Probe into hospital death rates has been launched

11:50am Wednesday 27th February 2013 in News Photograph of the Author Exclusive By Jessica Bell, Health reporter

Probe into hospital death rates has been launched Probe into hospital death rates has been launched
  • 800 cases of septicaemia recorded
  • Average for similar trusts is just 200
  • For six years, Bolton recorded poor death rates
  • In 2011, it was said to be "most improved" for mortality
  • Septacaemia receives higher payments than other infections

AN investigation into death rates at the Royal Bolton Hospital has been launched after an independent watchdog claims to have discovered “significant discrepancies” in the hospital’s data.

Bolton NHS Foundation Trust’s Acting Chief Executive, Dr Jackie Bene, has “stepped aside” following the discovery that an unusually high number of patients had been “coded” as having had septicaemia in a year.

Septicaemia, a severe infection that enters the blood stream, is coded, or tagged, in a different way to other illnesses and infections. This means deaths caused by septicaemia do not affect mortality figures.

The Trust recorded 800 cases of septicaemia between March 2011 and April 2012 — a similar sized trust would expect to have just 200.

Dr Bene, as former medical director, was in charge of recording the information.

Independent health researcher Dr Foster and Bolton’s Clinical Commissioning Group (CCG), are currently investigating 200 cases.

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Their report, which is supported by NHS Commissioning Board and Professor Sir Bruce Keogh, the UK’s national medical director, is expected to be completed on March 6.

It is too early to say why the Trust had so many cases of septicaemia, but the CCG said its interim findings for 50 of the cases show “cause for concern”.

It is believed patients’ records could have been coded incorrectly causing the “discrepancies”.

If some of the Trust’s deceased patients have been coded incorrectly as dying from septicaemia when they had a different cause of death, it could have a drastic impact on the Trust’s death figures.

Each year, Dr Foster compiles mortality statistics for all trusts.

In December, Bolton NHS Foundation Trust’s results were “better than expected”. This followed an award for “most improved” trust in 2011.

But for the six previous years, Bolton was one of the worst performing trusts for death rates, with figures massively above the national average.

The coding could also affect income as hospitals receive money for results and types of illnesses. Septicaemia receives a higher payments than other infections.

On Monday, the Trust’s interim chairman David Wakefield informed staff that Dr Bene had “stepped aside” to “allow a fully independent view to be taken”.

Mr Wakefield, who was appointed by health watchdog Monitor after the Trust was put in the highest risk rating for governance and finance, said an independent team would be brought in to look at coding practices.

He added that Deloitte, which is currently part of a £1 million financial turnaround plan at the Trust, would extend its work load to look at quality governance.

Mr Wakefield said the Trust wanted to “rule out any serious issues as soon as possible” and make sure the way they code patient outcomes meets “highest quality standards”.

He stressed the 50 cases would be reviewed by clinical staff to rule out any serious issues, and if there were any concerns with care then families would be contacted.

But he added: “We do not believe that there are any clinical concerns regarding the care of patients, but rather there are questions that need answering about how the trust reports information about their care for administrative and financial purposes.

Dr Wirin Bhatiani, chairman of Bolton Clinical Commissioning Group, said it first became aware of the “unusually high” number of septicaemia cases in October and commissioned Dr Foster to carry out an independent audit.

CCG chiefs discussed concerns with the Trust, Monitor, quality experts from the Strategic Health Authority in the North, NHS Greater Manchester and the Care Quality Commission on January 24.

Dr Bhatiani said: “While we are keen to wait for the final report, we are sufficiently concerned by the interim findings to commence further investigations, and to inform the chair of the trust.

“When the final report is available on March 6, we will present the findings openly and transparently, reflecting the fact that the Bolton public are our main concern and priority.”

The 50 cases will be reviewed by clinical staff and if any concerns arise with the care provided in them the hospital says it will directly contact their families.

The Trust said: "As always our PALS team is available to provide information and assistance on 01204 390244."

Comments (22)

9:25am Wed 27 Feb 13

NolaMac says...

