The recent 2012 Hospital Guide published by Dr Foster has found that high mortality rates are still persisting in many trusts in the UK, and NHS trust Aintree University Hospital is at the top of the list. The recent inquiry at Mid Staffordshire NHS Foundation Trust demonstrates the need for these kinds of evaluations of mortality rates, as they can uncover underlying issues that should urgently be addressed.
When assessing hospitals, the guide used four measures of mortality in order to rate each trust:
• Hospital Standardised Mortality Ratio (HSMR)
This measures deaths while in hospital, and is based on 56 conditions that account for 80% of mortalities. It checks the level of care provided in hospitals, and any high ratios could indicate basic problems that need to be dealt with.
• Summary Hospital-Level Mortality Indicator (SHMI)
This measures deaths following hospital treatment (either while in hospital or during the 30 days after leaving). It is based on all conditions and checks on the level of care provided while the patient is in hospital as well as the vital period after they’ve been discharged.
• Deaths After Surgery
This measures patients who have died due to possible complications during an operation, and checks on any issues with the surgery and if the operation should have taken place at all.
• Deaths in Low-Risk Conditions
This measures mortalities of patients who suffer from conditions where they would normally have survived, and checks unexpected deaths in hospitals.
Eleven other NHS trusts (as well as Aintree) were found to perform lower than expected on at least two of these four key measures:
• Blackpool Teaching Hospitals
• Buckinghamshire Healthcare
• George Eliot Hospital
• Hull and East Yorkshire Hospitals
• North Cumbria University Hospitals
• Northern Lincolnshire and Goole Hospitals
• United Lincolnshire Hospitals
• University Hospitals Birmingham
• Walsall Healthcare
• Western Sussex Hospitals
The report also found several NHS trusts that have achieved well on three out of four key measures over the year:
• Barnet and Chase Farm Hospitals
• Chelsea and Westminster Hospital
• Guy’s and St Thomas’
• Imperial College Healthcare
• Royal Free London
High mortality rates at the weekend have been related to the level of staff members who are employed on these days; the low number of senior doctors available on Saturdays and Sundays could be part of the problem. All of the measures that were evaluated are to be taken as warning signs about the level of care provided, not as proof that poor care is necessarily offered at these trusts.
Victim of medical negligence at Aintree University Hospital?
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