Hospital mortality rate falls as Pennine Acute Trust continues to focus on patient safety

Date published: 28 November 2011

The Pennine Acute Hospitals NHS Trust has experienced a dramatic fall in its hospital mortality rate across its hospitals following efforts to further improve patient safety.

Figures to be published today in the Dr Foster Hospital Guide 2011 (Monday 28 November 2011) are expected to show that the Trust’s Hospital Standardised Mortality Ratio (HSMR) has fallen again over the last year and is now below 100, meaning fewer patients died than would be expected.

Since November 2008, Dr Foster has annually published its Hospital Guide which includes rankings of NHS Acute Trust’s perceived relative performance with respect to patient safety. Included in the performance indicators used has been the Hospital Standardised Mortality Rate Indicator (HSMR).

The Hospital Standardised Mortality Rate (HSMR) is an indicator of healthcare quality. It compares an NHS Trust’s actual number of deaths to its expected or predicted number of deaths.

HSMR is a statistical number that enables the comparison of mortality rates between hospitals. This prediction takes account of factors such as the age and sex of patients, their primary diagnosis and complicating factors, and their length of stay in hospital. Standardisation of mortality rates allows comparison between different hospitals serving different communities.

If a Trust has an HSMR of 100, this means that the number of patients who died is exactly as would be expected. A Trust’s HSMR above 100 means that more patients died than would be expected; below 100 means that fewer patients than expected died.

The Trust’s reported HSMR figure is 99.6, compared with the figure of 110.4 as reported in last year’s Dr Foster Hospital Guide 2010. The data covers the period from April 2010 – March 2011.

Dr Sally Bradley, the new Medical Director at The Pennine Acute Hospitals NHS Trust said: “We are committed to improving patient safety and we aim to have no avoidable deaths and no avoidable harm across all our hospitals and services. We monitor hospital mortality closely on a monthly basis. Patient safety reports are presented and discussed at the Trust Board; these reports are publicly available on our website.

“Mortality across our hospitals has decreased every year since 2005. By any indicator, including Dr Foster and CHKS which we use, we have shown a huge improvement in our hospital mortality rate, particularly over the last two years. We have used these two main indicators to monitor our mortality rate; both have shown huge reductions of around 10% so we are now below or at similar level to other hospitals.

“This represents delivery of care with fewer than expected deaths across our hospitals. Sustained effort by our staff to improve clinical practice and patient safety across a whole variety of areas has led to this reduction. This is good news and a positive step in the right direction, on a journey to reduce our hospital mortality further.

“Although this is a complex area, and whilst there are differences in the way mortality is calculated, the important factor here is that all the indicators show that mortality is reducing and as a hospital trust we continue to focus our attention on ensuring our services are safe for our patients.”

The Trust has been working as a member and part of the North West regional Reducing Mortality Collaborative. The collaborative comprises nine NHS Trusts across the region and is supported by AQuA, the Advancing Quality Alliance. The collaborative was set up to improve clinical practice and understanding among clinicians to reduce avoidable deaths.

In addition to looking at the way mortality is measured, the regional collaborative is looking at a number of initiatives including emergency care pathways, End of Life Care and clinical pathways specific to heart failure, the management of venous thromboembolism and sepsis.

Dr Bradley added: “As part of the Trust’s commitment to improving patient safety across the organisation, we have signed up to the Safety Express Collaborative and we have been chosen as a host organisation for the programme within the North West. This is a national programme involving NHS Trusts as part of the Department of Health’s Quality, Innovation, Productivity and Prevention (QIPP) safe care programme. We will lead a team of representatives from our PCTs in Bury, Oldham, Rochdale and North Manchester, towards the aim of reducing harm across the whole health economy.”