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Fourteen trusts rated worst by first official hospital death rate

Fourteen hospital trusts have been identified as the poorest performers in the first official hospital-wide mortality ratings.

The NHS Information Centre published the summary hospital-level mortality indicator (SHMI) for all non-specialist acute trusts today, after the measure was agreed by a Department of Health review.

The 14 trusts that have been given the lowest banding score of one, after statistical adjustments have been applied, are likely to face attention from the national and local media.

Several of the 14 have been poorly rated previously by similar indicators, such as the Doctor Foster hospital standardised mortality ratio, or have had quality problems highlighted by regulators.

A further 22 trusts received the lowest banding score under a different DH sanctioned method – results of which have also been published.

NHS Information Centre chief executive Tim Straughan said in a statement: “The SHMI is best treated as a ‘smoke alarm’ that should be used locally by individual hospital trusts to assess and investigate their mortality-related outcomes.

“Though a powerful measure, it should not be taken in isolation as a headline figure of trust performance. It requires careful interpretation and for that reason it is not specifically tailored for use by patients or the public, though we understand there will be clear interest in it.”

He added: “The SHMI marks a major step forward for the NHS, as it will be the single summary hospital-level mortality indicator that will be used consistently across the NHS.

“We have ensured that everyone can see how it is calculated by publishing details of its methodology on our website. We’ve done this both in the spirit of transparency and also to help encourage debate about the measure and how it is used.”

The DH briefed journalists ahead of the publication yesterday, stressing the limitations of the measure for judging the quality of a hospital’s services.

The figures will be published each quarter.

The 14 trusts, ordered from highest ratio of deaths to expected deaths to the lowest, are:

  • GEORGE ELIOT HOSPITAL NHS TRUST
  • ISLE OF WIGHT NHS PRIMARY CARE TRUST
  • EAST AND NORTH HERTFORDSHIRE NHS TRUST
  • BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST
  • TAMESIDE HOSPITAL NHS FOUNDATION TRUST
  • MEDWAY NHS FOUNDATION TRUST
  • YORK TEACHING HOSPITAL NHS FOUNDATION TRUST
  • NORTHERN LINCOLNSHIRE AND GOOLE HOSPITALS NHS FOUNDATION TRUST
  • BASILDON AND THURROCK UNIVERSITY HOSPITALS NHS FOUNDATION TRUST
  • HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST
  • NORTHAMPTON GENERAL HOSPITAL NHS TRUST
  • EAST LANCASHIRE HOSPITALS NHS TRUST
  • UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST
  • WESTERN SUSSEX HOSPITALS NHS TRUST

Fourteen trusts were also given the highest banding score of three, awarded for the lowest ratio of observed deaths to actual deaths. From the lowest ratio to the highest, they are:

  • THE WHITTINGTON HOSPITAL NHS TRUST
  • BARTS AND THE LONDON NHS TRUST
  • UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST
  • IMPERIAL COLLEGE HEALTHCARE NHS TRUST
  • ROYAL FREE HAMPSTEAD NHS TRUST
  • ST GEORGE’S HEALTHCARE NHS TRUST
  • CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST
  • CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST
  • NEWHAM UNIVERSITY HOSPITAL NHS TRUST
  • NORTH WEST LONDON HOSPITALS NHS TRUST
  • SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST
  • KINGSTON HOSPITAL NHS TRUST
  • JAMES PAGET UNIVERSITY HOSPITALS NHS FOUNDATION TRUST
  • EALING HOSPITAL NHS TRUST

Readers' comments (7)

  • every one knows Healing Ealing is bad The enviorment of institutional racism and bullying against staff and patients shows that the management cares more about their jobs than the patients who should allways come first

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  • I might have missed this in the main article, but what exactly does the term,

    "...observed deaths to actual deaths" mean?

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  • Statistical data does not provide qualitative information - perhaps these areas serves an elderly demographic e.g. elderly retiring to the sea-side or the country. Being elderly brings one that much closer to death.

    In some cases, Orthopaedic Consultants may be more willing to operate and give a new hip to those elderly who have little qualitiy of life and are willing to accept the chance of death on the table or soon after rather than live on in pain.

    It is the latter group, perhaps, who will suffer the most if surgeons become more worried about their statistical profile on line than the quality of life of their potential patients.

    Statistics should not be looked at in isolation like this - things are not always how they seem.

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  • Surely it is understandable some of these trusts have a higher death rate, due to the nature of the patients they care for, for example Barts and the London, who have a major trauma centre. Do not think I am excusing higher rates, but should we not be worrying about ensuring patients have appropriate care with adequate staffing levels?

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  • @ Geeze | 1-Nov-2011 8:28 am

    very good question, some please enlighten me.

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  • yet another statistic that can be misrepresented and cause serious distress to the local population of these hospitals in the top ranking of the worst preforming Trusts in relation to mortality. Papers will always seek to sensationalise headlines yet the small print is always left out. I work for basildon and Thurrock University hospital NHS Foundation Trust and can tell you there are under 14 palliative beds in our local comunity for adults. Local nursing and care homes would appear to be overtly concerned with litigation so send their dying patients in to the hospital who would otherwise die at home and also, the mortality statistic using SHMI looks at patient outcomes for 30 days post discharge, so all those patients discharged palliatively from the acute trust to die in their own home to for fill their dying wish will still show in the mortality stats if they die within the 30 days. I dont think papers will share this information with its readers and therefore they are left to worry about attending hospital, may even leave conditions to long and come in late adding to our mortality because they have been unduly scared away.

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  • @Geeze and Anon 2 NOv 10.15am

    The new mortality rate compares how many deaths occured in a hospital and 30 days after discharge from that hospital with how many deaths would be expected. The expected deaths is calculated based on age, sex, admission method (ie. emergency or elective) diagnosis and co-morbidities of patients. It doesn't take into account other things, such a levels of deprivation in the population, if a patient has been admitted for palliative care or if they have undergone a procedure whilst in hospital so still very controversial.

    Hope that helps,

    Sarah

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