Trust calls in outside help after mortality rate rises

According to papers for its April board meeting, Dartford and Gravesham Trust’s hospital standardised mortality ratio rose to 117.8 in November 2020, which it describes as “significantly higher than expected”. This is up from 113 in September 2020. 

The papers added the rise is not necessarily linked to covid and a rise in mortality was seen prior to the pandemic.

However, another measure of mortality — the summary hospital mortality index — is within normal range at 104.81 and the trust said it cannot explain this disparity between the two. Its “crude” mortality rate for diagnoses captured by HSMR is also slightly lower than its peer group, at 3.2 per cent against a 3.6 per cent benchmark.

In a statement to HSJ, the trust said: “Whilst we cannot fully explain the disparity, we are taking a precautionary approach to managing the HSMR… the trust has embarked on a mortality quality improvement programme incorporating support from Dr Foster and a patient safety lead from the Royal College of Physicians to improve learning from deaths and embedding into practice to ensure delivery of care to a high standard with outcomes measured well against our peers.”

The trust added it was focusing on patient groups highlighted in the data. For example, it is: looking at benchmarked safety data following an alert for “other perinatal conditions” to make sure there is not a safety issue and to address coding anomalies; trying to reduce the time taken to get patients with fractured neck of femur to theatre; and carrying out “deep dives” into patient deaths from sepsis and pneumonia.

The statement continued: “We take the HSMR seriously and we have reflected this data through our board report to ensure our patients and public are kept informed and updated on progress.”