PERFORMANCE: United Lincolnshire Hospitals Trust is performing a ‘deep dive’ review into the deaths of some liver disease patients after mortality rates were found to be much higher than expected.

The most recent hospital standardised mortality ratio data at Lincoln County Hospital shows a rate of 119.15, which was “significantly higher than expected”, according to trust board documents.


The HSMR for liver diseases patients at Lincoln County Hospital was ‘significantly higher than expected’

This compares with a HSMR rate of 107.5 for the trust as a whole for the first quarter of 2015-16.

The HSMR is a measure of deaths while in hospital care based on 56 conditions that account for 80 per cent of deaths.

A breakdown of HSMR scores for particular diagnosis groups that were “alerting” found that the rate for patients being treated for “other liver diseases” was 195.38 for the year to March 2015.

An HSMR of 100 is the “expected” rate. Below 100 means fewer patients than would be expected are dying and above 100 means more than would be expected are dying.

While a recent NHS England commissioned review found that hospital-wide mortality rates were not a good way of comparing trusts’ performance, the authors said that looking at the indicators for individual, high fatality conditions could still be valuable.

The trust board documents said: “The actions and recommendations from all recent mortality reviews are to be compiled into a ‘tracker’ to ensure that lessons learnt and recommendations are suitably addressed and progressed.”

United Lincolnshire Hospitals medical director Suneil Kapadia said: “We are all aware by now of the limitations of using HSMR, which is not associated with avoidable hospital deaths.  

“Nevertheless, we still examine closely all diagnostic groups where ratios are high. We aim to review every patient death and also have a further group to review the quality of reviews.

“Our aim is to treat all quality indicators properly and make sure they lead to improvement in the way we care for patients.”