High death rates at 25 NHS trusts a result of medical negligence?
Professor Jarman believes the self-assessment system for NHS trusts is flawed and that twenty-five of them should be investigated over higher than normal death rates after 4,600 more patients died at those trusts in 2007-08 than would be expected.
Patient deaths a result of medical negligence?
Jarman told the BBC that a higher than expected death rate did not necessarily prove hospitals were doing anything wrong, but could help identify wider problems. The government said trusts with high death rates had already been checked.
He acknowledged there may have been some problems with the way the deaths were recorded, but called on the government to ask the Care Quality Commission (CQC) to investigate each of the trusts rather than relying on their own self-assessments.
The self-assessment system has been widely discredited, and Prof Jarman, a former British Medical Association president, is a long-standing critic of it. "The regulator uses a method which I think is fundamentally flawed. Only 20% of hospitals are inspected every year. They are assessing 20% of the cases in the hospital. So that's 20% of 20% which is 4%. But when you look at that 4% and see whether the self-assessment agrees with the actual on-site inspection for the hospitals that are at risk, two-thirds of the self-reporting is in fact incorrect."
In response, health minister Mike O'Brien said: "We'll look at Professor Jarman's letter, but the CQC has conducted a regional review of all the trusts identified as having high mortality ratios which confirmed in January that - at that time - they had no current concerns that they would be as bad as Mid Staffordshire clearly was."
List of NHS Trusts with higher than normal death rates
Barking, Havering and Redbridge University Hospitals NHS Trust
Basildon and Thurrock University Hospitals NHS Foundation Trust
Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust
Central Manchester University Hospitals NHS Foundation Trust
Colchester Hospital University NHS Foundation Trust
George Eliot Hospital NHS Trust
Great Western Hospitals NHS Foundation Trust
Heart Of England NHS Foundation Trust
Hull and East Yorkshire Hospitals NHS Trust
James Paget University Hospitals NHS Foundation Trust
Mayday Healthcare NHS Trust
Mid Cheshire Hospitals NHS Foundation Trust
Mid Staffordshire NHS Foundation Trust
Mid Yorkshire Hospitals NHS Trust
North Middlesex University Hospital NHS Trust
Pennine Acute Hospitals NHS Trust
Royal Bolton Hospital NHS Foundation Trust
Sherwood Forest Hospitals NHS Foundation Trust
Southampton University Hospitals NHS Trust
Stockport NHS Foundation Trust
Tameside Hospital NHS Foundation Trust
United Lincolnshire Hospitals NHS Trust
University Hospital Birmingham NHS Foundation Trust
University Hospitals Coventry and Warwickshire NHS Trust
Wrightington, Wigan and Leigh NHS Foundation Trust
Systematic failings in NHS Hospitals
Last month an independent inquiry into the Mid Staffordshire NHS Trust detailed evidence of systematic failings which caused "unimaginable" patient distress and suffering, despite being rated as a "fair" hospital by the NHS for most of the period in question. Last year it had been reported there were at least 400 more deaths than expected at the trust from 2005 to 2008.
Mr O'Brien acknowledged that the self-assessment system does have limitations. "Self-assessment I think has in the past been over-relied upon and that's why we've changed the way in which regulation is carried out. In the new system of registration, every hospital gets visited every two years, but if there's a higher risk then it'll be more often than that - and [the CQC] can make unannounced visits at any time," he said.
Susan Brown a leading medical negligence solicitor at Reading based law firm Boyes Turner said: “Professor Jarman’s warning supports a view held by many, that the failings at Mid Staffordshire NHS Trust are not necessarily an isolated event, but more likely systemic throughout the NHS. The medical negligence lawyers here at Boyes Turner act for a high number of patients across England and Wales who have suffered very poor care resulting in serious injury and for families whose relatives have died as a result of what they believe to be poor care or medical negligence.
What this article does not address is the number of other patients in these hospitals who have suffered a poorer outcome as a result of failings in care. This is yet another reason why a thorough investigation is needed."
Consistent with our policy when giving comment and advice on a non-specific basis, we cannot assume legal responsibility for the accuracy of any particular statement. In the case of specific problems we recommend that professional advice be sought.
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