PERFORMANCE: The acting chief executive of Bolton Foundation Trust has agreed to “step aside” while a probe is conducted into possible “discrepancies” in the way the trust has coded mortality information.
Bolton Clinical Commissioning Group announced yesterday that there was “some cause for concern” in the interim findings of an investigation into why the trust had recorded an “unusually high” number of septicaemia cases last year.
Deaths from septicaemia – a severe infection that enters the blood stream – do not count against a trust’s hospital standardised mortality ratio as much as deaths from conditions that are less likely to be fatal.
Bolton CCG chair Wirin Bhatani said it had commissioned the coding audit – by healthcare intelligence firm Dr Foster – after becoming aware of the issue in October last year.
Bolton had recorded 800 cases of septicaemia in 2011-12, where a trust of its size would be expected to have no more than 200, the CCG confirmed.
Dr Bhatani said: “Although the final report from this audit is not due to be given to us until 6 March, we have received some interim findings that indicate some cause for concern.
“While we are keen to wait for the final report, we are sufficiently concerned by the interim findings to commence further investigations, and to inform the chair of the trust.”
The foundation trust said in a statement that its acting chief executive Jackie Bene had agreed to step aside from the role while further investigations were carried out, to allow “a fully independent view to be taken”. As Bolton FT’s medical director, Dr Bene had overseen coding at the trust, the statement explained.
It added: “We have received early information from an initial audit about potential discrepancies in the way the Trust coded patient mortality information in 50 cases from between April 2011 and March 2012.
“The audit has not reported but we have decided to act on this information because we want to rule out any serious issues as soon as possible.”
The trust said it would work with Bolton CCG and foundation trust regulator Monitor to “jointly review all the relevant information”. It was also bringing in an “independent team to look at our current coding practices”, and extending the scope of a quality governance review already being carried out at the trust by consultancy Deloitte.
The CCG said it was receiving support from the NHS Commissioning Board and NHS medical director Sir Bruce Keogh to “urgently” conduct further investigations into the interim findings.
Information supplied to HSJ
27 February 2013