Lincolnshire hospitals trust rejects high death rate report

The figures are included in a study by Prof Sir Brian Jarman which says death rates at United Lincolnshire Hospitals NHS Trust (ULHT) were about three times higher in 2015/16 than in 2013/14 when its hospitals were put into special measures.

The study shows that the number of ‘unexpected deaths’ almost tripled from 129 to 357 during that period. Prof Jarman, who is co-director of the Dr Foster Unit at Imperial College, London, said that the figures show there are ‘ongoing problems’.

The report has used the summary hospital-level mortality indicator (SHMI), but ULHT says this is not a reliable measure.

Instead, it says its mortality rates are at the average level for a trust of its size. It quotes a HSMR (hospital standardised mortality ratio) figure which takes into account a number of factors such as population size and age profiles.

A spokesman for ULHT told the Journal: “We don’t accept Prof Jarman’s interpretation of our mortality figures.

“It’s important to point out that higher than expected HSMR and SHMI rates don’t necessarily mean that there were unnecessary or avoidable deaths.

“Mortality rates act like an alarm and they tell you to check things out and where to look for possible issues.

“A report published last year by Hogan, Zipfel, et al (2015) showed that there is no 
significant association between avoidable deaths and HSMR.

“Our HSMR is currently 97.5 and therefore in line with what’s expected for a trust of our size.

“The number of expected deaths in our hospitals is reducing and HSMR shows and over the last few years we have had fewer deaths than expected.

“SHMI is higher than expected but the data is nearly a year out of date and includes deaths that occurred out of hospital too – up to 30 days after being discharged from hospital – and includes patients at the end of their 
life.

“The quality and safety of patient care is the trust’s number one priority and we take patients’ deaths seriously.

“We ensure that patient deaths are reviewed by a senior doctor who hasn’t been involved in the patient’s care and any deaths where there is a potential cause for concern are reviewed by a mortality group which is chaired by our deputy medical director.

“As a trust, we are always looking to improve the quality of care we give our patients.”