There are a number of major issues at Royal Bolton Hospital which need to be addressed now!
The staff on the front line need 3 things;
• support in their duties and certainty about their future
• challenge, to ensure that they actually treat this as a vocation and not just a well paid job
• & a completely new management team and structure
Government targets and over complicated systems have placed pressure on the operation of the hospital and as this case may yet prove cause good people to make poor choices.
Those at the top of the organisation must be held to account and not allowed to collect very good pay and even better golden handshakes after leading the organisation into this mire.
The track record speaks for its self; a director of finance who failed and left (by agreement), a chief executive who failed and took early retirement, a chairman who should have been asking the pertinent and challenging questions but again failed and walked away (with seemingly no effect on his other similar public offices) and now the acting chief executive has to go because of a scandal regarding mortality rates.
Please someone get a grip before we face an even more catastrophic situation.
There are a number of major issues at Royal Bolton Hospital which need to be addressed now! The staff on the front line need 3 things; • support in their duties and certainty about their future • challenge, to ensure that they actually treat this as a vocation and not just a well paid job • & a completely new management team and structure Government targets and over complicated systems have placed pressure on the operation of the hospital and as this case may yet prove cause good people to make poor choices. Those at the top of the organisation must be held to account and not allowed to collect very good pay and even better golden handshakes after leading the organisation into this mire. The track record speaks for its self; a director of finance who failed and left (by agreement), a chief executive who failed and took early retirement, a chairman who should have been asking the pertinent and challenging questions but again failed and walked away (with seemingly no effect on his other similar public offices) and now the acting chief executive has to go because of a scandal regarding mortality rates. Please someone get a grip before we face an even more catastrophic situation. NolaMac

10:10am Wed 27 Feb 13

boltonchap says...

Yet another scandal at this hospital. When are the police going to get involved? What does it take to get a police response? Nice one Cliff Morris!
Yet another scandal at this hospital. When are the police going to get involved? What does it take to get a police response? Nice one Cliff Morris! boltonchap

10:10am Wed 27 Feb 13

duffbikes says...

"Please someone get a grip before we face an even more catastrophic situation."
Perhaps a true catastrophe will get rid of all consultants, including those brought in to investigate consultants, and lead to criminal prosecutions for the auditing that has been nothing other than fraud. Only then will people with a public conscience be given the responsible positions of trust.
"Please someone get a grip before we face an even more catastrophic situation." Perhaps a true catastrophe will get rid of all consultants, including those brought in to investigate consultants, and lead to criminal prosecutions for the auditing that has been nothing other than fraud. Only then will people with a public conscience be given the responsible positions of trust. duffbikes

10:22am Wed 27 Feb 13

boltonchap says...

Well said. A national newspaper needs to get on the case here and do some proper journalistic digging and delving. The BEN devote more time to stories of fabrice muamba: good luck to the young man I wish him well but for pete's sake getting a ph.d and constant BEN coverage when we have this scandal on our doorstep does irritate.
Well said. A national newspaper needs to get on the case here and do some proper journalistic digging and delving. The BEN devote more time to stories of fabrice muamba: good luck to the young man I wish him well but for pete's sake getting a ph.d and constant BEN coverage when we have this scandal on our doorstep does irritate. boltonchap

1:06pm Wed 27 Feb 13

Rememberscarborough says...

If four times the national average of people are dying of septicaemia in Bolton hospital why hasn't an emergency been declared because it's obvious these infections are an extremely dangerous epidemic? If around 600 people have been "mistakenly" diagnosed then those doctors making the diagnosis should be struck off because they are quite clearly incompetent. Now, if management have been instructing these diagnoses to receive higher payments then this is fraud and becomes a criminal matter.

Either way I believe the whole situation at Bolton Hospital is so bad that it should be grounds for a public inquiry to find out whether people are dying due to neglect or whether there has been gross financial mis-management. or both.
If four times the national average of people are dying of septicaemia in Bolton hospital why hasn't an emergency been declared because it's obvious these infections are an extremely dangerous epidemic? If around 600 people have been "mistakenly" diagnosed then those doctors making the diagnosis should be struck off because they are quite clearly incompetent. Now, if management have been instructing these diagnoses to receive higher payments then this is fraud and becomes a criminal matter. Either way I believe the whole situation at Bolton Hospital is so bad that it should be grounds for a public inquiry to find out whether people are dying due to neglect or whether there has been gross financial mis-management. or both. Rememberscarborough

1:41pm Wed 27 Feb 13

boltonnut says...

