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Deaths 'could have been prevented'

The high number of unexpected deaths at Mid Staffordshire NHS Foundation Trust could have been prevented if the shamed trust had paid more attention to mortality rates, according to the co-founder of a health information service.

The Dr Foster Hospital Guide said death rates at the trust were among the highest in England in 2007.

One year later, analysts reiterated their concerns over the higher-than-expected Hospital Standardised Mortality Ratio at the troubled trust.

Dr Foster Intelligence said that instead of investigating the causes behind the figures, the trust invested "huge amounts" of effort and resources into questioning the methodology, investigating data quality and changing the way it recorded deaths.

Roger Taylor, co-founder and director of research of the company, said that if the trust had paid more attention to the to the mortality rates it is "highly likely" that the death rate could have been cut.

"It is absolutely appropriate to question methodologies and to ensure that statistics are well founded," he said.

"However, to pursue this single avenue whilst failing to adequately inquire into the quality of care demonstrates an organisation which lacked the management skills to run a hospital.

"In this case, a focus on targets and external liability led to an incorrect conclusion with tragic consequences."

He continued: "Had the trust paid more attention to mortality rates, it is highly likely that deaths could have been prevented.

"The initial investigation by the Healthcare Commission, the regulator at the time, revealed that the trust's own arrangements for analysing preventable mortality had been inadequate and had failed to correctly identify patients whose care could have been improved.

"This was due to three main reasons: wholly attributing mortality rates to incorrect coding, use of flawed analyses, including comparisons of raw mortality rates, and a certain distrust of the methodology used.

"All of these errors contributed to the situation in which poor care was allowed to continue and almost certainly cost many patients their lives."

The former health watchdog, the Healthcare Commission, found that up to 1,200 extra deaths might have occurred at the trust between 2005 and 2009.

Mr Taylor also expressed concern that similar problems could be occurring elsewhere.

"While there may not be hospitals failing on the scale of Mid Staffordshire, it is absolutely possible that similar problems are occurring elsewhere.

"The last Dr Foster Hospital Guide raised concerns over 12 hospitals with worryingly high mortality so we must remain vigilant about other instances of poor care."

Dr Jenny Lewis, lead research analyst at Dr Foster, said: "Large variations in mortality and other measures of quality of care still persist.

"Poorly performing trusts who do not investigate in the light of these measures could well be failing to provide their patients with high quality, safe clinical care."

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