Preventable mortality

saving lives

Preventable mortality

Our Quality Strategy 2015-18 and 2015-16 Quality Report referenced this key quality goal as ‘Reducing mortality and improving outcomes’.

TARGET: To be in the 20% of NHS organisations with lowest risk adjusted mortality


Where are we now?

Over the last few years mortality rates at WSHFT have generally fallen year on year. The improvement in the Trust’s mortality rate can be seen in the position of its Hospital Standardised Mortality Ratio (HSMR) score in relation to other acute trusts.  The HSMR is produced by Dr Foster Intelligence and examines in-hospital deaths from 56 diagnosis groups (medical conditions) with the highest mortality.

In 2011/12 the Trust’s HSMR of 107.5 was ranked 112 of 141 acute trusts (the 79th centile), whereas for the latest data (12 months to September 2016) the Trust’s HSMR of 91.21 is now ranked 24th of 136 (the 18th centile).

Dr Foster 12 months to Sep 2016

Latest data available: 12 months to September 2016 (source: Dr Foster)


This year’s improvement stories


Draft priorities for 2017/18

 

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Sepsis recognition and treatment

Sepsis is a common problem that affects a wide range of patients in hospital and is a major influence on mortality rates – it is responsible for an estimated 37,000 deaths in the UK each year.  The trust has introduced a range of measures to improve identification of serious sepsis cases and the speed with which affected patients receive the antibiotics they need.

Target: 80% compliance with Sepsis 6 care bundle in 2017-18, 95% in 2018-19

Target (CQUIN): 90% of patients to receive antibiotic therapy within one hour in 2017-18, 95% in 2018-19

 

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Better births – encouraging natural childbirth

Maternity services at the Trust were rated Outstanding in our recent CQC inspection. Our successful ‘Better Births Programme’ focuses on the implementation of care bundles to reduce stillbirths and neonatal deaths, implementing recommendations of the national maternity review.

Target: We will continue to focus on normalising birth, reducing caesarean section rates (to below 26%) and development of an enhanced recovery programme for elective caesarean section.

 

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National Acute Frailty Network: Improve the identification of and care pathway for older people with frailty

There is currently no standardised, centrally recorded method of identifying all older people with frailty on presentation at the Trust. As a result, a proportion of attendees do not derive the benefit of a comprehensive geriatric assessment. We will standardise the identification of frailty and develop and implement a standard care pathway based on best practice.

Target: to reduce admissions of frail older patients by 10% over the next two years.

 

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Mortality Review and Learning

The Trust recognises the importance of monitoring mortality and acting on any trends identified. We will continue to develop and embed an ‘all mortality’ review process and organisation-wide sharing of lessons from reviews over the next 2 years.  We will be part of a pilot process co-ordinated by NHS England to test methodology for reviewing all deaths.  We will convene a ‘Community of Practice’ in collaboration with the Kent, Surrey, Sussex Academic Health Science Network and NHS Improvement to ensure process and learning from reviews is shared across the wider health community  

Target: 100% of deaths to be reviewed

 

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Seven Day Services Clinical Standards Programme

Patients should get the same high quality, safe care on a Saturday and Sunday as they do on a weekday. This means having enough consultants available to assess and review patients, providing access to important diagnostic tests and ensuring that consultants are there to make crucial clinical judgements.  We are committed to implementing a programme to deliver seven day services clinical standards, implementing the recommendations of the NHS England Seven Day Services Audit.

Target: Further progress against the implementation of NHS England’s seven day services clinical standards

 

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