The government will fund a national study into avoidable deaths in out of hospital settings to gauge the ‘feasibility’ of developing ‘locally attributable’ death rates.
Health secretary Jeremy Hunt told the Commons today that there needed to be a better understanding of avoidable mortality outside hospital and a methodology adopted to “identify avoidable harm as well as avoidable death”.
He was responding to Sir Robert Francis QC’s report today on the treatment of whistleblowers in the NHS, and outlining the progress the service had made in implementing the recommendations of Sir Robert’s 2013 public inquiry into Mid Staffordshire Foundation Trust.
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- Trusts should employ whistleblower ‘guardians’, Francis says
- No binding powers for national whistleblowing ‘officer’
- Francis calls for stronger legal protection for whistleblowers
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Similarly, the government wants to increase oversight of clinical accountability outside of hospital and has asked the Academy of Medical Royal Colleges “to develop guidelines for meaningful clinical accountability outside hospitals”.
Mr Hunt said that while the “name above the bed [initiative has] strengthened accountability in hospitals… there is still not enough clarity on the role of professionally accountable clinicians, particularly in community settings”.
HSJ reported last month that a third of trusts were not complying with the “name above the bed” policy.
Mr Hunt said that one of the “biggest causes” of poor care is “when no one takes responsibility for a vulnerable patient and the buck is passed”.
He added: “This leads to greater costs and also numerous personal tragedies as people are passed unnecessarily around the system.”
The academy will publish its findings this spring.
By the end of 2015-16 clinical commissioning groups will be expected to publish how many of their patients with long term conditions are being looked after by “clinically accountable community clinicians” in line with the guidance the academy will draw up.
Mr Hunt said: “Proper proactive care for our most vulnerable patients will not only reduce hospital costs, but will also reduce avoidable harm and improve the quality of compassionate care.”
The government has already announced a drive to cut the number of avoidable deaths in hospitals.
By the end of March 2016 an annual estimate of avoidable deaths by hospital trust will be published based on case note reviews and the safety record of trusts.
The chairs of trusts will also be asked to write to the health secretary by the end of May each year outlining the measures they will take to reduce the number of avoidable deaths in their trust.
Mr Hunt said this was not a process of “naming and shaming, but learning and improving”.
Nick Black, the professor whose research the idea of an avoidable deaths estimate is based on, told HSJ this week that an attempt to calculate the number of avoidable deaths for a hospital “wouldn’t have any meaning”.
Exclusive interview: Francis insists whistleblowing measures have 'teeth'
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Government to study 'feasibility' of out of hospital avoidable death rates