Hospital mortality rates worryingly high for FOUR years

Wigan Infirmary
Wigan Infirmary

Wigan’s hospital mortality levels should have been considered worryingly “high” for at least the last four years, not just the last one, a medical expert claimed today.

Prof Brian Jarman, the man who broke the mid-Staffs high death rates scandal, says Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust is one of many whose official ratings by NHS Digital understate potential problems.

Dr Martin Farrier

Dr Martin Farrier

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He used two variations on internationally-recognised ways of categorising mortality in hospitals to show WWL had a “high” rather than “average” death rate in each year since 2012 or 2013.

However, NHS figures give WWL an average mortality rate for every year in the same time period except for 2016, when it was acknowledged to be higher because it was a massive 14 per cent greater than the national average.

The other years it has been nearer six or seven per cent above the English norm. That puts it in the “average” bracket in NHS Digital’s categorisation but would trigger alarm bells under the international calculations.

Prof Jarman, who works at Imperial College London, is now calling for the threshold above which mortality rates are seen as a serious problem needing attention to be dramatically lowered.

He said: “The NHS is using a confidence interval which is not used anywhere else in the world as far as I know.

“I used an internationally-used method and that shows the mortality rates are significantly higher.

“This is really unacceptable in my view. When the Care Quality Commission (CQC) goes into the hospitals they are told there is no problem with mortality when of course there is.”

NHS figures show WWL’s death rate in 2016 was two per cent above the level at which health bosses classify it as high (12 per cent or more over the national average).

Prof Jarman has also claimed 19,000 deaths in English hospitals in the last five years should be classed as unexpected, even though NHS figures do not consider them to be.

His research has been greeted with fury by relatives of people who have died in hospitals in recent years.

Paul Highton, whose father Russell died at Wrightington in 2008 following an operation, said: “They are fudging the stats to make out there’s no problem, but Prof Jarman has used the correct threshold and the death rates are way over the NHS ones.

“It shows that nothing has changed from when my dad died. People are still going in and dying through poor care and negligence, nearly 10 years later.”

However, WWL has suggested that Prof Jarman’s figures do not show the whole picture of why people die in hospital and compare trusts against each other in a way which is unhelpful.

Dr Martin Farrier, consultant paediatrician and deputy medical director, said: “The best evidence for the numbers of deaths which can be prevented comes from PRISM studies.

“They indicate a preventable death rate of about three per cent, that is three per cent of hospital deaths might be prevented by better care.

“Mortality calculations have failed to alert services to an increasing death rate across the country. Because the rates are only comparative, the problems of an aging population and increasing deaths as a consequence are ignored.

“The problems of frailty and dementia are proving to be the great healthcare dilemmas of our age but they are completely invisible to mortality calculations.

“Mortality calculations have had their place. They helped us to consider ways of improving healthcare. They come with some deep problems. They are not a measure which allows simple comparison of one organisation with another. Nor do they help us with planning for the future.”