High number of patient deaths despite mortality rate reduction
THERE have been more than 1,300 excess patient deaths at nine Scottish hospitals in recent years, despite the overall reduction in the mortality rate.
Inverclyde Royal has 228 excess deaths recorded
More than half have occurred in three hospitals in the west – Royal Alexandra in Paisley, Vale of Leven in Alexandria, and Inverclyde Royal in Greenock.
There were 768 more patient deaths at the three units than were predicted by NHS statisticians from January 2011 to September last year.
The hospitals are located within a 10-mile radius and acute services in the area have been increasingly centralised in recent years.
By contrast, death rates in other parts of Scotland with similar social problems have been significantly reduced over the same period.
Whilst any reduction in mortality is to be welcomed, the top line figure hides problems at individual hospitals across the country
Most other hospitals with more deaths than predicted are in the Highlands and Islands, leading to fears staffing shortages may be having an impact.
But, despite frequent reviews by the SNP Government’s health watchdog, the reasons for high death rates are usually kept behind closed doors.
Health Secretary Shona Robison last week said the NHS had achieved its target of a 10 per cent reduction in hospital mortality 15 months ahead of schedule, praising the work of the Scottish Patient Safety Programme (SPSP) – run by the Healthcare Improvement Scotland (HIS) watchdog.
Under the programme, higher-than-expected death rates in a particular quarter can trigger a review and a “formal dialogue” between the health board and HIS.
More than half of the patient deaths have occurred in three hospitals in the west of Scotland
None of this dialogue is made public but opposition politicians are now calling for the reports to be routinely published.
There have been at least 19 HIS reviews triggered since 2011, including no fewer than six at Royal Alexandra and Vale of Leven hospitals.
Despite these repeated interventions, there have been 540 excess deaths at the two hospitals and the mortality rate was higher than predicted in 23 out of 27 quarters.
By contrast, Inverclyde Royal has recorded 228 excess deaths and a higher-than-predicted mortality rate in 20 out of 27 quarters but has not been reviewed by the watchdog.
Labour’s Jackie Baillie, whose Dumbarton constituency includes Vale of Leven, said: “Whilst any reduction in mortality is to be welcomed, the top line figure hides problems at individual hospitals across the country. What we don’t know is what is causing the death rates to be significantly higher than anticipated and I would call on the government to be open and transparent.”
Scottish Tory shadow health secretary Miles Briggs said: “The SNP must publish the findings of the reviews of all hospitals that fail to meet the targets and ensure that the recommendations are implemented.”
An NHS Greater Glasgow and Clyde spokesman said: “We are satisfied that there appears to be no serious patient safety issues that contributed to the data being high.
“We are therefore looking more closely at how we collate and use our data with Healthcare Improvement Scotland and the Information Services Division.
“Patient safety is treated as a priority in all our hospitals.”
National Clinical Director, Professor Jason Leitch, said: "We continue to lead the way on patient safety and sharing learning, with other countries looking to learn from our approach.
"We are in regular contact with Healthcare Improvement Scotland who support health boards in managing hospital mortality and have been reassured by their reports on the quality of care provided in our hospitals."
The reasons for high death rates have tended to be kept behind closed doors
EXCESS DEATHS TABLE
Royal Alexandra Hospital/Vale of Leven - 540 excess deaths
Six watchdog reviews
Inverclyde Royal - 228 excess deaths
No reviews
Forth Valley Royal - 146 excess deaths
One review
Dr Gray's Hospital, Elgin - 135 excess deaths
One review
Balfour Hospital, Orkney - 85 excess deaths
No reviews
Western Isles Hospital - 76 excess deaths
Two reviews
Belford Hospital, Fort William - 41 excess deaths
Two reviews
Lorn & Islands Hospital, Oban - 36 excess deaths
One review
Gilbert Bain Hospital, Shetland - 14 excess deaths
No reviews