John Marwood
I ♥ cryptic crosswords
How is sitting on your arse and doing nothing when you know something is drastically wrong going to cure the NHS?
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STAFFORD HOSPITAL IN ADMINISTRATION
- Thread starter John Marwood
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How is sitting on your arse and doing nothing when you know something is drastically wrong going to cure the NHS?
Withnail
Well-Known Forumite
There is a League of Friends you could volunteer for - click the link below
http://www.staffordandcannocklof.org/
Abyss
Newbie
For once the local MPs have this right - there is simply no capacity in the local NHS to cope when much of the DGH closes.
North Staffs is a new PFI with high costs associated and too few beds with regular bed crises. Wolverhampton doesn't have much more capacity. Burton is having problems of its own.Community services and social services are desperately trying to stay within their own budgets and manage existing demand, at great cost to the welfare of staff who get the brickbats for what isn't available to provide. Our population is getting older and sicker and the so called problems of success (surviving your heart attack to later develop expensive dementia or cancers) are growing.
When are we going to move back to planning what facilities are needed and resourcing them appropriately? Never in my lifetime it seems. Just more magical thinking about fewer beds being required and community services taking over.
North Staffs is a new PFI with high costs associated and too few beds with regular bed crises. Wolverhampton doesn't have much more capacity. Burton is having problems of its own.Community services and social services are desperately trying to stay within their own budgets and manage existing demand, at great cost to the welfare of staff who get the brickbats for what isn't available to provide. Our population is getting older and sicker and the so called problems of success (surviving your heart attack to later develop expensive dementia or cancers) are growing.
When are we going to move back to planning what facilities are needed and resourcing them appropriately? Never in my lifetime it seems. Just more magical thinking about fewer beds being required and community services taking over.
John Marwood
I ♥ cryptic crosswords
Logan's Run Ltd - supplying health needs for all ages
( terms and conditions apply )
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monkey bidness
Well-Known Forumite
Interesting Article from Sunday Times 2/3/2013
It chimes with some of the observations about the Coding of deaths as mentioned in Skywalkers blog (yes, I did read it through to the end. It may not be impartial but it is thought provoking. Lots of references, citations and traceable 'facts'.)
I dont have the stamina or inclination to join in the armwrestling, but it does help to move at least a little distance from the emotive and anecdotal rhetoric. And before anybody starts putting the boot in, I am not taking sides and yes I do have very personal, direct, experience of Stafford Hospital during much of the so-called 'bad' years)
QUOTE:
NHS trusts have been accused of using taxpayers’ money to cover up high death rates by hiring a company to reclassify the data.
The company, CHKS, advertised to NHS trusts that it had reduced by a third the mortality rate at one hospital, which is now being investigated for its high death rates.
The reduction was achieved by categorising patients so that their deaths were seen as unavoidable and had less impact on mortality league tables.
Sir Brian Jarman, the expert who helped expose the Mid Staffordshire scandal, said the result would have been to cover up problems with standards of care at the hospital.
The disclosure will lead to concerns that practices exposed at Mid Staffordshire NHS Foundation Trust, where 1,200 people died unnecessarily, were more widespread than previously thought.
It comes only days after the chief executive of another NHS Trust, in Bolton, was forced to step aside over an alleged cover-up of high death rates. The Bolton trust also used CHKS.
An investigation by The Sunday Times has established that CHKS, which has an annual turnover of about £7m, has been hired by at least three NHS trusts which have been investigated for their patient death rates.
CHKS has also claimed that it works with more than 120 NHS Trusts, although it is unknown how many it has advised on mortality figures.
At Medway NHS Foundation Trust, which is on a list of hospitals being investigated by Sir Bruce Keogh, medical director of the NHS, for high patient death rates, CHKS boasted it had found a way to dramatically reduce the trust’s score.
It was achieved by re-categorising deaths as being related to a terminal illness, rather than a diagnosis more likely to have been caused by poor care.
