'Deaths averted' at hospitals put into special measures

By Smitha Mundasad
Health reporter

Nurse and patientImage source, Thinkstock
Image caption,
Under special measures some trusts have hired extra staff

Hundreds of deaths might have occurred if emergency interventions had not been put in place at 11 failing hospital trusts in England, a report says.

The report by the Dr Foster data analysis company focuses on poorly performing hospitals identified in the wake of the Stafford Hospital scandal.

Researchers show average death rates fell after urgent measures, such as leadership changes, were enforced.

But Labour says problems - particularly on emergency wards - persist.

'National trend'

Hundreds of people suffered appalling care at Stafford Hospital in the years leading up to 2008 and inquiries suggest some may have died needlessly as a result.

The scandal prompted a review of hospital trusts in 2013, and 11 were put in special measures.

A range of problems were discovered including patients being left on trolleys for excessive periods and poor maintenance in operating theatres.

The measures included sending in teams of external experts to work with the senior management team.

Regular updates on their progress were also ordered, while some unsafe practices, such as the use of operating theatres with inadequate maintenance records, were stopped.

Analysts from Dr Foster tracked death rates at the trusts before and after they were placed under a regime of special measures.

And by comparing observed death rates to expected ones they say it is reasonable to conclude that "hundreds of deaths that might otherwise have occurred without the intervention did not happen".

Although they found death rates had fallen across all English hospitals since July 2013, the downward trend was more pronounced at the 11 special measure trusts when taken as a group.

The report found death rates had fallen by 9.4%, compared with a 3.3% decrease nationally. But some of the trusts performed better than others - Tameside NHS Foundation Trust, which is still in special measures, continues to have rising death rates.

Researchers say that despite all these trusts showing higher death rates than the national average, the difference has narrowed considerably.

'Urgent attention'

Roger Taylor at Dr Foster said: "It is now up to the NHS to learn lessons of what worked in each of the 11 trusts, so that a best practice approach for special measures can be adopted."

"Hospitals need to pay urgent attention to any warning signs coming from their data to ensure patient safety isn't compromised."

But Prof Sir Bruce Keogh, national medical director, said: "Mortality statistics require careful interpretation, but they do provide an important smoke signal.

"What this report shows is that by following the smoke and carrying out proper, transparent analysis and supporting as necessary, you can help hospitals make significant improvements."

Health minister Lord Howe added: "Since the scandal at Mid Staffordshire we have taken tough decisions to improve patient safety.

"A total of 19 trusts have now been placed in special measures and today's report is further evidence that our special measures programme is working."

Dr Katherine Rake, chief executive of the watchdog Healthwatch England, said: "The NHS is simply not good enough yet in terms of responding to people's concerns and complaints but I think what today's report shows is that when you turn that around you can deliver significant improvements."

Andy Burnham MP, Labour's shadow health secretary, said: "It was because of this government's decision to axe thousands of nursing jobs that these hospitals were placed in special measures in the first place.

"The hospitals are still getting worse on key measures now, particularly A&E performance, like the rest of the NHS."

Urgent support

In August 2014, following inspections by the Care Quality Commission, a number of trusts were removed from special measures, while others were given further urgent support:

  • Two trusts had a strong turnaround and moved out of special measures in August 2014 (Basildon and Thurrock University Hospitals NHS Foundation Trust and George Eliot Hospital NHS Trust)
  • Three also had declining rates and exited special measures at a later date (Buckinghamshire Healthcare NHS Trust, East Lancashire Hospitals NHS Trust and Northern Lincolnshire and Goole NHS Foundation Trust)
  • Another three have falling death rates but remain under special measures (North Cumbria University Hospitals NHS Trust, Sherwood Forest Hospitals NHS Foundation Trust, United Lincolnshire Hospitals NHS Trust)
  • Two show a flat-line (Burton Hospitals NHS Foundation Trust, Medway Hospitals NHS Foundation Trust, both still under special measures)
  • And one trust, which is still under special measures, (Tameside NHS Foundation Trust) shows a rising death rate

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