Dr Foster identifies 13 trusts with high mortality ratios

The company lists organisations which have a higher than expected score on two or more different mortality indicators: the hospital standardised mortality ratio, the summary hospital-level mortality indicator, deaths after surgery and deaths in low risk conditions.

The majority of trusts listed are district general hospital trusts but University Hospitals Birmingham Foundation Trust − a prestigious tertiary centre − is among those appearing.

Twelve of the trusts had higher than expected rates on two of the four indicators, Birmingham was an outlier on all of them except the summary hospital-level mortality indicator. None had a lower than expected rate on any of the four measures.

University Hospitals Birmingham − which itself offers a mortality indicator service available to other trusts, in competition with Dr Foster − made no comment on the report as HSJ went to press on Tuesday.

As in previous years, several trusts expressed doubts about Dr Foster’s methodology.

Northern Lincolnshire and Goole Hospitals Foundation Trust said the summary hospital level mortality indicator figures used by Dr Foster did not match official Department of Health figures.

Chief executive Karen Jackson said: “The trust’s Dr Foster scores have improved considerably compared with last year. However, I am concerned at Dr Foster’s decision to use a different interpretation of the SHMI that is at odds with the official nationally published figures. This is very confusing for both NHS staff and the public.”

In a statement Mid Cheshire Hospitals Foundation Trust said under a different mortality indicator, the risk adjusted mortality index, it was not an outlier.

It said its higher than expected rating on the summary hospital-level mortality indicator was the result of a “data recording issue [which] caused the SHMI to spike”.

The trust said the same data issue accounted for its higher than expected score on the hospital standardised mortality ratio.

It added that from October it had “doubled the number of consultant physicians who work over the weekend”, from one to two.

In Dr Foster’s report 20 trusts were lower than expected on two or more of the four indicators.

Eleven of the 20 were in London and one, Guy’s and St Thomas’ Foundation Trust, was lower than expected on all four measures.

NHS England has commissioned professors Lord Darzi and Nick Black to conduct a study into the relationship between mortality rates and actual avoidable deaths. This would then be used to inform a new measure based on clinical case notes and would supersede the measures currently in use.

Four of the 13 trusts in the Dr Foster list were also inspected this year by teams working for NHS England medical director Sir Bruce Keogh as part of the government’s response to the Francis Inquiry. These were: Medway Foundation Trust, North Cumbria University Hospitals Trust, Northern Lincolnshire and Goole and United Lincolnshire Hospitals Trust.