Analysis reveals 'significantly high' NHS death rates

‘Significantly high’ death rates have been recorded at 19 of England's 133 NHS trusts.

There were 15,396 more deaths than expected between 2011 and 2016. Blackpool Teaching Hospitals Foundation Trust had the highest number - 1,878 during the five years.

The analysis reveals a strong link between high mortality rates in England and lower-than-average doctor numbers and high levels of occupancy of hospital beds.

The analysis was carried out by co-director of the Dr Foster Unit at Imperial College London, which monitors NHS performance, Prof Sir Brian Jarman.

He said: "We've found that hospitals which have very high death rates also have fewer doctors per bed than the national average. Nearly all have more overcrowding than expected.

"During the last 25 years in England we have doubled the number of admissions and halved the number of beds. I think that if we cut more beds - without proving that we have adequate care in the community - it is a dangerous way to run a health service."

Winter saw hospitals across the country trying to cope with record occupancy levels, often way above the 85 per cent capacity safety figure recommended by experts.

Prof Jarman examined mortality rates using the Summary Hospital-Level Mortality Indicator (SHMI) that covers deaths in hospitals and within 30 days of discharge.

The 19 NHS trusts with significantly high mortality rates all had below average numbers of doctors per bed while those with low death rates had above average doctor numbers. The average was 83 doctors per 100 beds.

• The total number of deaths above the number expected, taking into account age, sex, and diagnosis of the patients treated, was 15,396.
• Two trusts with higher-than-expected mortality rates, Blackpool Teaching Hospitals NHS Foundation Trust, and Tameside Hospital NHS Foundation Trust, had 59 and 56 doctors per 100 beds respectively.
• Seventeen of the 19 trusts had bed occupancy levels above the recommended safety mark of 85 per cent. The 16 best performing trusts had above average numbers of doctors per bed and experienced 22,565 fewer-than-expected deaths.
• The Imperial College Healthcare NHS Trust had 2,777 fewer-than-expected deaths but had 138 doctors per 100 beds, more than double that for Blackpool.

  Vice-president of the Royal College of Emergency Medicine, Dr Chris Moulton, said: "The figures show that there is a postcode lottery. If you live in some parts of England your chance of dying if you're admitted to hospital with the same condition are much higher than others.

  "Hospitals with the worst numbers of staffing and facilities are invariably in the areas with the biggest change in demographic and also the sickest and most needy patients."

  Blackpool Trust medical director, Prof Mark O'Donnell, said SHMI should not be viewed in isolation and warned against thinking that excess deaths were the same as avoidable deaths.  

  He said the trust had focused efforts on improving the treatments patients received, particularly in the first 24 to 36 hours after admission, and was now reducing in mortality figures.

  He added: "Any discussion around SHMI figures must recognise a number of factors including the health of the local population. Although there are pockets of affluence, the population of Blackpool is among the most deprived in England with high levels of HIV infection, drug and alcohol misuse and anti-depressant prescribing.”