VOTE: Hospital has second worst death figures
3:40pm Monday 30th November 2009 in News
THE Royal Bolton Hospital has the second worst death rate in the country, according to a new report.
But the organisation which produced the data last night admitted the figures did not tell the full story, saying Bolton’s hospital had made “real improvements in care”.
David Fillingham, chief executive of the Royal Bolton Hospital NHS Trust, said Bolton appeared to have performed poorly because of how the figures are worked out — for example, if other trusts make improvements, Bolton’s standing is affected.
He added: “The quality of care that patients receive is our priority. We’ve had some outstanding achievements in reducing death rates, for instance, for patients who have had a stroke.”
Dr Foster, a consultancy that analyses health information, said 128 more people died at the hospital last year than expected.
The organisation uses complicated formula for working out hypothetical “expected deaths”, based on factors such as economic deprivation in an area.
It then produces a Hospital Standardised Mortality Ratio, or HSMR, to show if more, or fewer, people than expected have died in hospital.
The average HSMR is 100. A figure under that means a hospital has fewer deaths than expected, so is performing well — anything over 100 suggests it is not performing as well as it could, according to Dr Foster.
The Royal Bolton Hospital’s rate was 122. Only scandal-hit Basildon Hospital, last week criticised for its “filthy” wards, had a worse a rate — 131.
In Dr Foster’s annual Hospital Guide 2009, Bolton is one of seven trusts to record a poor mortality rate over five years.
However, despite Bolton’s mortality rate rising — from 118 the previous year — the number of unexpected deaths has actually gone down and the gap between the numbers of actual and predicted deaths has been nearly halved.
There were 1,309 deaths at the hospital last year, 128 more than Dr Foster predicted. But the previous year there were 1,415 actual deaths, 220 more than predicted.
Mr Fillingham said the trust would be looking into the figures with Dr Foster to see if it could make improvements that “accurately reflect our performance”.
He added: “We are going to see whether factors, such as poor health of the region, may lie behind this.
“We’re also going to be working with Imperial College London, who provide and interpret the data, to see where we can make further improvements.”
Cllr Andy Morgan, chairman of Bolton’s health scrutiny committee, said he had asked for a report from the hospital to explain how it would reduce the rate.
He added: “It’s disappointing to see Bolton appear as one of the worst performing hospitals, but we are very aware of the work they are doing to narrow the gap.
“You also have to question the validity of the figures if on one hand Dr Foster is saying we are the second worst for mortality rates, and in the next breath, saying it’s not as bad as it looks.”
A spokesman for Dr Foster said: “We believe Royal Bolton’s reduction in HSMR relative to last year’s benchmark reflects real improvements in care. Over the longer term the policies being pursued by Royal Bolton may be expected to see the HSMR fall relative to the national average.”
He said Dr Foster expected Bolton’s rate to fall in the longer term.
The Dr Foster Guide also highlights overall patient safety, giving hospitals a score from one to five, with one being poor and five the best. Bolton was rated “two”, an average score.
Health watchdog the Care Quality Commission, which rates Bolton “fair” for patient care and “good” for its finances, has questioned the Dr Foster figures.
One trust is threatening legal action against Dr Foster.
The Royal Bolton Hospital is one of five in the region with high HSMRs. The others are Pennine Acute Hospitals, Blackpool, Fylde and Wyre Hospitals, Mid Cheshire Hospitals and Tameside Hospital.
