Issue - meetings

Paul Dodds, Medical Director of Mid Cheshire Hospitals NHS Foundation Trust, and Dr Bill Forsyth, Medical Director of Central and Eastern Cheshire Primary Care Trust, will brief the Committee on issues contained in the Dr Foster report “How Safe is your Hospital?”.

Dr M Dickinson, GP and Tracy Bullock, Deputy Chief Executive and Director of Nursing, Mid Cheshire Hospitals Foundation Trust, briefed the Committee on mortality rate figures following concerns that had been raised in the Dr Foster report “How Safe is your Hospital?” in relation to the Hospital Trust. 

Dr Dickinson explained that the two main commercial companies which provided information on the Standard Mortality Rate (SMR) were Dr Foster and CHKS.  However, each used a different logistic model, which meant different Standardised Mortality Rates could arise for the same hospital.  This had resulted in criticism nationally.

Nonetheless, the Hospital Trust was committed to ensuring mortality rates were as low as possible and had introduced a Mortality Reduction Group whose role was to review patients’ records and highlight any lessons to be learned.  The Trust had also recruited 3 Acute Physicians to deal with admissions via Accident and Emergency; this had resulted in improved patient flow and fewer moves between wards following admission.  Mortality rates were measured using an average of 100 and in July, the Hospital Trust mortality rate was 65.

Members of the Committee were given the opportunity to ask questions and the following points were raised:

      Whether there were pre and post operative delays in treating fractures?  In response, the Committee was advised that there were not usually lengthy waits for surgery and the Hospital used an emergency list to operate within around 24 - 48 hours where it was safe to do so;  the Hospital also had low infection rates particularly in relation to orthopaedic surgery;

      The need when looking at performance and target information in relation to the health service to take into account local demographic information such as whether there were local areas of deprivation that would impact on people’s health.  In response the Committee was advised that alcohol had a significant impact with 2 medical wards often having patients with alcohol issues such as liver failure;

      The Committee was advised that targets relating to time taken to admit onto a ward began 15 minutes after arrival in an ambulance (if not admitted straightaway) but in the case of suspected stroke, a rapid triage system was in place due to the importance of early admission and treatment.

RESOLVED:  That representations be made to the Department of Health urging the use of one model to measure Standard Mortality Rates.