Dr. Foster Good Hospital Guide

The RWHT has a tremendous reputation for patient safety, I am proud that within our hospital, safety and quality of patient care are at the heart of everything we do. Recently we passed [519] days without a MRSA blood stream infection. In this way, I want to assure our patients and staff that we rigorously monitor the rates of mortality in this hospital to identify if any action need to be taken to improve the care we offer our patients.

Dr. Foster, a commercial organisation, will be publishing the Dr. Foster Good Hospital Guide in the Observer on Sunday 28 November. The Royal Wolverhampton Hospitals NHS Trust will be named as an outlier for the hospital standardised mortality rates (HSMR) and this is assumed to be an indicator of quality and mortality, which is not the case. We have done a great deal to analyse our mortality over a longer period of time and our full report with an audit example is available to download at the bottom of this page.

HSMRs have generated considerable debate and public interest. We believe that along with other measures such as, death rates, standardised mortality ratio (SMR), the level of community services, hospice provision, deprivation and a full understanding of the local context, they can help us to understand comparative information about in-hospital deaths.

It has been recognised in the British Medical Journal that Dr Foster HSMRs have limitations and should not be used as a sole indicator of patient safety.

Our own detailed analysis shows that our death rates have stayed level for a number of years, despite sharp rises in the amount of patients that choose to come to our hospital from other neighbouring regions. In 2009/10 the number of observed deaths was less than the previous year.
Our death rate is lower than the West Midlands average.
Our clinical audits have shown that the way in which we monitor mortality is robust and that we are proactive in making changes to heighten patient safety and quality.
We have already looked into these statistics and last year undertook detailed reviews of several complex conditions which contributed to the high HSMR in Dr Foster’s Good Hospital Guide. The Trust Board is satisfied that each mortality was risk assessed, the explanations explored and appropriate actions were taken by the clinical team to ensure the safety of patients. The Care Quality Commission (independent regulator of health and social care in England) corroborated our findings.

I would like to reassure our patients that we will continue to look for improvements; we will continue to challenge our clinical practice so that our services are even safer.

David Loughton, CBE

Chief Executive

Full Report - An Analysis of Mortality Performance in 2008/09, 2009/10 and 2010/11

Audit of emergency readmission following primary total hip replacement at New Cross Hospital

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