Havering’s Hospital Trust defends high death rate and poor stroke care

HAVERING’S hospital trust has defended damning claims putting it towards the top of a table for having a higher than expected mortality rate and being one of the worst for stroke care in England.

Barking, Havering and Redbridge Hospital Trust, which manages Queen’s Hospital in Romford and King George’s Hospital in Goodmayes, faired poorly in both areas as detailed in the Dr Foster Hospital Guide, published this week.

But BHR Trust chief executive John Goulston defended the Trust’s performance saying it had made “great improvements” in the last 18months and “the findings of the Hospital Guide reflect that”.

The Trust now carries out stricter audits and has been working closely with the Care Quality Commission and Dr Foster on ways of improving, and pointed out that people with incurable illnesses who are cared for in hospital instead of a home or hospice and die makes hospital mortality rates higher.

The guide is produced annually by Dr Foster Intelligence - a joint venture by The Department of Health and Dr Foster Holdings LLP

BHR Trust had the fourth highest percentage of hospital deaths in the last year based on a calculated ratio of expected deaths and performed below expectation in two of six areas used to measure a Trust’s handling of stroke care - acute treatment for pneumonia due to swallowing problems, and providing medication within 24hours to patients requiring urgent treatment.

The guide measures death rates in three ways - by the number that occur after surgery, a standardised mortality ratio and by hospital standardised mortality ratios (HSMRs). It picked out BHR Trust as having one of the worst HSMR mortality rates in the country - 116per-cent - comparing the number of actual deaths to what it outlines as being the Trust’s standard death rate.

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It looks at all admissions to hospital where there is a significant risk of death and considers a number of factors including looking at the local area, the condition of patients when they arrive at hospital and how ill they are, as well as their age, sex and how deprived the area is to calculate how many deaths “should have occurred” to compare to the actual figure - meaning BHR Trust had 16per-cent more deaths than it should have had between April 2009 and March this year.

But Chief Executive of BHR John Goulston said: “Much of the information in the guide is now out of date. In particular, the Trust’s stroke care has improved so much in the past year that it has been given a national award.”

The Trust was also named the best Trust in London for specialist urology care.

Mr Goulston said: “The Dr Foster data was taken some time ago, when the Trust was in the bottom quartile for stroke performance. Since that time we have opened our Hyper Acute Stroke Unit and have leapt into the upper quartile.

“Our mortality ratio improved by nine points on the previous year, but other hospitals have made more rapid improvements and we are disappointed to still be towards the bottom of the national table.

“We have audited areas where the figures suggest we have higher rates of death, and Dr Foster is reassured that no issues of poor care have been identified.

“We are committed to improving the outcomes for patients and the safety of our services, and have introduced a range of measures to deliver this.

“Since April our mortality ratios have improved even further and now stand at less than 102.”

BHR Trust was ranked jointly with The Royal Wolverhampton Hospitals NHS Trust and Royal Bolton Hospital Foundation Trust on mortality rates.

The three were better only than Buckinghamshire Hospitals NHS Trust which recorded a ratio of 118per-cent and Hull and East Yorkshire Hospitals NHS Trust and Shrewsbury and Telford Hospital NHS Trust which both recorded 117per-cent.

BHR Trust had neither one of the highest nor the lowest mortality ratios when using the other two mortality indicators according to the Dr Foster Hospital Guide.