PERFORMANCE: The advent of a new hospital death rate indicator which includes all patients who die within 30 days of admission means the foundation must ensure people “at risk of dying” are not admitted “inappropriately”, its board has been advised.

A paper submitted to Tameside Hospital’s December board advises that the new Summary Hospital-level Mortality Indicator “demands a different approach” to addressing mortality rates.

Unlike the Hospital Standardised Mortality Indicator, it explains, the SHMI does not take palliative care or social deprivation into account, and includes all deaths within 30 days of discharge.

According to the report Tameside’s HSMR for 2010-11 was 101, whilst its SHMI was 117. Its HSMR for the first six months of this year was 112.

It continues: “Given that the method includes people who die within 30 days of admission to hospital, there is a need to ensure that people who are at risk of dying are not admitted to hospital inappropriately.

“It is also important to understand the effects of social deprivation, particularly as fewer people die in care homes or their own homes (and therefore more die in hospital) than is the average for the country as a whole.

“A further consideration is whether primary and community services are optimally configured to identify early, patients who are in acute need of specific interventions which, if responded to would allow the patient to remain in their own home.”

The hospital and its clinical commissioning group have established a working group to “assess the effect of all of the factors which impact on the SHMI, with the aim of identifying tangible solutions to the SHMI issue”. “The group will report its findings and develop a health economy action plan shortly, the report adds.