29 NHS trusts have excess deaths

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Blackpool Victoria Hospital, ran by the Blackpool Teaching Hospitals NHS FT, has been flagged up for having excess deaths every year since 2014


More patients are dying than they should be at 29 NHS trusts, claims an eminent hospital death rates expert.

MailOnline last week named and shamed the 13 health service-ran organisations across England that recorded excess deaths in 2017.

But Professor Sir Brian Jarman, who helped expose the Mid-Staffordshire hospital scandal, fears the true figure is much higher.

He recalculated the NHS Digital data for MailOnline and found a further 16 trusts ran by the health service fall into the excess deaths category.

According to his analysis, there were 6,800 more deaths than expected at hospitals ran by the 29 trusts – significantly more than NHS estimates of 3,700.

Blackpool Victoria Hospital, ran by the Blackpool Teaching Hospitals NHS FT, has been flagged up for having excess deaths every year since 2014

Blackpool Victoria Hospital, ran by the Blackpool Teaching Hospitals NHS FT, has been flagged up for having excess deaths every year since 2014

The County Hospital is ran by Wye Valley NHS Trust, which was named as one of the 13 NHS trusts with excess deaths in 2017

The County Hospital is ran by Wye Valley NHS Trust, which was named as one of the 13 NHS trusts with excess deaths in 2017

The County Hospital is ran by Wye Valley NHS Trust, which was named as one of the 13 NHS trusts with excess deaths in 2017

WHERE WERE THE 29 NHS TRUSTS THAT PROFESSOR SIR BRIAN JARMAN FOUND HAD EXCESS DEATHS? 

The Royal Wolverhampton NHS Trust

Northern Lincolnshire and Goole NHS Foundation Trust

South Tyneside NHS Foundation Trust

Wrightington, Wigan and Leigh NHS Foundation Trust

United Lincolnshire Hospitals NHS Trust

James Paget University NHS Hospitals Foundation Trust

Blackpool Teaching Hospitals NHS Foundation Trust

Colchester Hospital University NHS Foundation Trust

Wye Valley NHS Trust

University Hospitals Coventry and Warwickshire NHS Trust

Sandwell and West Birmingham Hospitals NHS Trust 

Southport and Ormskirk Hospital NHS Trust

Dorset County Hospital NHS Foundation Trust

Hull and East Yorkshire Hospitals NHS Trust 

Southend University Hospital NHS Foundation Trust

South Tees Hospitals NHS Foundation Trust

Royal Devon and Exeter NHS Foundation Trust

The Princess Alexandra Hospital NHS Trust

Kettering General Hospital NHS Foundation Trust

North West Anglia NHS Foundation Trust  

Mid Essex Hospital Services NHS 

Isle of Wight NHS Trust

Walsall Healthcare NHS Trust  

Basildon and Thurrock University Hospitals NHS Foundation Trust

Gloucestershire Hospitals NHS Foundation Trust 

Norfolk and Norwich University Hospitals Foundation Trust

East and North Hertfordshire NHS Trust

East Lancashire Hospitals NHS Trust

The Rotherham NHS Foundation Trust

Trusts in bold also fell under the excess deaths category by NHS Digital 

Chiefs warn the data is only a 'smoke alarm' and only warrants the need for further investigations to examine the cause of the excess deaths

Chiefs warn the data is only a 'smoke alarm' and only warrants the need for further investigations to examine the cause of the excess deaths

Chiefs warn the data is only a ‘smoke alarm’ and only warrants the need for further investigations to examine the cause of the excess deaths

NHS Digital releases its Summary Hospital-level Mortality Indicator (SHMI) data every summer for the previous year. 

It collected the data from 134 hospital trusts between January and December last year and then statistically analysed the results.

There were around nine million discharges, from which 294,000 deaths were recorded either while in hospital or within 30 days of discharge. 

The findings were supposed to have been published last month, but officials had to push the date back. The reason behind the delay is unclear.

In the NHS report, 103 trusts reported no excess deaths and 18 even had a lower number of fatalities than expected.

The data showed slightly less than a tenth, or 9.7 per cent, of NHS trusts reported higher than expected deaths.

WHAT WAS THE MID STAFFS SCANDAL? 

A disputed estimate suggested that hundreds of people may have needlessly died at Stafford Hospital, ran by Mid-Staffordshire NHS Trust, due to poor care between 2005 and 2009.

In what is one of the worst care scandals in living memory, anecdotes provided by Julie Bailey, who was responsible for exposing neglect at the hospital, suggested patients were left lying in their own excrement and had been so thirsty that they were reduced to drinking water from vases.

The Francis report, the inquiry into the hospital’s workings in 2013, found that box ticking bureaucrats prioritised targets over basic levels of care.

