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Use of special measures saved lives at Keogh hospitals

The decision to put 11 trusts into special measures following the Keogh review in 2013 saved hundreds of lives according to a new report.

Professor Sir Bruce Keogh, medical director at NHS England, placed the trusts in special measures after looking at 14 with higher-than-expected mortality figures in the wake of the Mid Staffordshire scandal, where high death rates were found to have been symptomatic of major failings in care.

Analysis of those 11 trusts by Roger Taylor, director of research at medical thinktank Dr Foster, found there has been “significant” reductions in mortality.

The analysis shows that, while mortality rates fell across all English hospitals in the period since July 2013, this trend was significantly more pronounced in the 11 special measures trusts taken as a group. The special measures trusts still have higher mortality rates than the national average but the difference has narrowed considerably.

There has been a fall of roughly 450 deaths across the 11 hospitals between August 2013 and June 2014.

Taylor said: “Our analysis gives us some hard evidence that special measures can be an effective tool for turning around NHS trusts that experience problems. It’s now up to the NHS to learn the lessons of what worked in each of the 11 trusts, so that a best practice approach for special measures can be adopted.”

However it was revealed that at one trust, Tameside Hospital NHS Foundation Trust in Greater Manchester, mortality rates had continued to worsen.

Tameside, Medway NHS Foundation Trust and East Lancashire Hospitals NHS Trust have all appointed new chief executives in the wake of the Keogh review.

Others replaced key board members, and special measures hospitals were “buddied” with a successful neighbouring hospital.

Across all 11 Keogh trusts Dr Foster’s analysis shows annual mortality rates fell by 9.45% after being placed in special measures. The hospitals are now closer to average mortality rates. Two hospitals mortality rates, however, remained flat and the rise at Tameside Hospital was being investigated.

A Tameside Trust spokesman said: “Initially we focused our attention on understanding and improving the care and treatment given to our patients. We now have a fully embedded mortality review process, where all deaths are comprehensively reviewed. We are now clearer on the data quality issues which require further action.”

The analysis is based on national Hospital Standardised Mortality Ratio (HSMR) and Summary Hospital-level Mortality Indicator (SHMI) data. Mortality data from the 11 Keogh trusts was compared with thousands of randomised samples from other English trusts to establish how they had performed relative to the average.

Prof Sir Bruce Keogh said: "Mortality statistics require careful interpretation, but they do provide an important smoke signal.

"What this report shows is that by following the smoke and carrying out proper, transparent analysis and supporting as necessary, you can help hospitals make significant improvements."

Health minister Lord Howe added: "Since the scandal at Mid Staffordshire we have taken tough decisions to improve patient safety.

"A total of 19 trusts have now been placed in special measures and today's report is further evidence that our special measures programme is working."

(Image: Sir Bruce Keogh. Source: Joe Giddens/PA Archive)

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