The RBH is being run like a football team, afew bad results, fire the manager then hire some cast off from another team who has also failed at his job.This brings poor results,instead of religation you have patients suffering.As in football when someone is fired,let go,terminated,they leave with pensions and pay till their contract runs out,then move on to do their worst some where else.As Iv'e said before,it's a circle game.Ms.Bene, is she related to Mr.Bean?
The RBH is being run like a football team, afew bad results, fire the manager then hire some cast off from another team who has also failed at his job.This brings poor results,instead of religation you have patients suffering.As in football when someone is fired,let go,terminated,they leave with pensions and pay till their contract runs out,then move on to do their worst some where else.As Iv'e said before,it's a circle game.Ms.Bene, is she related to Mr.Bean? boltonnut

2:31pm Wed 27 Feb 13

boltonnut says...

Just realised Ms.Bene began this job in January,so for one months work( and I use the word work with sarcasm) does she get a life time pension? The big wigs are falling like flies,I think some thing is about to happen? maybe an investigation? People jumping ship.Maybe they're are trying to distance themselves from the FAT MAN !!!!!!!!!!!!!
Just realised Ms.Bene began this job in January,so for one months work( and I use the word work with sarcasm) does she get a life time pension? The big wigs are falling like flies,I think some thing is about to happen? maybe an investigation? People jumping ship.Maybe they're are trying to distance themselves from the FAT MAN !!!!!!!!!!!!! boltonnut

2:46pm Wed 27 Feb 13

boltonchap says...

the fat man cant be touched - how else can his continued presence be explained?
the fat man cant be touched - how else can his continued presence be explained? boltonchap

3:09pm Wed 27 Feb 13

rnorris says...

boltonchap wrote:
Yet another scandal at this hospital. When are the police going to get involved? What does it take to get a police response? Nice one Cliff Morris!
Well said. Get the police involved.
[quote][p][bold]boltonchap[/bold] wrote: Yet another scandal at this hospital. When are the police going to get involved? What does it take to get a police response? Nice one Cliff Morris![/p][/quote]Well said. Get the police involved. rnorris

3:34pm Wed 27 Feb 13

Harold 1 says...

The place is overrun with pinstriped chinless bean counters threatening clinical staff with more and more targets and penalties . At RBH the lunatics really are running the asylum. The ruin of the NHS can be traced back to the Tories with the introduction of the internal market and sadly NuLabour perpetuated the folly. I'm glad I don't work there but I feel for the clinical staff doing their best under impossible conditions. There are too many vested self interests to reel back the bureaucracy which has caused this national catastrophe
The place is overrun with pinstriped chinless bean counters threatening clinical staff with more and more targets and penalties . At RBH the lunatics really are running the asylum. The ruin of the NHS can be traced back to the Tories with the introduction of the internal market and sadly NuLabour perpetuated the folly. I'm glad I don't work there but I feel for the clinical staff doing their best under impossible conditions. There are too many vested self interests to reel back the bureaucracy which has caused this national catastrophe Harold 1

4:09pm Wed 27 Feb 13

steveG says...

The high salaries being paid are a major problem,as in Councils these exorbitant rates of remuneration serve only to attract the wrong type of people.
Greedy,self serving,arrogant,car
eless and shameless are not qualities we should be requiring of Managers in our public services,unfortunate
ly since the last Labour Government introduced these high salaries,these undesirable types have been attracted and recruited,often from the private sector.
The high salaries being paid are a major problem,as in Councils these exorbitant rates of remuneration serve only to attract the wrong type of people. Greedy,self serving,arrogant,car eless and shameless are not qualities we should be requiring of Managers in our public services,unfortunate ly since the last Labour Government introduced these high salaries,these undesirable types have been attracted and recruited,often from the private sector. steveG

5:49pm Wed 27 Feb 13

Kaewyed says...

steveG wrote:
The high salaries being paid are a major problem,as in Councils these exorbitant rates of remuneration serve only to attract the wrong type of people. Greedy,self serving,arrogant,car eless and shameless are not qualities we should be requiring of Managers in our public services,unfortunate ly since the last Labour Government introduced these high salaries,these undesirable types have been attracted and recruited,often from the private sector.
I see you agree with this Tory Unelected Government. Every time they do something wrong or do a U Turn, It's the last Labour Governments fault.