But not a single individual will be prosecuted in connection with the scandal, police admitted last year – despite a three-year investigation.

Stafford Hospital has been renamed County Hospital, and is now run by a different trust.

They included Blackpool Teaching Hospitals NHS FT, South Tyneside NHS FT and Wye Valley NHS Trust, which have all had excess deaths since 2013.

Chiefs warn the data is only a ‘smoke alarm’ and only warrants the need for further investigations to examine the cause of the excess deaths.

But Professor Jarman’s recalculation of the data shows more than a fifth of NHS trusts, or 21.6 per cent, have deaths higher than expected.

He used the internationally recognised system, recommended by the Association of Public Health Observatories, called Byar’s confidence intervals.

A similar process helped uncover poor care at the Mid Staffordshire trust, which was at the centre of one of the biggest scandals to ever hit the NHS.

However, the NHS uses another method, called overdispersion, which gives trusts slightly more leeway in terms of recording deaths.

Under that system, a trust is regarded as having a higher than expected number of deaths only if its SHMI is about 12 per cent or more above the national average.

In contrast, the Byar’s method is used internationally and classifies a much higher proportion of trusts as being significantly above the national average. 

Professor Jarman told MailOnline: ‘I don’t consider it is appropriate to give some additional “leeway” to hospitals, if it leads to the Care Quality Commission considering the 16 trusts I have listed as having “no problem with mortality”.

Professor Jarman said the NHS had used the internationally recognised Byar’s confidence intervals in the past.

Until January 2012 it was used in tandem with overdispersion. But the Byar’s method was then dropped, with bosses at NHS Digital, saying it was confusing to have two systems running at once.

Chris Roebuck, director of publications and head of profession for statistics for NHS Digital, said: ‘The SHMI is designed to act as a high level measure and is a helpful indicator that may flag potential problems that require further investigation. 

‘It needs to be used with care and should always be used in conjunction with other information. The UK Statistics Authority has endorsed its use in this way.

‘It was commissioned by the Department of Health following a review of the design and use of similar mortality indicators. 

‘That review benefitted from input from specialists from NHS organisations, regulators, universities, royal colleges and field experts including Professor Jarman.’

He added: ‘All the experts we worked with brought different perspectives on how to construct the indicator, and we took all of their advice into account.

‘The expertise of this group was invaluable to the development of SHMI methodology to best serve what is a complex area. 

‘It has been continually reviewed and developed drawing on expert opinion and we will continue to do this. 

‘NHS Digital in association with other relevant organisations have recently been reviewing the use and existence of a range of mortality indicators including SHMI.’

South Tyneside NHS Foundation Trust said: ‘These figures include patients from Sunderland who die in St Benedict’s Hospice, which we run, but the patients have not otherwise been under our care during their treatment. 

‘Removing deaths in St Benedict’s results in our mortality figures returning to within the expected range. This has also been confirmed by an independent review conducted by the North East Quality Observatory.’

HOW DID PROFESSOR SIR BRIAN JARMAN MAKE THE CALCULATION? 

NHS Digital releases its Summary Hospital-level Mortality Indicator (SHMI) data every summer for the previous year. Last week the body flagged 13 trusts as having more deaths than expected.

It uses a method called overdispersion to sift through the data and highlight trusts with excess deaths, which gives trusts slightly more leeway in terms of recording deaths.  

Under that system, a trust is regarded as having a higher than expected number of deaths only if its SHMI is about 12 per cent or more above the national average.

Professor Sir Brian Jarman used an internationally recognised system, recommended by the Association of Public Health Observatories, called Byar’s confidence intervals, to sift through NHS Digital data. 

In contrast to overdispersion, the Byar’s method is much stricter, classing anything with a SHMI of more than six or seven per cent above the national average as significantly high.

A similar process helped uncover poor care at the Mid Staffordshire trust, which was at the centre of one of the biggest scandals to ever hit the NHS.