In a press release the company said: “Adjusting the mortality index to exclude these deaths reduced the hospital’s score by just over a third — most hospitals would consider a reduction of 5% as a good achievement.”
Jarman, emeritus professor of medicine at Imperial College London, criticised the reclassification of deaths in this way. Asked whether the changes to the way deaths at Medway were classified would have covered up problems for a period, Jarman said: “It would have done. Correct, it would have had that effect.
“Maybe a better approach would have been to reduce the mortality as has been done in various other trusts rather than just changing the numbers.”
Putting patients in the “end of life” or “palliative care” category means that their deaths have less impact on the mortality rate because they are considered unavoidable. Jarman says trusts were making wide interpretations of these terms.
A spokeswoman for Medway said: “The trust understands that its adoption of CHKS advice was in line with national guidance on the use of palliative care codes at the time. Revised guidance was issued by the Department of Health in June 2010. The trust revised its approach in line with the new guidance at that point and is confident that its use of palliative care codes is appropriate.”
Julie Bailey, founder of Cure the NHS, which represents relatives of those who died at Mid Staffordshire, said: “It is obscene — we are talking about people’s lives here. What the NHS should be for is to care for patients not to try and manipulate [figures] after people have died to disguise it.”
CHKS also wrote to seven specific NHS trusts, offering to assist them with their death rate figures.
Mid Staffordshire NHS Foundation Trust said this weekend that it had commissioned CHKS to review its clinical coding department “which included a review of skills/ capacity, processes, procedures and controls”.
Bolton NHS Foundation Trust, which is being investigated over concerns that it has manipulated death rates by categorising an unusually high number of patients as suffering from septicaemia (severe blood poisoning), said that it used CHKS for “information analysis and benchmarking”. It is unclear whether it gave any advice on coding.
CHKS denied it advised trusts to recode deaths to improve death rates. Jason Harries, managing director, said: “CHKS auditors follow Connecting for Health [Department of Health] coding rules. If, for example, CHKS is recommending coding for palliative care it is because specialist or generalist palliative care is recorded in the clinical notes and coders have missed it, not because it improves mortality rates.”
It chimes with some of the observations about the Coding of deaths as mentioned in Skywalkers blog (yes, I did read it through to the end. It may not be impartial but it is thought provoking. Lots of references, citations and traceable 'facts'.)
I dont have the stamina or inclination to join in the armwrestling, but it does help to move at least a little distance from the emotive and anecdotal rhetoric. And before anybody starts putting the boot in, I am not taking sides and yes I do have very personal, direct, experience of Stafford Hospital during much of the so-called 'bad' years)
QUOTE:
NHS trusts have been accused of using taxpayers’ money to cover up high death rates by hiring a company to reclassify the data.
The company, CHKS, advertised to NHS trusts that it had reduced by a third the mortality rate at one hospital, which is now being investigated for its high death rates.
The reduction was achieved by categorising patients so that their deaths were seen as unavoidable and had less impact on mortality league tables.
Sir Brian Jarman, the expert who helped expose the Mid Staffordshire scandal, said the result would have been to cover up problems with standards of care at the hospital.
The disclosure will lead to concerns that practices exposed at Mid Staffordshire NHS Foundation Trust, where 1,200 people died unnecessarily, were more widespread than previously thought.
It comes only days after the chief executive of another NHS Trust, in Bolton, was forced to step aside over an alleged cover-up of high death rates. The Bolton trust also used CHKS.
An investigation by The Sunday Times has established that CHKS, which has an annual turnover of about £7m, has been hired by at least three NHS trusts which have been investigated for their patient death rates.
CHKS has also claimed that it works with more than 120 NHS Trusts, although it is unknown how many it has advised on mortality figures.
At Medway NHS Foundation Trust, which is on a list of hospitals being investigated by Sir Bruce Keogh, medical director of the NHS, for high patient death rates, CHKS boasted it had found a way to dramatically reduce the trust’s score.
It was achieved by re-categorising deaths as being related to a terminal illness, rather than a diagnosis more likely to have been caused by poor care.
