Toll of superbugs and NHS errors laid bare
THE number of unexpected deaths in Scottish hospitals is falling – but improvements in some parts of the country are much smaller than others, new figures suggest.
• Figures for unexplained deaths fell across Scottish hospitals in the past 18 months, although there was a wide variation in the latest figures. Picture: Getty
For the first time, the Scottish Government has published data on hospital standardised mortality ratios (HSMRs) – a calculation of how hospitals perform based on their expected number of deaths.
The figures show that, in the space of 18 months, the number of unexpected deaths in hospitals – such as those caused by infections like MRSA and clinical errors – dropped by 6 per cent.
But in five hospitals the mortality ratio increased, while elsewhere there was little change despite growing efforts to improve patient safety.
The latest statistics, for April to June 2009, also showed wide variations between hospitals, though statisticians said this could be due to random blips or inaccurate data.
Health secretary Nicola Sturgeon said the figures were "encouraging", but they were not complacent and wanted to drive the numbers down further.
Scottish Labour called on the Scottish Government to do more to lower the number of unexpected deaths in hospitals, voicing concern about the impact of cuts being made by boards to staff numbers.
Health spokeswoman Jackie Baillie said: "While I welcome the 6 per cent decline in overall unexpected deaths in hospitals in the last 18 months, it is clear that more can be done.
"Some individual hospitals have higher rates than others and the health secretary needs to find out why and then do something about it.
"One thing is clear and that is if the SNP cut the number of nurses in Scotland then patient safety will not improve."
The new figures were published as Ms Sturgeon visited staff and patients at Edinburgh Royal Infirmary.
She said driving down unintended harm to patients was a top priority for the NHS and publishing the figures would improve transparency and give boards information on how to improve their services.
Ms Sturgeon also praised the work of the Scottish Patient Safety Programme (SPSP), which supports hospitals in tackling issues such as infections, drug errors and surgical complications, all of which contribute towards unexpected deaths.
The SPSP was launched two-and-a-half years ago and aims to reduce mortality rates by 15 per cent by the end of 2011, compared to 2006-7.
"Everyone knows it is a sad fact of life that people die in hospitals," Ms Sturgeon said.
"But the patient safety programme is about reducing what are known as unexpected deaths – people who come into hospital and suffer complications, perhaps contracting an infection, and die when they would not have been expected to die, and we must drive down those unexpected deaths."
The new ratios are based on the number of patients who died within 30 days of admission to hospital, compared to what would be the expected number of deaths for each hospital.
For the whole of Scotland a baseline figure of 1 was set, meaning those hospitals with a ratio above 1 were classed as higher than the Scottish average and those with a lower figure were below average. For the country as a whole, the ratio fell from 1 to 0.94 over 18 months – a drop of 6 per cent. The Scottish Government said if this reduction had been applied to the period before the patient safety programme was introduced in January 2008, 1,600 deaths could have been avoided over the course of a year.
The most recent figures, for April to June 2009, found rates ranged from 0.24 for Stracathro Hospital near Brechin – a small hospital carrying out non-emergency operations – to 1.16 at Crosshouse Hospital in Kilmarnock, followed by 1.15 at both Caithness General Hospital and Arbroath Infirmary.
The data published yesterday included figures backdated to October 2006, showing some hospitals with rates consistently above the national baseline level. These included Crosshouse and Falkirk Royal Infirmary/Stirling Royal Infirmary.
Many hospitals saw big improvements in their mortality ratios between October 2006 and June 2009.
Western Isles Hospital saw a drop of 22.75 per cent in unexpected deaths, while Arbroath Infirmary, Stracathro, Balfour Hospital and Dr Gray's Hospital in Elgin all dropped by more than 20 per cent.
But five hospitals saw their rates worsen, including Caithness which was up 12 per cent and St John's at Livingston up 3.25 per cent.
Some hospitals saw little movement, including Glasgow Royal Infirmary with a drop of just 0.75 per cent.
Dr Bob Masterton, executive medical director of NHS Ayrshire and Arran which runs Crosshouse Hospital, said: "There are a number of factors that influence values, and a high HSMR does not necessarily reflect avoidable deaths or poor quality of care. However, the figures act as a valuable trigger and help us focus on our over-all aim of reducing mortality."
• Margaret Watt: Patients deserve more than bare statistics
• Charles Saunders: Why these statistics don't tell the whole story
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