HOW MANY EXTRA PATIENTS DIED AT YOUR HOSPITAL THAN EXPECTED? 
NHS HOSPITAL TRUST ACTUAL DEATHS EXPECTED DEATHS THE DIFFERENCE
AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 2,082 2107 -25
AIREDALE NHS FOUNDATION TRUST 1,053 1068 -15
ASHFORD AND ST PETER’S HOSPITALS NHS FOUNDATION TRUST 1,757 1854 -97
BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST 3,294 3219 75
BARNSLEY HOSPITAL NHS FOUNDATION TRUST 1,505 1483 22
BARTS HEALTH NHS TRUST 3,777 4148 -371
BASILDON AND THURROCK UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 2,269 2096 173
BEDFORD HOSPITAL NHS TRUST 1,194 1164 30
BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST 2,445 2135 310
BOLTON NHS FOUNDATION TRUST 1,726 1640 86
BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST 1,846 1984 -138
BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST 2,430 2436 -6
BUCKINGHAMSHIRE HEALTHCARE NHS TRUST 1,658 1650 8
BURTON HOSPITALS NHS FOUNDATION TRUST 1,326 1350 -24
CALDERDALE AND HUDDERSFIELD NHS FOUNDATION TRUST 2,507 2491 16
CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 2,338 2703 -365
CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST 1,621 1989 -368
CHESTERFIELD ROYAL HOSPITAL NHS FOUNDATION TRUST 1,946 1910 36
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 1,976 2051 -75
COLCHESTER HOSPITAL UNIVERSITY NHS FOUNDATION TRUST 2,473 2164 309
COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST 1,462 1370 92
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 3,005 2876 129
CROYDON HEALTH SERVICES NHS TRUST 1,261 1427 -166
DARTFORD AND GRAVESHAM NHS TRUST 1,570 1453 117
DERBY TEACHING HOSPITALS NHS FOUNDATION TRUST 3,162 3366 -204
DONCASTER AND BASSETLAW TEACHING HOSPITALS NHS FOUNDATION TRUST 2,831 2706 125
DORSET COUNTY HOSPITAL NHS FOUNDATION TRUST 1,132 995 137
EAST AND NORTH HERTFORDSHIRE NHS TRUST 2,510 2338 172
EAST CHESHIRE NHS TRUST 926 865 61
EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST 4,164 4100 64
EAST LANCASHIRE HOSPITALS NHS TRUST 2,711 2540 171
EAST SUSSEX HEALTHCARE NHS TRUST 2,633 2520 113
EPSOM AND ST HELIER UNIVERSITY HOSPITALS NHS TRUST 1,944 2041 -97
FRIMLEY HEALTH NHS FOUNDATION TRUST 3,525 3840 -315
GATESHEAD HEALTH NHS FOUNDATION TRUST 1,516 1491 25
GEORGE ELIOT HOSPITAL NHS TRUST 1,004 924 80
GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST 3,019 2823 196
GREAT WESTERN HOSPITALS NHS FOUNDATION TRUST 1,818 1910 -92
GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST 1,459 2025 -566
HAMPSHIRE HOSPITALS NHS FOUNDATION TRUST 2,116 2057 59
HARROGATE AND DISTRICT NHS FOUNDATION TRUST 905 1001 -96
HEART OF ENGLAND NHS FOUNDATION TRUST 4,624 4804 -180
HOMERTON UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 569 698 -129
HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST 3,509 3180 329
IMPERIAL COLLEGE HEALTHCARE NHS TRUST 2,237 2978 -741
IPSWICH HOSPITAL NHS TRUST 2,037 1940 97
ISLE OF WIGHT NHS TRUST 971 864 107
JAMES PAGET UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 1,636 1390 246
KETTERING GENERAL HOSPITAL NHS FOUNDATION TRUST 1,738 1570 168
KING’S COLLEGE HOSPITAL NHS FOUNDATION TRUST 3,199 3445 -246
KINGSTON HOSPITAL NHS FOUNDATION TRUST 1,267 1478 -211
LANCASHIRE TEACHING HOSPITALS NHS FOUNDATION TRUST 2,350 2251 99
LEEDS TEACHING HOSPITALS NHS TRUST 4,116 4055 61
LEWISHAM AND GREENWICH NHS TRUST 2,424 2500 -76
LONDON NORTH WEST UNIVERSITY HEALTHCARE NHS TRUST 2,550 3086 -536
LUTON AND DUNSTABLE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 1,845 1724 121
MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST 2,400 2349 51
MANCHESTER UNIVERSITY NHS FOUNDATION TRUST 3,526 3627 -101
MEDWAY NHS FOUNDATION TRUST 1,897 1847 50
MID CHESHIRE HOSPITALS NHS FOUNDATION TRUST 1,561 1499 62
MID ESSEX HOSPITAL SERVICES NHS TRUST 2,013 1847 166
MID YORKSHIRE HOSPITALS NHS TRUST 3,048 3091 -43
MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 1,254 1340 -86
NORFOLK AND NORWICH UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 3,520 3306 214
NORTH BRISTOL NHS TRUST 2,302 2410 -108
NORTH CUMBRIA UNIVERSITY HOSPITALS NHS TRUST 1,903 1936 -33
NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST 1,271 1485 -214
