medway NHS Foundation Trust, North Cumbria University Hospitals NHS Trust, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, United Lincolnshire Hospitals NHS Trust, University Hospitals Birmingham NHS Foundation Trust, Walsall Healthcare NHS Trust, Western Sussex Hospitals NHS Trust.

Start your day with The Independent, sign up for daily news emails
News
Ben Little, right, is a Labour supporter while Jonathan Rogers supports the Green Party
general election 2015
News
The 91st Hakone Ekiden Qualifier at Showa Kinen Park, Tokyo, 2014
news
Life and Style
Former helicopter pilot Major Tim Peake will become the first UK astronaut in space for over 20 years
food + drinkNothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
News
Kim Wilde began gardening in the 1990s when she moved to the countryside
peopleThe singer is leading an appeal for the charity Thrive, which uses the therapy of horticulture
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA special investigation by Andy McSmith
Sport
Alexis Sanchez celebrates scoring a second for Arsenal against Reading
football
Life and Style
health
Voices
An easy-peel potato; Dave Hax has come up with an ingenious method in food preparation
voicesDave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
News
i100
News
Japan's population is projected to fall dramatically in the next 50 years (Wikimedia)
news
Life and Style
Buyers of secondhand cars are searching out shades last seen in cop show ‘The Sweeney’
motoringFlares and flounce are back on catwalks but a revival in ’70s car paintjobs was a stack-heeled step too far – until now
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Project Implementation Executive

£18000 - £23000 per annum: Recruitment Genius: They work with major vehicle ma...

Recruitment Genius: Chiropractic Assistant

£16500 per annum: Recruitment Genius: A Chiropractic Assistant is needed in a ...

Recruitment Genius: Digital Account Executive - Midlands

£18000 - £26000 per annum: Recruitment Genius: They work with major vehicle ma...

Recruitment Genius: Web Developer

£28000 - £30000 per annum: Recruitment Genius: This company provides coaching ...

Day In a Page

NHS struggling to monitor the safety and efficacy of its services outsourced to private providers

Who's monitoring the outsourced NHS services?

A report finds that private firms are not being properly assessed for their quality of care
Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

The Tory MP said he did not want to stand again unless his party's manifesto ruled out a third runway. But he's doing so. Watch this space
How do Greek voters feel about Syriza's backtracking on its anti-austerity pledge?

How do Greeks feel about Syriza?

Five voters from different backgrounds tell us what they expect from Syriza's charismatic leader Alexis Tsipras
From Iraq to Libya and Syria: The wars that come back to haunt us

The wars that come back to haunt us

David Cameron should not escape blame for his role in conflicts that are still raging, argues Patrick Cockburn
Sam Baker and Lauren Laverne: Too busy to surf? Head to The Pool

Too busy to surf? Head to The Pool

A new website is trying to declutter the internet to help busy women. Holly Williams meets the founders
Heston Blumenthal to cook up a spice odyssey for British astronaut manning the International Space Station

UK's Major Tum to blast off on a spice odyssey

Nothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
John Harrison's 'longitude' clock sets new record - 300 years on

‘Longitude’ clock sets new record - 300 years on

Greenwich horologists celebrate as it keeps to within a second of real time over a 100-day test
Fears in the US of being outgunned in the vital propaganda wars by Russia, China - and even Isis - have prompted a rethink on overseas broadcasters

Let the propaganda wars begin - again

'Accurate, objective, comprehensive': that was Voice of America's creed, but now its masters want it to promote US policy, reports Rupert Cornwell
Why Japan's incredible long-distance runners will never win the London Marathon

Japan's incredible long-distance runners

Every year, Japanese long-distance runners post some of the world's fastest times – yet, come next weekend, not a single elite competitor from the country will be at the London Marathon
Why does Tom Drury remain the greatest writer you've never heard of?

Tom Drury: The quiet American

His debut was considered one of the finest novels of the past 50 years, and he is every bit the equal of his contemporaries, Jonathan Franzen, Dave Eggers and David Foster Wallace
You should judge a person by how they peel a potato

You should judge a person by how they peel a potato

Dave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
Beige is back: The drab car colours of the 1970s are proving popular again

Beige to the future

Flares and flounce are back on catwalks but a revival in ’70s car paintjobs was a stack-heeled step too far – until now
Bill Granger recipes: Our chef's dishes highlight the delicate essence of fresh cheeses

Bill Granger cooks with fresh cheeses

More delicate on the palate, milder, fresh cheeses can also be kinder to the waistline
Aston Villa vs Liverpool: 'This FA Cup run has been wonderful,' says veteran Shay Given

Shay Given: 'This FA Cup run has been wonderful'

The Villa keeper has been overlooked for a long time and has unhappy memories of the national stadium – but he is savouring his chance to play at Wembley
Timeless drama of Championship race in league of its own - Michael Calvin

Michael Calvin's Last Word

Timeless drama of Championship race in league of its own