Birmingham’s Queen Elizabeth Hospital among 13 NHS trusts reporting alarming mortality rates

How mortality rates should be calculated is a hotly debated question in the medical world and Dr Foster’s latest reports will make sure that it remains to be. According to their latest findings 13 hospital trusts have recorded higher than expected mortality indicator scores –  and the results from the Queen Elizabeth Hospital in Birmingham give most cause for concern.

These statistics are a key feature of Dr Foster’s annual reports on the subject; an NHS trust must fail in 2 or more of the following areas to be flagged up.

  • Deaths after surgery
  • Deaths in low-risk conditions
  • Site based HSMR [the hospital standardised mortality ratio]
  • Summary hospital-level mortality indicator

The 13 poorly performing NHS trusts named

Out of the 28 NHS hospital trusts that Dr Foster featured in their reports, the 13 who reported poor mortality scores were:

  • West Hertfordshire Hospitals Trust
  • United Lincolnshire Hospitals Trust
  • University Hospitals Birmingham Foundation Trusts [which runs Birmingham’s Queen Elizabeth Hospital]
  • East Sussex Healthcare Trust
  • Heart of England Foundation Trust
  • Northumbria Healthcare Foundation Trust
  • Northern Lincolnshire and Goole Hospitals Foundation Trust
  • Medway Foundation Trust
  • North Tees and Hartlepool Foundation Trust
  • Mid Cheshire Hospitals Foundation Trust
  • North Cumbria University Hospitals Trust

The fact that 13 trusts returned higher than average results is alarming, but it is Birmingham Foundation Trusts results that will draw the most concern amongst medical governing bodies. They stand out as the worst amongst the 13, as they posted the worst failures in 3 of the 4 marking categories. On top of that none of the trusts listed above had a lower than expected rate in any of the areas judged. Dr Foster’s reports as a whole won’t make pleasant reading for NHS officials, especially at a time in which the organisation is under scrutiny.

However the NHS has often questioned Dr Foster’s reports on mortality rates, with their reliability and accuracy being debatable. However, given the clear culture of refusing to admit mistakes that seems prevalent in the health service, a culture that has been clear displayed in the recent series of medical negligence scandals, and is very familiar to experienced medical negligence lawyers, this response and the NHS is hardly surprising .

What’s more, a team led by Sir Bruce Keogh (NHS England medical director), has conducted their own investigation into the performance of 4 of the 13 trusts. The 4 trusts in question were:

  •  Medway Foundation Trust
  •  North Cumbria University Hospitals Trust
  • Northern Lincolnshire and Goole Hospital Trust
  • United Lincolnshire Hospitals Trust.

As a further response to the concerning Dr Foster report, NHS England will be launching a study into mortality rates, avoidable deaths and how they relate to each other. Lord Darzi and Nick Black will be running the study, with many hoping that the results will provide the NHS with new measures based upon clinical case notes. Let’s hope that rather than arguing that the stats simply are not accurate, the NHS tries to ensure that all hospitals consistently adopt good medical practice – which the best hospitals have long taken on board, and which the highly reputable Dr Foster team at University College London identifies and promotes.

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