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Hospital death data a 'distraction', claims academic


Questions have been raised over the value of mortality statistics published for NHS hospitals, after an academic taking part in a review of their use branded them “spurious” and said the public would be better off ignoring them.

Hospital Standardised Mortality Ratios (HSMRs) have been published by Dr Foster Intelligence since 2001 and have been credited with helping to uncover excessive death rates at hospitals, such as Mid Staffordshire Foundation Trust.

However, Professor Nick Black, whose review is due to report to NHS medical Sir Bruce Keogh at the end of this year, has warned that they can give a misleading picture of a hospital’s performance.

He suggested that the data could be distorted by factors beyond hospitals’ control, such as the presence of a hospice in the neighbourhood.

“Personally, I would suggest that the public ignore them”

Nick Black

Professor Black, of the London School of Hygiene and Tropical Medicine, told BBC Radio 4’s File On Four programme: “I don’t think there’s any value in the publication of HMSR.

Professor Nick Black

Nick Black

“I would go further and say it is a distraction, because it creates the risk of it giving a misleading idea of the quality of care of a hospital,” he said.

“That’s why I think we should be focusing on measures of the quality of care and not on a spurious measure of mortality ratios, which can be altered relatively easily.

“Personally, I would suggest that the public ignore them,” he added.

Roger Taylor, research director of Doctor Foster Intelligence, defended the use of the statistic, telling the programme: “We can point to the fact that they helped to identify issues at Mid Staffordshire Hospital and Basildon Hospital.

“We can point to the fact that the number of hospitals that use them actively as part of their quality assurance and quality improvement programmes,” he said. “They identify those areas where there’s a greater risk of poor quality care.”


Readers' comments (2)

  • michael stone

    Isn't coming up with a way to measure 'the quality of care' the problem ?

    As a cynic, it seems to me that almost every measure that could be 'fiddled' will be manipulated by somebody: 'did this patient die whuile in the hospital ?' might be misleading, but the actual number probably can't easily be manipulated, at least !

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  • Nick Black is just adding to the debate.

    HSMSR's are indeed difficult to interpret but whilst in the public arena provide ammunition for ignorant journalists and other malcontents to misuse and generate alarm within the general public.

    Whilst I believe HMSR's are valuable finger pointers there is a need for widespread education to improve understanding of the measures limitations.

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