Friday, April 17, 2009

NHS death rates

The NHS is going to be publishing hospital death rates on the internet...
The NHS is to make it easier to compare success and failure of English hospitals by publishing death rates and other tables on its own website.

The Department of Health will publish the Mortality Ratio on the NHS Choices site, allowing patients to compare death rates at their nearest hospitals.

The NHS says the move is part of a commitment to sharing more information.

It follows a damning report into failings at Stafford Hospital, triggered by its high mortality rates.

Hooray! This is, as far as it goes, a good move by the government. However, the point of being able to view mortality rates—hopefully weighted by operation risk—is a reasonable first step. However, since you can, if I recall correctly, now only choose between three hospitals in your local area; as such, if all three of your local hospitals are totally shit, you're a bit screwed.

Besides, your humble Devil's first thought was: "I wonder how NuLabour will contrive to screw this one up."


Serf said...

Look for a movement by hospitals to send patients home to die. For compassionate reasons you understand.

Letters From A Tory said...

I thought the idea what that we can now choose any hospital in the country, or am I being WAY too optimistic?

Wossat? said...

Maybe it's just me but instead of posting statistics on some site that many people in our society have no access to - how many OAP's have a PC or laptop? - shouldn't NHS time be better spent helping people to NOT fucking die?

HoonisaHoon said...

All three hospitals near me are part of the same trust, i hope that they aren't too awefull

SteveShark said...

Hospitals' mortality rates need to be weighted by more variables than operation risk.
What about the medical qualifications of its staff?
Area of the country?
Money spent on admin versus medical care?
The efficiency of the Primary Care Trust that the hospital belongs to?
If any list of mortality rates is going to be of any use then all the variables need to be factored in.

Big Fat Trucker said...

I posted about "choose and book" over on Leg Iron's blog a while back.
It worked for me, but for 2 reasons: I had internet access, and I was lucky.

Basically, it's been crippled. You're in the GP's surgery, you have about 3 minutes to pick 5 hospitals, and you can't research them. You research your picks at home, but if you made 5 wrong choices, you're stuffed.

My surgeon turned out to be cutting edge. He did my op under NHS sub-contract in the local private; he won't work in the NHS because they won't let him do what's best for the patient.

A far cry from the murdering shits who shortened my father-in-law's life by dehydrating him. If someone can't hold a glass, you don't mark up their fluid chart as "does not require assistance".


Mark M said...


The reason you would weight by operational risk is in order to not give lower scores to hospitals who attempt trickier operations.

All the other factors you mention are factors you'd want to see going into such a score. If I go to a hospital I want to know the staff are well qualified and experienced. If you say 'well that hospital has worse staff but don't let that show in the score' then you are defeating the point of publishing information.

Essentially, all you want to know from these rankings is whether a hospital kills more people than you would expect, given the operations they do (i.e. actual deaths v expected deaths).

Anonymous said...

Just think, we wouldn't have this NHS Trusts if MPs from Scotland, whose own constituents WON'T be having them, decided that we should. The votes of MPS representing Scots constitiencies swung it. Good of them, wasn't it?

Roger Thornhill said...

So, what is the website going to be called?

Centaur said...

Mark M - exactly right.

Anonymous said...

All good and well but look at this bullshit: gems:

"I think we should be less tolerant of mediocrity and failure" ... of the managers and bureaucrats

By definition doctors can't be mediocre or else they wouldn't have got their university places. On the other hand, bureaucrats... need no merit or qualifications but can boss around what used to be one of the respected professions.

"We should expect more from our professionals who are well paid and well educated." ... such as senior officials in the Department of Health who are spouting that shit

"We need to create a culture where doctors are obliged to challenge each other... There is a silence among professionals. [Nurses] are the glue in the system that. They are there 24/7."
WTF, so there are no doctors in the hospital at night?? As a "baroness" this crackpot might only work 10 hours a week but doctors who used to work 100 hrs a week and know they need to, can't any more because Europe says NO. And you want nurses instead of doing proper nursing to challenge doctors to blow the whistle??

As an aside the BBC have again managed to write an article that is totally irrelevant to the point they are trying to make: Scroll down to the comments to see why.

Dr John Crippen said...

Sounds good to me, DK

Presumably all the Hospices will be closed forthwith. That will save a bob or two.


the a&e charge nurse said...

