Comments Trigger Hospital Death Rate Row

Comments About Death Rates Have Triggered A Row Over Whether They Can Be Used To Measure The Performance Of A Hospital


Dave Grimshaw, Press Officer | 0114 274 4397

An expert leading a review into hospital death rates has triggered a row after making comments about the benchmark's usefulness.

Professor Nick Black has been asked by the NHS to investigate whether death rates properly assess the performance of trusts, but has come out with his conclusion earlier than expected.

While professor Black's report is not due to be published until December, the academic has told the BBC that mortality rates at hospitals seem to have little or no value at all.

Speaking on the File on 4 programme, professor Black said his prior knowledge showed that the hospital standardised mortality ratio (HSMR), which compares expected death rates with actual figures recorded, were useless.

The crux of his argument is that they do not take a number of outside factors, such as the availability of hospice care nearby and public health, into consideration and therefore this benchmark should be scrapped.

"I don't think there's any value in the publication of HSMR and I'd go further, I think it's actually a distraction because it gives ... a misleading idea of the quality of care of a hospital," he added.

"Personally, I would suggest that the public ignore them."

Professor Black's findings have not been well received by some experts - including Roger Taylor, of the Dr Foster health intelligence and insight organisation, who stated there are countless cases where HSMR has proven useful.

At Stafford Hospital, for example, an elevated HSMR was the first sign of a problem and led to a number of other failings being identified.

"What they do is they identify those areas where there's a greater risk of poor quality care," Mr Taylor stated.

Among other backers of the HSMR are the Department of Health, which uses it to assess performance at trusts at risk of being put into special measures, as well as the Care Quality Commission, where it is used to prioritise which hospitals to visit first for its inspections.

Expert Opinion
Several indicators are used to assess the performance levels of hospitals and death rates are just one of them. While there are some questions over whether on their own they give an accurate reflection of the standard of care, there are circumstances where abnormally high rates have identified serious issues affecting patient safety.

“It is important that hospitals are appropriately monitored and reviewed so that lessons can be learnt from any issues and mistakes to protect future patients from harm.

“We see people on a daily basis whose lives have been shattered by medical negligence and many of the issues in their care are avoidable.”
Lisa Jordan, Partner