Issue - meetings

To consider the attached report.

Tracy Bullock, Chief Executive of the Mid Cheshire Hospitals NHS Foundation Trust (MCHFT), briefed the Committee on the recently published Dr Foster Guide which looked at hospital performance in relation to various matters including mortality rates, best practice, patient safety and patients’ views.  The Guide suggested that MCHFT had higher than average mortality rates -  Ms Bullock clarified that Dr Foster suggested that higher mortality rates occurred at weekends only (not at other times as suggested in the Committee papers).

Ms Bullock explained that there were differing methods available to hospitals to use to measure mortality rates – Dr Foster, CHKS and SHMI (Standardised Hospital Mortality Index). The SHMI measurement had been intended for use as a standardised measurement tool suitable to be used by all hospitals, but this had not proved possible.  This meant hospital trusts could chose their own measurement method out of the three possibilities and MCHFT had chosen to use CHKS as its mortality measurement tool. 

Ms Bullock explained that MCHFT had worked continuously to make sustainable improvements in mortality rates and, over the past two years, rates had decreased; rates for the six months to September 2011 were “as expected” according to the Dr Foster measurements although these were not reflected in the current Guide which covered the period April 2010 – March 2011. 

The MCHFT had undertaken various actions to address high weekend mortality rates including investing in Consultants and Specialist Nursing staff.   The Trust also used a nationally recognised acuity tool to assist with nursing levels on the wards; the tool looked at the patient dependency on a ward and used the data to ensure the appropriate number of nursing staff was matched to the patient dependency.  Ms Bullock clarified that this acuity tool did not focus on minimum numbers of staff but rather the focus was on patient need.  In response to a question, she explained that information on causes of deaths could be obtained by National Confidential Enquiries. 

Finally, Ms Bullock explained that the Trust carried out regular Mortality Audits.  One finding had been that a number of older people were dying within a very short time of arrival at the hospital; on investigation it was found that a high proportion of such patients were being referred to the hospital from 3 specific Care Homes.  As a result, the hospital had worked with the relevant local GPs to reach a 46% reduction in attendances at Accident and Emergency; this work had now been rolled out across other Care Homes and had won a national award.

RESOLVED:  that the report be received and noted.