Apologies for absence were received from Cllr Milkinderpal Jaspal and Cllr Phil Page. 

There were no declarations of interest. 

Dr. Ankush Mittal

Consultant in Public Health, City of Wolverhampton Council

Dr. Jonathan Odum

Medical Director, The Royal Wolverhampton Trust

[Report is marked to follow]

The Chair welcomed members of the Staffordshire County Council, Healthy Staffordshire Scrutiny Committee to the meeting.  She stated that she understood there had been a Summit held in Wolverhampton recently with the various health agencies on the 10 October 2018 concerning the subject of Mortality statistics. 

The Consultant in Public Health presented a report titled, “Learning from Deaths in Wolverhampton and Steps Forward.”  He stated that there had been some constructive discussion on the subject of mortality with health partners.  The Council had recently hosted a summit, led by Public Health, to discuss the subject of Hospital and City wide mortality data with representation from the Clinical Commissioning Group and the Royal Wolverhampton Health Trust.  The purpose of the report was to provide a summary of the data relating to deaths in Wolverhampton at both a City wide level and Hospital level.  The report also assessed the implications of the data and made recommendations on the best approach moving forward.   

The Consultant in Public Health stated that hospital mortality statistics worked on a ratio.  The ratio was, observed deaths divided by expected deaths.  The most difficult part of the equation was the calculation of expected deaths.   There were a few different statistics used to measure expected deaths to create the ratio, which all relied on some logical processes.  They looked at what proportion of people admitted nationally die and then applied that proportion to the local numbers of people admitted in any given hospital, to predict the expected mortality rate in the hospital.  If the ratio figure was close to one, it showed that the hospital was on the same level as the national average mortality rate.  If the ratio figure was above or below one, then the hospital was having higher or lower deaths than the national hospital average.  He added that there were a variety of different adjustments made, depending on the measure, used on various elements of the admitted population.  As examples, he cited the age mix of the patients admitted to the hospital, their associated medical conditions and their mode of admission.   

The Consultant in Public Health stated that the national average was for men to die around four years earlier than women.  There were a variety of reasons for the difference with one of the main reasons being that men were at a higher risk of suffering from a cardiovascular disease. 

The Consultant in Public Health commented that when reviewing hospital mortality data it was important to understand that some hospitals coded conditions differently.  He cited the example of a cough being classed as a chest infection or pneumonia.  The expected number of deaths could be significantly different depending on how the condition had been coded, with pneumonia carrying a higher risk of death than a standard chest infection.  Due to the differences in coding practices, the process of evaluating the data

The Consultant in Public Health stated that local care pathways could have an impact on hospital mortality data.  There were therefore many factors  ...  view the full minutes text for item 3.