Hospital deaths data is inaccurate and needs to be investigated, says expert

Twenty-five trusts across the country had higher mortality rates than would normally be expected, warns expert

Death rates at 25 hospital trusts in England are higher than they should be, according to one of the country\'s leading experts who is calling for the government to investigate.

Professor Brian Jarman of Imperial College London says that across the 25 trusts, there were 4,600 unexpected deaths in the year 2007-08. He claims the current system of hospital inspections and regulation is "fundamentally flawed".

Hospitals do not report accurate data to the regulator, the Care Quality Commission (CQC), he says, and onsite inspections focus on only a selection of cases at a selection of hospitals every year.

Jarman, who became an adviser to the inquiry into the excess numbers of deaths of babies at the Bristol Royal Infirmary over a decade ago because of his expertise in hospital mortality rates, said that after 10 years of "no action, I needed to say something".

He said the high death rates - more than 150 more than would be expected at each of the trusts - did not prove malpractice or inadequacy, but that they needed to be investigated.

"My main concern is that the government only focuses on self-inspection rather than launching wider inquiries. That is why I have decided to take action," he will say on a BBC Radio 4 programme tonight.

"An investigation may not prove anything is being done wrong but it could still boost our ability to reduce death rates."

The CQC, said death rates were only one of the factors it took into account when assessing the safety and competence of a trust.

"These figures need to be considered as part of a wider picture," said Richard Hamblin, CQC\'s director of intelligence. "It is over-simplistic to say that a mortality rate across an entire trust is a direct indicator of quality of care. We have found reasons for concern at trusts with both high and low mortality rates.

"CQC looks closely at the mortality rates of every trust in England alongside a range of other data, such as readmission rates, infection rates and reported incidents, as well as information from our inspections, the public and other organisations. It is all of this together that gives a picture of performance. We do not rely on trusts\' self-assessment."

A Department of Health spokesman said it was confident the CQC would investigate any underperforming hospitals. "We have armed them with powers to take tough enforcement action to make sure all hospitals give patients high quality care," he said.

He added that the CQC had investigated all hospitals with a higher than average standardised mortality rate and found no cause for concern.

Some of the trusts said their mortality rates had dropped since 2007-08. Southampton said its death rates were now within the normal range. "The improvement we have shown has been a result of more accurate recording of deaths at the trust," said Dr Michael Marsh, medical director at the trust.

Tameside also said its death rate had fallen and was now closer to the average. "We know some people have genuine concerns about services here at Tameside hospital and we want to reassure them that this hospital continues to provide safe and effective patient care," said a spokeswoman.