Profiles crackdown on 'too high' death rates

Published on Tuesday 10 November 2009 21:31

SCOTTISH hospitals with higher than expected rates of deaths and complications linked to surgery have been told to take action to improve their services.

NHS Quality Improvement Scotland (NHS QIS) has published "surgical profiles" for each hospital, covering areas such as mortality and post-operative infections.

The figures – outlined in hundreds of tables and graphs published online – show wide variations between hospitals.

In some cases hospitals had mortality rates which fell outside expected levels, meaning they needed to investigate why they may have more surgical deaths in their area.

NHS QIS said the statistics were intended for boards to use to improve quality, safety and effectiveness of their care.

The watchdog said that the majority of health boards had responded to their profiles, given to them last year, and taken action on areas of concern.

Only Western Isles failed to respond to their profile. The board has been given until 11 December to investigate its data.

Yesterday's figures showed a number of hospitals in the west of Scotland with higher than expected death rates after surgery.

At the Royal Alexandra Hospital in Paisley, the mortality rate at 120 days after planned surgical admissions was 1.74 per cent by the end of September 2007, while at Stobhill in Glasgow it was 1.83 per cent. This compared to a Scottish average of 1.37 per cent.

The Royal Alexandra also had a mortality rate for emergency surgical admissions of 6.04 per cent, compared to the Scottish average of 4.65 per cent.

In Lanarkshire, Wishaw General Hospital had a mortality rate for planned surgical admissions of 1.99 per cent, and 6.04 per cent for emergency admissions.

Monklands in Airdrie also had an above expected rate of mortality for emergency surgical admissions of 5.92 per cent.

A spokeswoman for NHS Lanarkshire said: "The data provided does not highlight the mix of patients seen at Lanarkshire's hospitals or factors which may impact on the health of a patient and therefore any interpretation of these figures should be made with caution."

NHS Greater Glasgow and Clyde said they supported the surgical profiles.

It is thought that the higher rates of deprivation and people with multiple health problems living in the west of Scotland helps explain increased deaths.

Some hospitals may also have higher death rates because they deal with patients with the most serious conditions. NHS QIS provided examples of where boards were able to act on the statistics to improve care for patients.

The system alerted NHS Fife to a relatively high rate of deep vein thrombosis in patients after they were admitted for general surgery at Queen Margaret Hospital, Dunfermline. This enabled them to review data collection and guidance on thrombosis, and the rate has since fallen.

The system also flagged up a "relatively high" death rate in NHS Forth Valley during one quarter for a type of bladder operation, enabling new processes to be put in place for reviewing post-operative deaths.

Sir Graham Teasdale, chairman of NHS QIS, said: "The surgical profiles project is having an increasing impact."