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 2,068 1970 98
NORTH WEST ANGLIA NHS FOUNDATION TRUST 2,806 2602 204
NORTHAMPTON GENERAL HOSPITAL NHS TRUST 1,950 1992 -42
NORTHERN DEVON HEALTHCARE NHS TRUST 1,110 1031 79
NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST 2,549 2140 409
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 3,199 3154 45
NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST 4,358 4279 79
OXFORD UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 3,180 3416 -236
PENNINE ACUTE HOSPITALS NHS TRUST 3,836 3807 29
POOLE HOSPITAL NHS FOUNDATION TRUST 1,633 1890 -257
PORTSMOUTH HOSPITALS NHS TRUST 3,081 2915 166
ROYAL BERKSHIRE NHS FOUNDATION TRUST 2,108 1998 110
ROYAL CORNWALL HOSPITALS NHS TRUST 2,452 2529 -77
ROYAL DEVON AND EXETER NHS FOUNDATION TRUST 2,293 2060 233
ROYAL FREE LONDON NHS FOUNDATION TRUST 2,743 3173 -430
ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS NHS TRUST 2,093 1991 102
ROYAL SURREY COUNTY HOSPITAL NHS FOUNDATION TRUST 1,170 1444 -274
ROYAL UNITED HOSPITALS BATH NHS FOUNDATION TRUST 2,027 2050 -23
SALFORD ROYAL NHS FOUNDATION TRUST 1,851 2079 -228
SALISBURY NHS FOUNDATION TRUST 1,121 1038 83
SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 2,137 1898 239
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST 3,610 3785 -175
SHERWOOD FOREST HOSPITALS NHS FOUNDATION TRUST 2,026 1986 40
SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 2,800 2722 78
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 2,919 2640 279
SOUTH TYNESIDE NHS FOUNDATION TRUST 1,124 936 188
SOUTH WARWICKSHIRE NHS FOUNDATION TRUST 1,238 1225 13
SOUTHEND UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 2,382 2136 246
SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST 1,291 1131 160
ST GEORGE’S UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 2,019 2470 -451
ST HELENS AND KNOWSLEY HOSPITAL SERVICES NHS TRUST 2,312 2274 38
STOCKPORT NHS FOUNDATION TRUST 1,850 1925 -75
SURREY AND SUSSEX HEALTHCARE NHS TRUST 1,947 2051 -104
TAMESIDE AND GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST 1,433 1328 105
TAUNTON AND SOMERSET NHS FOUNDATION TRUST 1,738 1951 -213
THE DUDLEY GROUP NHS FOUNDATION TRUST 2,433 2332 101
THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST 1,049 1110 -61
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 2,579 2778 -199
THE PRINCESS ALEXANDRA HOSPITAL NHS TRUST 1,600 1427 173
THE QUEEN ELIZABETH HOSPITAL, KING’S LYNN, NHS FOUNDATION TRUST 1,769 1801 -32
THE ROTHERHAM NHS FOUNDATION TRUST 1,467 1345 122
THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS NHS FOUNDATION TRUST 2,132 2193 -61
THE ROYAL WOLVERHAMPTON NHS TRUST 2,654 2179 475
TORBAY AND SOUTH DEVON NHS FOUNDATION TRUST 1,820 1987 -167
UNITED LINCOLNSHIRE HOSPITALS NHS TRUST 3,704 3225 479
UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST 1,165 1550 -385
UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST 3,046 3223 -177
UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 2,692 2615 77
UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST 1,712 1684 28
UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 2,979 2660 319
UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST 4,419 4573 -154
UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST 1,781 1774 7
UNIVERSITY HOSPITALS OF NORTH MIDLANDS NHS TRUST 4,313 4123 190
UNIVERSITY HOSPITALS PLYMOUTH NHS TRUST 2,520 2438 82
WALSALL HEALTHCARE NHS TRUST 1,668 1521 147
WARRINGTON AND HALTON HOSPITALS NHS FOUNDATION TRUST 1,422 1332 90
WEST HERTFORDSHIRE HOSPITALS NHS TRUST 2,144 2188 -44
WEST SUFFOLK NHS FOUNDATION TRUST 1,476 1667 -191
WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST 3,137 3271 -134
WESTON AREA HEALTH NHS TRUST 931 911 20
WHITTINGTON HEALTH NHS TRUST 597 803 -206
WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST 2,206 2308 -102
WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 2,903 2771 132
WRIGHTINGTON, WIGAN AND LEIGH NHS FOUNDATION TRUST 1,905 1624 281
WYE VALLEY NHS TRUST 1,259 1079 180
YEOVIL DISTRICT HOSPITAL NHS FOUNDATION TRUST 1,047 1096 -49
YORK TEACHING HOSPITAL NHS FOUNDATION TRUST 3,124 3159 -35





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