Shropshire hospital death rates higher than expected

The death rate at Shrewsbury and Telford Hospital Trust (SATH) was 2.9 per cent higher than the forecast, with 79 more patients dying last year than had been forecast.

However, the figure falls within the official ‘expected’ rating for NHS trusts, which allows a margin of error for the estimates.

The picture appears to be far more serious at the neighbouring Wye Valley trust, where the death rate was nearly 17 per cent higher than expected.

Wye Valley, which runs the Hereford County and Leominster Community hospitals, was one of the 13 worst performing trusts in the country as measured by the Standardised Hospital Mortality Index (SMHI) figures. It is the second year running it has suffered from higher-than-expected death rates.

The biggest shock, though, came in Wolverhampton where there were a staggering 475 more deaths than expected. The Royal Wolverhampton trust, which runs the city’s New Cross Hospital, had the worst unexpected death rate in England, with the number of mortalities 22 per cent higher than expected.

The figures are compiled by NHS Digital, and were brought in following the Mid-Staffordshire Hospital crisis. They compare the number of patients who die either in hospital or within 30 days of discharge, to estimates based on factors including the characteristics of patients treated at the hospitals.

Dr Edwin Borman, medical director at SaTH, said: “The SHMI is a very useful statistical tool which we use, in conjunction with a number of other indicators, to evaluate our performance.

“The latest figures show that we are about where we would expect to be for a hospital of our size and for the complexity of conditions which we treat.

“We work hard to learn from patients’ deaths in order to improve the care of all patients.”

A similar form of data analysis was used to help uncover the Mid-Staffordshire scandal in 2010, which saw between 400 and 1,200 patients die as a result of poor care at Stafford Hospital between January 2005 and March 2009.

Appalling

Sir Robert Francis QC held a public inquiry in to the matter in 2010. His report, published in 2013, concluded that hospital managers became obsessed with government targets at the expense of care.

He found that hundreds of patients experienced "appalling and unnecessary" suffering.

Amanda Millichip, of Wye Valley NHS Trust said it took the investigation, and the lessons learned from the deaths in hospital, extremely seriously.

"Regular investigation of individual deaths, review of a range of more serious illnesses often causing death and regular assessment of statistics relating to mortality are features of the trust’s rigorous approach to ensure it delivers the highest quality of patient care," she said.

She said the figures were of limited use when comparing different hospitals as they were substantially influenced by a number of factors, such as the type of cases admitted to a trust and the length of time a patient may stay in hospital.

“A higher percentage of older frail people among the trust’s patients does lead to an increase in the proportion of deaths from urinary and respiratory infection as these conditions are associated with the end of life in older adults," she said.

“These latter factors have influenced a high SHMI in Herefordshire over many years; repeated investigations and reviews have confirmed high standards of clinical care, and processes are in place to continue learning from these reviews. This ongoing monitoring ensures high quality care is provided," she added.

“The figures published today reflect the period from January to December last year.

“In April this year the Trust implemented its mortality strategy and can confirm that more recent mortality figures show a consistent downward trend in in-month SHMI scores and a reduction in the SHMI rate overall.

“While this is encouraging, the trust continues to investigate and seek any learning from all deaths.”