Data recording may explain trust’s high death rate

An inadequate system for recording and coding data on patients has been blamed by Mid Staffordshire NHS Foundation Trust for its mortality rates coming under investigation by the Healthcare Commission.

England’s healthcare watchdog announced that the trust’s mortality rate was higher than the national average, and that the commission was concerned about the effectiveness of the trust’s system for monitoring this data.

Undisclosed figures sent to the commission by the trust raised an alert from the Dr Foster monitoring unit, based in Imperial College London, resulting in an urgent investigation into the cause of the incident.

Nigel Ellis, the commission’s head of investigations, said: “An apparently high rate of mortality does not necessarily mean there are problems with safety. It may be there are other factors here such as the way that information about patients is recorded by the trust. Either way it does require us to ask questions, which is why we are carrying out this investigation.”

In a statement, the trust confirmed it believes the apparent high rate was due to problems with recording and coding information using the current system.

Trust chief executive, Martin Yeates, said: “We worked with the strategic health authority and investigated this apparently high mortality rate and concluded that it was due to problems in the way we were recording and coding information about patients.

“We have, over the last year, employed more clinical coding experts to work within the various specialty departments to help staff to record information and improve the quality of data. As a result, there has been a significant improvement in our SMR [standardised mortality ratio] and our processes have been confirmed as being appropriate by our internal auditors.”

The Healthcare Commission says the investigation will now focus on “examining the ability of the trust’s information systems to provide an accurate picture of mortality rates and identify potential problems so that swift action can be taken, wherever improvements need to be made.”

Ellis added: “It is absolutely critical that, on behalf of patients, we get to the bottom of these issues and bring clarity to the data on mortality rates. The figures at Mid Staffordshire Foundation Trust are out of normal range which is why we are carrying out this investigation to get a clear picture of what is going on.

“People using the trust’s hospital services, should be assured, however, that if we thought the trust was unsafe we would have already taken action. There is no cause for immediate alarm.”

In addition, the commission will investigate the quality of care at the trust, in particular the care given to older people, following a number of concerns raised by patients. The investigation will also examine governance arrangements to protect the safety of patients.

The full results of the investigation will be published later this year, along with any recommendations for improvement, should they be necessary.

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