What about Osbourne taking us into a Triple Dip Recession. This Unelected Government have been in power nearly 3 yrs., why haven't they rectified ALL these discrepancies in the NHS Hospitals.

They won't, they want to Shut them and bring in their Friends in the Private Sector. Cameron has done nothing but Attack Public Sector Workers.
[quote][p][bold]steveG[/bold] wrote: The high salaries being paid are a major problem,as in Councils these exorbitant rates of remuneration serve only to attract the wrong type of people. Greedy,self serving,arrogant,car eless and shameless are not qualities we should be requiring of Managers in our public services,unfortunate ly since the last Labour Government introduced these high salaries,these undesirable types have been attracted and recruited,often from the private sector.[/p][/quote]I see you agree with this Tory Unelected Government. Every time they do something wrong or do a U Turn, It's the last Labour Governments fault. What about Osbourne taking us into a Triple Dip Recession. This Unelected Government have been in power nearly 3 yrs., why haven't they rectified ALL these discrepancies in the NHS Hospitals. They won't, they want to Shut them and bring in their Friends in the Private Sector. Cameron has done nothing but Attack Public Sector Workers. Kaewyed

5:56pm Wed 27 Feb 13

temujin says...

If there's been fiddling of the figures, heads will have to roll and, if taxpayers' money has been obtained under false pretences, criminal proceedings will need to be considered.

Let's wait for the results of the inquiry however.
If there's been fiddling of the figures, heads will have to roll and, if taxpayers' money has been obtained under false pretences, criminal proceedings will need to be considered. Let's wait for the results of the inquiry however. temujin

9:02pm Wed 27 Feb 13

Citizen Cane says...

Virtually the whole of the public sector is a complete sham with woefully low standards and a cover-up culture rammed with cronyism. Privatise the lot of it and drop the hangers-on.
Virtually the whole of the public sector is a complete sham with woefully low standards and a cover-up culture rammed with cronyism. Privatise the lot of it and drop the hangers-on. Citizen Cane

9:36pm Wed 27 Feb 13

boddingtons101 says...

The question is, how many off the 'managers' are adequately qualified to run a multi-million pound business. I think you will find, if you look hard enough, not many off them. Why let a Nurse (ex CEO) do something she is not qualified (no business degree, experience of management) to do.Its like taking a maintanence fitter and asking them to run a major high street retail company. Needs an expose by a national rag.
The question is, how many off the 'managers' are adequately qualified to run a multi-million pound business. I think you will find, if you look hard enough, not many off them. Why let a Nurse (ex CEO) do something she is not qualified (no business degree, experience of management) to do.Its like taking a maintanence fitter and asking them to run a major high street retail company. Needs an expose by a national rag. boddingtons101

11:59pm Wed 27 Feb 13

jellbellkell says...

I survived sceptacemia 4 years ago... Was very lucky!!
I survived sceptacemia 4 years ago... Was very lucky!! jellbellkell

12:15am Thu 28 Feb 13

jellbellkell says...

Or did I have septicaemia ????? After reading this : /

Never been right since!!
Or did I have septicaemia ????? After reading this : / Never been right since!! jellbellkell

12:15am Thu 28 Feb 13

jellbellkell says...

Or did I have septicaemia ????? After reading this : /

Never been right since!!
Or did I have septicaemia ????? After reading this : / Never been right since!! jellbellkell

7:12am Thu 28 Feb 13

grimtown says...

rnorris wrote:
boltonchap wrote:
Yet another scandal at this hospital. When are the police going to get involved? What does it take to get a police response? Nice one Cliff Morris!
Well said. Get the police involved.
i agree how a chairman can walk away when he new full well this story was going to break to the press and if he didn't then what data where the trustee board looking at holiday brochures containing £4000 per night expenses.

