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Royal Devon and Exeter Hospital hit back at death rate report

By Exeter Express and Echo  |  Posted: January 31, 2013

The highest death rate of all the trusts listed in the report is Northern Devon Healthcare Trust, which includes Exeter Community Hospital as well as hospitals in Exmouth, Ottery St Mary and Honiton

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A REPORT listing two Devon health trusts with having some of the highest mortality rates in the country has been criticised as "deeply misleading".

The Sunday Telegraph produced details for all 141 general hospital trusts in England which compared the number of deaths during 2011-12 with the number which would have been expected for the type of patients they were treating.

The highest death rate of all the trusts listed in the report is Northern Devon Healthcare Trust, which includes Exeter Community Hospital as well as hospitals in Exmouth, Ottery St Mary and Honiton. The report claimed that almost 20 per cent more patients died than would have been expected — a total of 198 "excess deaths" in 12 months.

However, the trust said its mortality rate was in the expected range according to the Department of Health's preferred measure. The published article was based on alternative figures from Dr Foster Good Hospital Guide and excludes figures of elderly or terminally ill patients that it more commonly deals with in its community hospitals.

The Royal Devon and Exeter Hospital came 12th on the list with a total of 181 excess deaths. However, bosses at the RD&E said they were also angry about their misrepresentation and argued their high ranking was a result of a coding error which meant deaths of terminally ill patients were wrongly included in their figures.

Dr Alison Diamond, medical director at the Northern Devon Trust, said: "We continue to provide safe, high-quality healthcare, and this is proved by a range of measures.

"Our mortality rates are within the expected range according to the Summary Hospital-level Mortality Indicator, the Department of Health's preferred measure. More people do not die in our hospitals, as the Sunday Telegraph alluded to in its misleading article.

"One of three key facts the newspaper neglected to mention was that our most recent Hospital Standardised Mortality Ratio figure, dating from November 2011 to October 2012, showed a significant improvement.

"We are one of very few trusts in the country with such a noticeable difference between SHMI and HSMR figures. This is because most trusts only run acute hospitals, whereas we manage the acute North Devon District Hospital as well as 17 community hospitals. Community hospitals look after a larger proportion of patients at the end of their lives, so a higher mortality rate is to be expected.

"Indicators are a very useful tool for clinical leaders to assess the quality of care they provide. As soon as the anomaly over our figures was spotted, we worked with the Dr Foster team to investigate the issue and help us understand what caused this result, fully briefing our commissioners throughout the process.

"I would like to reassure the public that we have closely examined huge amounts of clinical information, including about 200 sets of patient notes, and have found no major cause for concern."

Dr Vaughan Lewis, joint medical director at the Royal Devon & Exeter NHS Foundation Trust, said: "We are disappointed that the Sunday Telegraph published this misleading piece without contacting us. We can reassure our patients and their families that the RD&E continues to deliver safe, high quality health care.

"In October 2011, the Department of Health created a standard benchmark to measure all deaths in hospital, called the Summary Hospital-level Mortality Indicator. For the period covered by the Sunday Telegraph, our figure was 0.88, putting us in the best-performing 16 trusts in the country.

"The Sunday Telegraph appears to be basing its information on data collected for the Dr Foster Good Hospital Guide. Their definition of a death in hospital excludes terminally ill patients receiving palliative care.

"Due to a coding error during the period in question, we attributed fewer than one per cent of deaths to this group compared to the national average of 15.9 per cent.

"This skews the figures, as we have been reporting a group of patient deaths that other hospitals have been excluding, thus explaining the anomaly reported by the Sunday Telegraph."

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