Barking, Havering and Redbridge Hospital Trust defends three poor ratings

HAVERING’S hospital trust has been rated poorly for maternity services, stroke care and mortality rates, all in the same week.

The Barking, Havering and Redbridge Hospital Trust – which runs Queen’s Hospital, Romford, and King George, Goodmayes – was judged to be one of the worst performing trusts in England in a maternity survey published by the Care Quality Commission yesterday (Thursday).

It was ranked among the worst for higher than expected mortality rates and noted as performing below expectation in two of six areas used to measure a trust’s handling of stroke care in the Dr Foster Hospital Guide published by the Department of Health and Dr Foster Holdings LLP earlier this week.

But BHR – one of the largest acute trusts in England serving a population of around 700,000 – has defended its record.

Chief executive John Goulston said the Trust had improved in the past 18 months and won a national award for its stroke care.

He said the Dr Foster data was “out of date” adding that people with incurable illnesses who are cared for and die in hospital, instead of at home or in a hospice, makes hospital mortality rates higher.

The Trust now carries out stricter audits on deaths and is working with the Care Quality Commission and Dr Foster to further improve.

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Director of women’s and children’s services, Carol Drummond was “surprised and disappointed” by the maternity survey results and said more midwives had been recruited in the past year to ensure one-to-one care during labour.

The maternity survey placed BHR Trust among the worst performing of the bottom 20 per cent of trusts.

The survey was handed out to all 295 mothers who had given birth at one of the two hospitals or at home in February this year and the results were based on responses to 19 questions across five areas – care during pregnancy, labour and birth, staff during labour and birth, postnatal care and feeding the baby in the first few days.

BHR Trust scored an average between 5.2 and 7.4 out of 10 in each section – all of which compared badly with most of the other 144 hospital trusts providing maternity services in England.

But it was within the best performing 20 per cent of trusts for swift repairs of tears or cuts requiring stitches which occurred during labour.

Carol Drummond said: “The recent Dr Foster Hospital Guide highlighted that the Trust offers good clinical care to women in labour, and this report backs that up by confirming that we have low rates of tears and they are quickly repaired.”

“However, we need to make sure that we are listening to the needs of women before, during and after birth.”

She said the Maternity Services Liaison Committee, made up of mothers who have given birth under the Trust, regularly gets feedback from mothers on ways to improve the service.

In the Dr Foster Guide, BHR was listed as having the fourth highest number of hospital deaths in the past year based on a ratio of expected deaths – a hospital standardised mortality ratio (HSMR) which compares the number of deaths to what it outlines as being the trust’s standard death rate (one of three measures used).

It looks at all admissions to hospital where there is a significant risk of death and considers 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”.

BHR had one of the worst in the country (116 per cent) meaning the Trust had 16 per cent more deaths than it should have had between April 2009 and this March.

Mr 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 in London for specialist urology care.

Mr Goulston said: “The 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.”