A COMPANY which worked with hospitals on their death rates has been working for Bolton NHS Foundation Trust since April, 2011, it has been revealed.

CHKS, a specialist company which advises hospitals on how to improve their overall performance, including reviewing “coding”, has denied claims it helped trusts change their coding to improve mortality rates.

The firm said it gave advice on coding to trusts, but it was regarding palliative care and would not affect mortality figures.

But the company confirmed it has been working with Bolton since April, 2011 – although it strenuously denied any wrongdoing.

It comes as independent health researcher Dr Foster investigates “coding” at the Royal Bolton Hospital between March, 2011 and April, 2012.

During that period, the hospital recorded 800 cases of septicaemia when a similar-sized trust would be expected to have 200.

It is thought they could have been “coded” incorrectly and the Trust’s acting chief executive and medical director Dr Jackie Bene has “stepped aside” while the investigation takes place.

If some of the Trust’s deceased patients have been wrongly “coded” as dying from septicaemia, it could have an impact on the Trust’s death figures.

It could also affect finances as cases of septicaemia receive more money than other infections.

Dr Foster’s report about Trust will be published tomorrow.

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 after six consecutive years when it was among the worst in the country.

CHKS only started working with the Trust after it won the improvement award.

But in 2008, CHKS wrote to several hospital trusts claiming they could help them to “better understand mortality measures” and “minimise any negative impact”.

Professor Sir Brian Jarman, the expert who helped come up with Dr Foster said: “In Mid Staffs it looks as though they changed the diagnosis a lot.

“The coder said at the inquiry she changed the coding and 80 per cent of the codings were changed.”

Heather Edwards, head of communications at Bolton NHS Foundation Trust, said: “We have used both Dr Foster and CHKS, which are both private companies, in the past for information analysis and benchmarking. We currently use CHKS.”

Jason Harries, managing director of CHKS, said: “CHKS auditors follow Connecting for Health coding rules. If, for example, CHKS is recommending coding for palliative care it is because specialist, or generalist palliative care is recorded in the clinical notes and the coders have missed it, not because it improves mortality rates. Some hospitals are now being investigated for high mortality rates.

“However, the Department of Health’s mortality measure (SHMI) does not exclude or weight palliative care so there is nothing to be gained from over coding palliative care in this measure.

“CHKS started working with Bolton in April, 2011, providing a comparative benchmarking service on a number of indicators.

“CHKS has done no coding reviews at the trust. CHKS offers advice to NHS trusts in accordance with NHS Connecting for Health rules to ensure that coding is an accurate reflection of hospital activity.

“This means auditing cases following strict guidelines to ensure the coding rules have been correctly applied.”