Don't forget the law of unintended consequences, Devil, an inevitable corollary of number crunching and the percentages game.

Reward hospitals for low death rates then watch how those with high risk, rare or complex conditions are avoided like the plague.

After all no self respecting surgeon would want some old crumbly with advanced cancer mucking up his/her figures.

AndrewSouthLondon said...

In a previous attempt to provide government "League Tables" for hospital mortality they showed Heatherwood & Wexham park top of the list. Reason emerged as was there were no local Hospice service so the hospital provided a terminal care facility. It had more deaths than others for the same reason.

My local hospital had near it a large private nursing home. When patient/residents were at deaths door, they whacked them into hospital to avoid the beaurocracy of death registration. Result - high "death rates"

Its surgical staff included a surgeon who was will in to perform "last ditch" heroic surgery for patients with colorectal cancer. Two thirds died, compared with probably all of them but for his intervention.

Result? High death rates in hospital.

You think this stuff is easy? Do not allow politicians who tell lies to get elected to tell you anything - not even the time of day. Especially not those who scare people with the NHS. The NHS pisses away more money for no good purpose every day than you could imagine. If you want a good question, ask how many of their current AIDS patients being treated are Africans here "as students" Have a laugh. All of them.

Anonymous said...

People only are dead if they are certified dead. So some clever high earning manager has decided that they will now transfer the “undead patients” and they will be certified on the way to another hospital. Nobody from now on will die in any hospital. He will get a big bonus.

Anon 8

Barry Tebb said...

Andrew Way -Chief Exec of The Royal Free-is finally on HIS way,having finally handed in his notice on Thursday.Rumour has it that he's going back to his native Australia.Let's hope that Way is one boomerang that won't come back.For 18 months NHS protester Brenda Williams placarded against Way outside the hospital he thought was HIS,a delusion not even he can sustain any longer.Way was a walking disaster,a nacissist who once projected his own head onto the wall of the atrium at a public meeting.He said at the same meeting that Brend'a protest placards-mostly poems were"Litter"and plotted with councillors to have them ripped down and BINNED an illegal act of barbarism and brutality so typical of Way.Now the SHA have binned Way-JUSTICE AT LAST AND I DONT REGRET THE HOURS I SPENT BRIEFING AGAINST HIM-IN FACT IT WAS IT INSPIRATIONAL

Barry Tebb said...

Following my DK blog I left a brief blog on the Health Service Journal on the same topic but much milder.Within hours Way had it off and the blog on the topic of his departure was closed .I suspect a lot of others had joined in the celebrations!This is the placarded poem -on display outside the Royal Free for six months until Way had it ripped down by his friends on Camden Council.FOR ANDREW WAY

I met a brute last night at the Royal/Free and I let the marauder in while/Hesitantly,suddenly,offering/Apologies for protesting outside/The Free,while emphasizing loyalty/To the liver ward for saving/ me.Casually he cut in,at his/Ease completely and like a heat-seeking/missile locked on target the words went in./"It is my job to keep the hospital/Tidy and the placards look like litter."/Ingenuously I countered,"Litter?"/Recoiling from the turmoil within me,/"The litter is what's on them"at the Free.
Brenda Williams 11th June 2007

Anonymous said...

Within hours of the online story of Andrew Way's resignation-a story I phoned in to them incidentally-the editor's blog on this story was summarily closed to readers' comments.Why?Surely the 'Baby P'case should have ended censoring of negative feedback.Way was a disaster as the whole of Camden knows.I campaigned and briefed against Way unceasingly and now I'm reminded of Belloc's 'Lord Lundy'"The press was squared/The middle class quite prepared/But as it is!My language fails!/Go out and govern New South Wales."The Health Service Journal is based in Camden,were they squared?

Bishop Brennan said...

Some of the comments here are misplaced:

- Choice is supposed to be free now - although without info, it's a bit meaningless.

- Therefore, the government's proposals to force publication of death rates adjusted by the difficulty of operation / expected death rate is a good thing.

- But until I can see success / death rates for each surgical team and choose between teams, it will still be far from enough.

- And some people need help choosing. And not from their GP, who has a mate from the Lodge / gets a Christmas card from the local hospital, etc.......