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Death rates at Medway Maritime Hospital fall to expected HSMR ratio as Medway NHS Foundation Trust tries to leave special measures

00:01, 18 November 2016

Death rates at Medway Maritime Hospital have fallen to normal levels as the trust in charge battles to be taken out of special measures.

Medway NHS Foundation Trust has been in that category since July 2013, after a review into the number of deaths at hospitals across the country.

The report by Sir Bruce Keogh, NHS Medical Director for England, revealed more than 200 patients died unnecessarily in 2012 at the hospital.

Cliff Evans has helped transform the A&E department at Medway Maritime Hospital
Cliff Evans has helped transform the A&E department at Medway Maritime Hospital

Medway was one of 11 trusts placed under the emergency measures but 18 months later the situation had still not improved.

A report published by healthcare analysts Dr Foster found that between April 2013 and March 2014, there were 185 more deaths than expected.

The trust’s own hospital standardised mortality ratio (HSMR), which compares the expected rate of death with the actual rate of death, was 120 in 2013 and 119.66 in 2014. But now, this stands at 100.19, almost in line with the national average of 100.

Over the last two years, the trust has been following an improvement plan to cut the death rate.

"Those results are down to all staff at the hospital working their socks off and doing a brilliant job" Rehman Chishti, MP

It was given £13.4m by the Department of Health to improve A&E, a project which has seen the creation of a children’s emergency department, a minor injuries area, and work on a new building for people with serious injuries or conditions.

Vacancies have been filled with permanent staff, reducing the reliance on agency staff, and a new board of directors is in place.

Rehman Chishti, MP for Gillingham and Rainham, said: “I’m delighted with the results and I can see that all the hard work is really paying dividends in improving and delivering good quality care at the hospital.

“They’ve got stability and excellent leadership and those results are down to all staff at the hospital working their socks off and doing a brilliant job. We’ve still got a long way to go but this is really good news.”

Kelly Tolhurst, MP for Rochester and Strood, said: “I am delighted to see the huge improvements made at Medway Maritime Hospital on the reduction of deaths – yet another good news story at our local hospital.

“Given that a high mortality rate was one of the reasons we found ourselves in special measures, this latest improvement will hopefully go some way towards changing this status for the better. That more patients are now leaving hospital care with a healthier future is great news for our community who rely on this vital local service.

Work begins on the new major injuries emergency department at Medway Hospital
Work begins on the new major injuries emergency department at Medway Hospital

“I regularly visit Medway Maritime Hospital and each time I am heartened by the hard work and dedication of clinicians and the new management to turn our fortunes around and once again make our hospital home to the highest standards of care.”

Tracey Crouch, MP for Chatham, said: “The reduction in mortality rates to just above the expected number is welcome.

“It shows that the hospital is progressing towards coming out of special measures and I think the medical and non-medical staff ought to be congratulated for their continued commitment to improving services at Medway Maritime.”

At the time of the Keogh review, the trust said reducing mortality rates was a top priority. Since March 2015, Medway has been partnered with Guy’s and St Thomas’ NHS Foundation Trust, whose HSMR is one of the lowest in the NHS and stood at 74.9 in March this year.

Medical director Diana Hamilton-Fairley said: “We are extremely pleased to have achieved a significant and sustained reduction in our mortality rate, which is now nearly in line with the national average and comparable to NHS trusts similar to us. It’s no secret that our high mortality rate was one of the over-riding reasons we were placed into special measures back in 2013.

“Since then, we have put in place a wide range of changes to make sure our patients receive safe and compassionate treatment, with a better safety culture throughout the hospital, as well as a strong focus on recognising and responding quickly to patients whose conditions deteriorate.

Dr Diana Hamilton-Fairley, Medical Director
Dr Diana Hamilton-Fairley, Medical Director

“As part of this concerted effort, we’ve embarked on a major education programme with our staff in the use of the National Early Warning Score – a clinical set of criteria that plays a vital role in determining the severity of a patient’s illness.

“The trust has also introduced a number of new and innovative pathways for emergency admissions, frail elderly patients and those with chronic respiratory and cardiac conditions.

“Mortality is only one measure of our improvement, however. We have also seen other positive outcomes, with more patients recommending us to their friends and family.

“As a trust, we will all continue to work extremely hard to embed these improvements and many more are being developed. We’re very hopeful that all of these improvements will stand us in good stead for the forthcoming CQC inspection.”

The Care Quality Commission is due to visit Medway Maritime Hospital on November 28 and 29.

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