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Dr Foster Report Shows Sixteen NHS Trusts Have Higher Than Average Death Rates

237,100 Patients Died In Hospital In 2012/13, 4,400 More Than In 2011/12


Sixteen NHS Trusts in England have higher than expected death rates, while some score poorly on at least two indicators relating to patient death, according to a major report.

The Dr Foster Hospital Guide confirmed 16 hospital trusts had higher than expected death rates among patients in hospital, down from 20 the previous year.

The following trusts had death rates in hospital that were "significantly higher" than expected:

• Blackpool Teaching Hospitals NHS Foundation Trust
• Burton Hospitals NHS Foundation Trust
• George Eliot Hospital NHS Trust
• Heart of England NHS Foundation Trust
• Medway NHS Foundation Trust
• Mid Cheshire Hospitals NHS Foundation Trust
• North Cumbria University Hospitals NHS Trust
• North Tees and Hartlepool NHS Foundation Trust
• Northern Lincolnshire and Goole Hospitals NHS Foundation Trust
• Northumbria Healthcare NHS Foundation Trust
• Salisbury NHS Foundation Trust
• Sherwood Forest Hospitals NHS Foundation Trust
• South Tees Hospitals NHS Foundation Trust
• United Lincolnshire Hospitals NHS Trust
• University Hospitals Birmingham NHS Foundation Trust
• West Hertfordshire Hospitals NHS Trust.

However, analysis showed 13 hospital Trusts scored poorly on at least two out of four main indicators relating to patient death.

The indicators included a measure of in-hospital deaths, which are deaths within 30 days of the patient leaving hospital, deaths after surgery and deaths among people with low-risk conditions who would normally survive.

Out of these 13, five of the Trusts were investigated earlier in the year by NHS medical director Sir Bruce Keogh over concerns about their standards of patient care.

The five Trusts were North Cumbria, Northern Lincolnshire, Blackpool, Medway, Goole and United Lincolnshire hospital trusts. In the analysis revealed today, Blackpool Medway had higher than expected death rates across three out of the four indicators.

Overall, Dr Foster’s report showed that 28 Trusts had lower than expected in-hospital death rates and more Trusts scored low on two or more of the death rate indicators than scored highly.

The data also showed that 10 hospital Trusts have one or more hospital sites with a death rate higher than the overall trust level.

The number of people who died in hospital in England and Wales in 2012/13 was also higher than in the previous year but lower than 2010/11.

Some 237,100 patients died in hospital in 2012/13, 4,400 more than in 2011/12 but 5,300 fewer than 2010/11.

Roger Taylor, director of research at Dr Foster, said: "These findings reveal overall that while the number of people who are dying in hospital has risen slightly since last year it is still a much more improved picture than in the 10 years previous.

“This year, following the inquiry in Mid Staffordshire, the NHS has renewed its efforts to tackle avoidable mortality resulting from failures in healthcare.

"Hospital level mortality indicators can provide vital insights into where problems are worst.

"They also help us to monitor the extent to which outcomes for patients are improving. We are pleased that there are fewer hospitals with outlying high mortality rates this year compared to last."

Dr Foster awarded four "Trust of the Year" awards for good performance, one of which went to Salford Royal NHS Foundation Trust, which had lower than expected death rates across two indicators, along with West Suffolk NHS Foundation Trust.

Guy’s and St Thomas’ NHS Foundation Trust in London has been singled out by the report as one of the best performing Trusts in England as it scored lower than expected on all death rates.

Amongst the Trusts in the south, Frimley Park Hospital NHS Foundation Trust in Surrey had lower than expected death rates across three indicators.

Expert Opinion
The findings in the latest Dr Foster report are worrying particularly as the number of people who have died in hospital in 2012/2013 has risen from the previous year. For 16 hospital trusts to be identified as having higher than expected death rates, despite the Mid-Staffs inquiry aiming to reduce the number of avoidable mortality figures, is a cause for concern.

“There is never an excuse for patient safety to be compromised and this report highlights the importance of ensuring it is at the very top of every health professional’s agenda. Immediate steps must be taken to investigate what is causing their higher than expected death rates and improve standards as soon as possible.

“The NHS carries out a great service for our country and the majority of staff work tremendously hard to care for their patients. However, sadly we see firsthand that all too often there are problems with treatment and care which can lead to serious injury and in some cases, the unnecessary death of patients.”
Lisa Jordan, Partner