You could film a documentary on this muppet. And the trail of waste and destruction.
[quote][p][bold]rnorris[/bold] wrote: [quote][p][bold]boltonchap[/bold] wrote: Yet another scandal at this hospital. When are the police going to get involved? What does it take to get a police response? Nice one Cliff Morris![/p][/quote]Well said. Get the police involved.[/p][/quote]i agree how a chairman can walk away when he new full well this story was going to break to the press and if he didn't then what data where the trustee board looking at holiday brochures containing £4000 per night expenses. You could film a documentary on this muppet. And the trail of waste and destruction. grimtown

1:07pm Thu 28 Feb 13

genesis22 says...

a senior NHS Clinical Consultant once said to me the beauty of his profession was that mistakes are buried, literally speaking, the dead can tell you nothing. NHS management is an edifice polarising the problems of internal self promotion, 90% of senior management rise from the lower orders, perpetuating the reality that individuals who create a positive impact with their peers enjoy repeated promotion until they eventually reach a level of incompetence. In addition promotions from within entrench cultural mentality and organisational self protection. The NHS does not want outsiders investigating their methods and practices for fear if the protective crust is removed the organisation will be exposed for what it truly is, a disjointed autocratic, dictatorial shambles, wasting millions every day with no responsibility or accountability directed at those responsible. Public need and dependancy for the NHS provides the perfect cloak, allowing the organisation to gorge on the £Billions thrown at it, patients are nothing more than numbers on a sheet of paper, the organisation enriches itself and those who work for it at the expense of the public whose taxes sustain it.
a senior NHS Clinical Consultant once said to me the beauty of his profession was that mistakes are buried, literally speaking, the dead can tell you nothing. NHS management is an edifice polarising the problems of internal self promotion, 90% of senior management rise from the lower orders, perpetuating the reality that individuals who create a positive impact with their peers enjoy repeated promotion until they eventually reach a level of incompetence. In addition promotions from within entrench cultural mentality and organisational self protection. The NHS does not want outsiders investigating their methods and practices for fear if the protective crust is removed the organisation will be exposed for what it truly is, a disjointed autocratic, dictatorial shambles, wasting millions every day with no responsibility or accountability directed at those responsible. Public need and dependancy for the NHS provides the perfect cloak, allowing the organisation to gorge on the £Billions thrown at it, patients are nothing more than numbers on a sheet of paper, the organisation enriches itself and those who work for it at the expense of the public whose taxes sustain it. genesis22

1:21pm Thu 28 Feb 13

genesis22 says...

I should add, the 800 sceptascemia cases in question arose during 2011 / 2012, the higher than average monthly figures during this period, from which the accumulated annual figure is arrived at, where known to the authorities 18 months ago in mid 2011. Why was no investigation ordered at that time ? Why has it taken almost 2 years before the matter has been made public ? Why did the clinical commissioning group or strategic health authority not express any concern towards the figures presented to them at that time ? These facts indicate the so called concern now being claimed by the CCG is a public relation scam, any responsible authority worth its salt genuinely interested in protecting the public would have taken action as soon as the problem emerged. This scenario STINKS of conspiracy and heads should roll
I should add, the 800 sceptascemia cases in question arose during 2011 / 2012, the higher than average monthly figures during this period, from which the accumulated annual figure is arrived at, where known to the authorities 18 months ago in mid 2011. Why was no investigation ordered at that time ? Why has it taken almost 2 years before the matter has been made public ? Why did the clinical commissioning group or strategic health authority not express any concern towards the figures presented to them at that time ? These facts indicate the so called concern now being claimed by the CCG is a public relation scam, any responsible authority worth its salt genuinely interested in protecting the public would have taken action as soon as the problem emerged. This scenario STINKS of conspiracy and heads should roll genesis22

1:33am Wed 6 Mar 13

boltonnut says...

You're to fat to run fat man,you're going down,kiss your fat @ss goodbye.
You're to fat to run fat man,you're going down,kiss your fat @ss goodbye. boltonnut

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