Hunt Delay on Avoidable Deaths Receives Criticism

The commitment of Health Secretary Jeremy Hunt to publish trust level information on unavoidable deaths will be subjected to a major delay.

There are doubts over how, and indeed whether, the information can be adequately calculated.

Hunt had indicated back in February that the government intended to publish estimates of the proportion of deaths available for every trust by April.

Yet no national information has been published, and the Department of Health and NHS Improvement, both involved in leading the work on the mortality, have been able to provide any form of timetable.

Nick Black, professor of health services research at the London School of Hygiene and Tropical Medicine, has been involved in the advisory process behind the initiative.

Yet Black is critical of the ultimate approach, suggesting that the exercise had been a failure.

“I get the impression that nothing more has happened [with the self-assessment data] but to my mind that was a good outcome as I really didn’t understand the point of the whole exercise. The only value I could see in it was to alert trust board members as to the numbers of avoidable deaths probably occurring in their trust as that might act as a spur to do more work on quality and safety. That would be no bad thing but it would not be a metric that you would then monitor”.

The Department of Health is currently attempting to develop an alternative proposal for the calculation of avoidable mortality data, but even the awarding of the contract in order to conduct this process is not due until January 2017.

Once this has taken place, it is anticipated that the research will require at least two further years to be undertaken to the requisite standard.

Kevin Stewart, clinical director of the Royal College of Physicians’ clinical effectiveness and evaluation unit, is leading a project for the DH to develop a standardised national model for mortality case record reviews.

However, Stewart was keen to emphasise that the tone of the review had not been to his liking.

“The college is very keen that this review is about learning and improving, it is not about naming and shaming and it is not about being able to determine a percentage of avoidable mortality. Trying to determine a number per hospital of avoidable deaths is a distraction because it is incredibly difficult and we will miss opportunities to learn”.

The Department of Health remains in “discussion with leading clinicians on how to develop this data and publish it as soon as possible,” according to a spokeswoman.

But there is no timeline for completion of this process at the time of writing.

NHS Improvement has confirmed that it is reconsidering the original research proposal, but there has been no official confirmation on whether trust level data will be published.

A spokesman for NHS Improvement indicated that the organisation is now collaborating with the Department of Health on the process going forward.

“We are currently working with the DH to determine how best we can learn from, and be transparent about, deaths that may have been caused by problems in care. We will set out more detail as soon as we can”.


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