An email sent last autumn from the medical director of the English NHS to his Welsh counterpart has revealed the extent of his concern about deaths in Welsh hospitals. Sir Bruce Keogh told Dr Chris Jones that there are "six hospitals with a persistently high mortality which warrant investigating".
In the email, which has been released under the Freedom of Information Act, Sir Bruce sets out his suspicion that the long wait for diagnosis is the underlying cause of at least some of the high death rates. Here is the full text of the email:
From: Keogh Bruce (NHS ENGLAND)Sent: 28 November 2013 09:39
To: Chris Jones Subject: Medical Leaders
Good to talk to you. Firstly, through this email I am copying [redacted under Section 40(2) FOIA] who co-ordinates the Medical Leaders Group. It would be great if you could join. Secondly, as I explained I am worried about the broader political implications of the data that has been shared with me by Ann Clywd.The data falls into two categories, mortality (RAMI) and diagnostic waiting times. Examples are:
There are six hospitals with a persistently high mortality which warrant investigating. I do not have adequate data to form a view. The RAMIs are high but I don't have a comparative statistical analysis. Waiting times in A&E are considerably worse than England, but the real concern is around prolonged (>6 weeks) waiting times for diagnostics which, of course, translates to delayed treatment. I present these as investigation, % Waiting longer than six weeks in Wales, then in brackets % waiting longer than 6 weeks in England.
- MRI, 48.6 (0.9)
- CT, 14.9 (0.3)
- Non obstetric ultrasound 41.4 (0.4)
- Echocardiography 38.9 (0.9)
- Urodynamics 80.1 (7.8)
- Colonoscopy 47.8 (2.3)
- Flexible sigmoidoscopy 50.7 (1.4)
- Cystoscopy 49.6 (3.0)
- Gastroscopy 46.4 (1.8)
I cannot vouch for the veracity of these data but they are worrying. Given that they represent a potential diagnostic delay and may underpin some of the mortality concerns, it would seem sensible to investigate.
Please let me know if there is anything I can do to help.
With best wishes, Bruce