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There was plenty of scepticism when Jeremy Hunt announced a major new policy for trusts to publish data on avoidable deaths.

The key concerns raised at the time appear to have been borne out, with 26 acute trusts claiming they had zero avoidable deaths within a three-month period, out of almost 10,000 cases that were reviewed.

The vast majority of other acute trusts each reported just a handful of avoidable deaths.

An expert on the subject, Nick Black, who has previously highlighted problems with the policy, told HSJ: “Zero is not what one would expect. Our best estimate, which fits with other studies, is that four per cent of deaths from any random sample are avoidable. A recent study in Norway also confirmed that figure. If trusts are not finding that then they are sort of kidding themselves.”

The problem, says Professor Black, is that trusts are expected to investigate the deaths themselves, rather than an external review being carried out.

He added: “The policy is misconceived, if you want it to work then you have to do what we did in our reviews and use completely independent reviewers. To do that routinely is prohibitively expensive so (the Department of Health and Social Care) has gone for something feasible where the cost lies with the trust…

“The worry is they are not learning and it’s just a tick-box exercise. Or worse, that the non-exec directors are reassured by the process and that could induce false or unjustifiable complacency, so it could make the situation worse.”

End of ‘bonkers’ system?

After weeks of criticism and media pressure, the Home Office has finally agreed to review its Tier 2 visa system, for skilled workers from outside the EU.

Sajid Javid confirmed the review on the Andrew Marr show on Sunday, which will give some relief to NHS workforce leaders.

It comes after HSJ revealed how hundreds of non-EU doctors had had their visa requests denied in recent months, including those recruited through a well-established programme run through Wrightington, Wigan and Leigh Foundation Trust.

The trust’s chief executive Andrew Foster has been doing the rounds on national media, describing the decision as “bonkers” last week.

Danny Mortimer, chief executive of NHS Employers, welcomed news of the review but stressed that action is needed urgently, ahead of the August intake of new recruits.

He added: “It is now six months since we first started having problems, along with other sectors. The NHS is fast approaching the major August intake and changeover period for many doctors in training.

“A speedy, effective solution is urgently needed to clear the backlog, account for any increase in applications linked to the August changeover and provide a sustainable approach to the management of the system.”