UK - Hospital defends death rate figures

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August 24, 2002 19:00

MORE than three people in 100 die within a month of emergency surgery at Ipswich Hospital, we can reveal today.

But the hospital says it is not worried about the figure we can finally make public today, which is slightly worse than the national average.

We pledged to get the full story, after the Department of Health branded the hospital's performance as 'significantly below average' because its assessors said: "Major problems were found in the quality of the data supplied by Ipswich Hospital.

"As a result, the clinical indicators produced for this Trust were considered to be unreliable and could not be used in the calculation of the performance ratings."

We know this judgement caused anger at Ipswich Hospital, but directors refuse to publicly argue with their ultimate bosses.

Gremlins in the computer system have now been blamed for the data not arriving at the Department of Health, but human error was originally responsible for programming the computer software.

The Star can reveal that an information technology expert at the hospital has already modified the software programme, so the same problem can never happen again.

The Strategic Health Authority - which along with primary care trusts, replaced Suffolk Health in April - today confirmed Ipswich Hospital's data is fine, but some had been lost in electronic transmission to the Department of Health.

Peter Davies head of communications at the SHA, said a quarter of a year's figures went missing during transmission to the Department of Health, and when hospital staff tried to add it back in, it kept cancelling out the next quarter figures instead.

He said: "There was a technical error in the transmission of information. The figures which went into the central database were incomplete and that triggered a 'significantly below average' result. "Unfortunately once a gremlin has got into the system it is very hard to unravel.

"We have the checked the hospital's data and I am confident it is okay. It has been for the last ten years, and that hasn't changed."

He added that hospital staff spotted the error but too late for the judgement to be changed, and now the Department of Health has refused to review it.

He said if the information was reinstated, it would not boost the hospital's one-star status to two.

Hospital medical director Ian Scott said: "The differences between our performance and the national average are marginal for two of the indicators.

"There isn't anything which gives me cause for concern. That doesn't mean that I don't look at the figures - I do and it's very important to do so - but I am much more inclined to rely on the benchmarking by peer organisations which show we are performing well."

Benchmarking is where independent assessors (senior clinicians from other hospitals, analysts and health economists) compare hospitals with similar numbers of beds and patient populations.

Mr Scott, who is also elected chairman of the national Association of Trust Medical Directors, added: "This is the best place I've ever worked in, and clinical standards across the board are excellent. Our data information team work extremely hard."

He said one reason for the slightly high death rate after emergency surgery, could be that consultants at Ipswich were able to tackle more complex operations than other hospitals, but added: "I am happy there is not anything there which needs to be addressed."

A spokeswoman for Ipswich Hospital said there were two reasons why three out of 100 patients die within 30 days of emergency surgery.

She said: "There is a very big difference between planned operations and emergency surgery.

"It is likely that people who have emergency operations are very poorly, so the survival rate is obviously going to be highly influenced by their state of wellbeing before the operation.

"Our consultants have a philosophy of doing absolutely everything possible to help people, and they attempt operations which perhaps other clinical teams may not tackle. The risks and implications of surgery are always discussed with the patient or next of kin, so they can make an informed choice, and we would not proceed without consent."

Mr Scott added that the hospital's failure to meet the target for two week cancer waits, did not reflect the fact that only one out of five patients with suspected cancer, were referred by GPs under that target.

He said cancer network assessors "found the vast majority of patients were seen within a month, which is a good performance."

Bosses at Heath Road are now confidently aiming high - hoping for two stars next year, and a three-star rating by 2004.

Increasing the number of beds and reducing the number of bedblockers will be a major priority.

Mr Scott admitted: "We have a major bed management problem, when we try to get elective (planned) surgery patients in."

He also hopes that more money will soon be forthcoming to upgrade information technology, at hospitals across the country.

Evening Star

-- Anonymous, August 25, 2002


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