Concerns hospital death records 'covering up poor treatment'

The way hospitals record deaths could be covering up poor care and costing lives, according to health analysts Dr Foster. Data showed a sharp rise in deaths recorded as needing palliative care - relieving patient suffering at the end of their life.

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Hospitals respond to Dr Foster death record report

Several NHS hospitals have responded to concerns raised in a new report from health analysts Dr Foster that they may be wrongly recording deaths.

The chief executive of East and North Hertfordshire NHS, Nick Carver, said his trust's high level of palliative care was because it ran an NHS hospice and was "possibly the only NHS trust in the country to offer a seven-day-a-week palliative care service to local people".

A spokesman for King's College Hospital in London said the rise in the number of its palliative cases was because the hospital now has a "much better system for formally recording palliative care".

King's College Hospital in London was one of the NHS trusts with an above-average rate of palliative care. Credit: Andy Hepburn/PA Archive/Press Association Images

A spokesman for the Royal Liverpool and Broadgreen University Hospital said it had a high number of specialist services offering care to patients with terminal illnesses.

"We now code those patients as palliative to ensure they receive the most appropriate care during any stays with us. This is why there has been an increase in this type of coding," he said.

NHS says death record report 'raises serious concerns'

A report saying hospitals may be covering up poor care by wrongly recording deaths "raises serious concerns", an NHS spokeswoman has said.

It is important that data recording about patient admissions is consistent and accurate so that providers and commissioners of healthcare as well as patients and the public have reliable information about the quality of care.

The Dr Foster report raises serious concerns which should give providers cause for reflection. Organisations have a responsibility to submit accurate and honest data, while the Health and Social Care Information Centre has a statutory duty to fully and publicly assess NHS data quality, giving national advice and guidance to help resolve problems and issues.

– NHS spokeswoman


Rules on recording deaths in hospitals 'too vague'

There are "real concerns around the gaming of indicators" used by NHS hospitals to record deaths, with experts accusing them of using a system which is "too vague".

Roger Taylor, director of research at Dr Foster, said "imprecise rules" governing how hospitals code deaths was harming patient care, may distort death rates and needed urgent review.

The rules are too vague. Poor quality data is harming patients because you can't see where things are going wrong and you can't see where there are issues.

If the data is not being recorded consistently and, moreover, if that isn't picked up because of a lack of auditing there is a risk that poor patient care is being disguised, and the public misled.

We're worried this issue is not being given sufficient priority. The bottom line is it could increase the possibility of failing to identify another Mid Staffs and potentially cost lives.

– Roger Taylor

60 trusts 'outstrip' national average of palliative deaths

Nearly half of the 142 hospital trusts in a report into the way deaths are recorded outstripped the national average for palliative care, experts said.

According to data from Dr Foster, out of the 60 trusts recording a rise were:

  • At East and North Hertfordshire NHS Trust, 43.18% (785 deaths) were recorded as palliative in 2012. In 2008, just 9.92% of deaths recorded by the trust were for palliative care.
  • At King's College Hospital NHS Foundation Trust, 38.41% (472 deaths) were coded the same way in 2012 (compared with just 8.71% of deaths in 2008).
  • Some 38.03% (610 deaths) at Aintree University Hospital NHS Foundation Trust were palliative in 2012 - almost double the 19.24% in 2008.
  • Guy's and St Thomas' NHS Foundation Trust in London jumped from having 1.18% of deaths recorded as palliative in 2008 to 31.65% in 2012 - a 27-fold rise.
  • The Royal Liverpool and Broadgreen University Hospitals NHS Trust also jumped from 1.35% palliative deaths in 2008 to 29.23% in 2012.

Rise in palliative care deaths raises cover up concerns

The way hospitals record deaths could be covering up poor treatment and costing lives, according to a new report.

Some hospitals may also be "fiddling" the figures to make their death rates appear better than they actually are, experts said. Credit: PA

A sharp rise in the number of deaths recorded as needing "palliative care" - relieving patient suffering at the end of their life - has lead some experts to believe the term could be used to cover up poor treatment.

Some hospitals have recorded a rise of 35% in the number of deaths deemed palliative, with 36,425 recorded as part of end of life care in England last year.

This was 17.3% of the number of deaths overall and almost double the 9.1% (2,1130) recorded as needing palliative care in 2008. In 2006, just 3.3% of deaths were palliative.

Palliative care deaths are not included in the hospital standardised mortality ratio (HSMR), which compares the expected rate of death in a hospital with the actual rate of death.

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