Agenda item

[To  receive an update report on the Mortality Agenda from The Royal Wolverhampton NHS Trust]. 

The Medical Director introduced a report on Mortality rates at, The Royal Wolverhampton NHS Trust.  It was a positive picture.  Over the course of the last 18 months, through the programme of work, the mortality statistics had declined steadily and were now in expected limits with the latest SHMI (Summary Hospital Level Mortality Indicator).  Extensive reviews of case records had taken place, they hadn’t found any evidence of avoidable deaths. 

The Medical Director explained that there had been a decline in the observed death rate, which they thought was related to the work in the community with nursing homes.  This was identifying patients where their end of life care could be managed at home rather than being transferred to hospital.  The patients that died in hospital in Wolverhampton was significantly higher than the national average.  But there had been an improvement over the last three years of observed deaths in hospital, which suggested more people were receiving their end of life care at home or their preferred place of death.

The Medical Director commented that they had extended the number of the new Medical Examiners to allow them to work more comprehensively.  They were aiming to have 90% of the deaths in hospital reviewed by the Medical Examiner.  

The Medical Director stated that they had completed a review of the quality of coding.  There had been some significant improvement over the last two years, which partly accounted for the better expected death rate.  They had been working with Price Waterhouse Cooper over the last 18 months who had reviewed the data collection systems, identified areas for change and provided intelligence with their predictive models to identify potential data quality issues on a case by case basis.  The independent Consultant had now left the organisation. 

The Medical Director commented that a significant piece of work was taking place on how they engaged with families.  It had been supported by Healthwatch. 

There were some questions to the Medical Director about the Medical Examiner Role and standards of care.  

The Scrutiny Officer commented that the digital monitoring of sepsis was being trialled in some hospitals, he asked the Medical Director to comment.  He responded that his thoughts were positive.  They currently used the traditional early warning scoring system to identify patients at risk of sepsis.  At the front door they had very good data, capturing most patients and they were treated in line with guidance.  There was a little fluctuation, but even at the busiest times they did very well.   He believed there was a particular problem with data capture inaccuracies when looking at the inpatient population, so he couldn’t comment on the performance for inpatients.  They were looking at some of the new digital technologies, which looked at tissue to try and indicate if the patient had sepsis.  They were going to trial them out soon and they had been given some samples.  A meeting was setup in the coming weeks with one of the companies.  He thought digital monitoring probably was the future, but it was still early days.  The Chairman paid tribute to the excellent work that had been completed to date to improve the mortality statistics. 

Resolved: That the report on the Mortality Agenda be noted and tribute be paid to the excellent work that had taken place.