The chair of the independent board created by the government to run the NHS was “worried” by incorrect claims about hospital deaths surrounding the publication of the Keogh mortality review, he revealed to HSJ.
Several media reports ahead of the publication of the investigation last week suggested large numbers of patients had died, based on figures from statistical models. One report was headlined: “13,000 died needlessly at 14 worst NHS trusts”.
NHS England medical director Sir Bruce Keogh’s report itself strongly rejected these assertions. The Department of Health has denied it released the figures to journalists.
However, on the day of the report’s publication, health secretary Jeremy Hunt told the Commons that “mortality rates suggest that since 2005, thousands more people may have died than would normally be expected at the 14 trusts reviewed”.
Asked whether the government had overstepped the mark in the presentation of the report, NHS England chair Sir Malcolm Grant said: “I’m worried about this. I think when somebody does an independent review the outcome of that needs to be reported as an independent review…
“What the government does with the data is a matter entirely for the government, but it did seem to me in the press coverage prior to last Tuesday, there was a conflation of the data related to 13,000 deaths, which has nothing to do with Bruce’s report.”
He declined to comment directly on whether the government had acted wrongly.
Sir Malcolm also warned the government’s proposed “refresh” of its mandate to NHS England for 2014-15 risked pushing the NHS back towards “command and control”.
He said the proposals which are currently being consulted on were not clear enough, did not include costing, and attempted to “prescribe process” rather than only outcomes.
“We’ve got to have stability over time [in the mandate],” he said. “The whole point of these reforms – and an enormous amount of money has gone into achieving them – was to allow proper planning over time, and to bring the health service away from day to day management by ministers.”
Sir Malcolm said any new requirements NHS England was set, it had to pass on to clinical commissioning groups. He said this meant, “the model gets skewed back in the old direction”. “We all have to be vigilant, us and ministers, to ensure the spirit of the reforms is recognised properly in practice. We’re all learning.”
Asked about whether NHS England was being broadly given the intended autonomy from government, he said: “We’re in a transitional period. It’s very difficult to overcome some of the habits of the past.” He said public, media and government “will take some time to adapt to the new model”.
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Grant 'worried' by hospital death claims