In a press release the company said: “Adjusting the mortality index to exclude these deaths reduced the hospital’s score by just over a third — most hospitals would consider a reduction of 5% as a good achievement.”
Jarman, emeritus professor of medicine at Imperial College London, criticised the reclassification of deaths in this way. Asked whether the changes to the way deaths at Medway were classified would have covered up problems for a period, Jarman said: “It would have done. Correct, it would have had that effect.
“Maybe a better approach would have been to reduce the mortality as has been done in various other trusts rather than just changing the numbers.”
Putting patients in the “end of life” or “palliative care” category means that their deaths have less impact on the mortality rate because they are considered unavoidable. Jarman says trusts were making wide interpretations of these terms.
A spokeswoman for Medway said: “The trust understands that its adoption of CHKS advice was in line with national guidance on the use of palliative care codes at the time. Revised guidance was issued by the Department of Health in June 2010. The trust revised its approach in line with the new guidance at that point and is confident that its use of palliative care codes is appropriate.”
Julie Bailey, founder of Cure the NHS, which represents relatives of those who died at Mid Staffordshire, said: “It is obscene — we are talking about people’s lives here. What the NHS should be for is to care for patients not to try and manipulate [figures] after people have died to disguise it.”
CHKS also wrote to seven specific NHS trusts, offering to assist them with their death rate figures.
Mid Staffordshire NHS Foundation Trust said this weekend that it had commissioned CHKS to review its clinical coding department “which included a review of skills/ capacity, processes, procedures and controls”.
Bolton NHS Foundation Trust, which is being investigated over concerns that it has manipulated death rates by categorising an unusually high number of patients as suffering from septicaemia (severe blood poisoning), said that it used CHKS for “information analysis and benchmarking”. It is unclear whether it gave any advice on coding.
CHKS denied it advised trusts to recode deaths to improve death rates. Jason Harries, managing director, said: “CHKS auditors follow Connecting for Health [Department of Health] coding rules. If, for example, CHKS is recommending coding for palliative care it is because specialist or generalist palliative care is recorded in the clinical notes and coders have missed it, not because it improves mortality rates.”
tek-monkey
wanna see my snake?
Data is only meaningful when you interrogate it to get your desired response. I work with data every day, and can show you the same figure in a variety of ways depending on how you want to look at it. Or rather how you want it looked at.
monkey bidness
Well-Known Forumite
Any particular data in mind?
John Marwood
I ♥ cryptic crosswords
Three percent exceeds 2 percent by 50 percent, not by 1 percent.
tek-monkey
wanna see my snake?
Nothing serious, just different ways of looking at data. But it's not really relevant the figures I work with, just the fact that the way you ask for the same figures can have an effect on the results provided. Several sets of figures can all be right, depending on how you framed the question.
Example: For a meeting of 10 people:
4 turn up
2 have previously agreed with the organiser they do not need to go
2 phone in sick
2 Just don't turn up
What % was the attendance?
Example: For a meeting of 10 people:
4 turn up
2 have previously agreed with the organiser they do not need to go
2 phone in sick
2 Just don't turn up
What % was the attendance?
John Marwood
I ♥ cryptic crosswords
Cowdenbeath
John Marwood
I ♥ cryptic crosswords
Three statisticians went out hunting, and came across a large deer. The
first statistician fired, but missed, by a meter to the left. The second
statistician fired, but also missed, by a meter to the right. The third
statistician didn't fire, but shouted in triumph, "On the average we got it!"
first statistician fired, but missed, by a meter to the left. The second
statistician fired, but also missed, by a meter to the right. The third
statistician didn't fire, but shouted in triumph, "On the average we got it!"
monkey bidness
Well-Known Forumite
This is the first foundation trust to go into administration, these are the whole cause of problems in the NHS.
To demonstrate good financial management so they get freedom from local authority control they sacked lots of staff, their financial accounts then showed a surplus (or profit, but they're not allowed to call it that), meanwhile patient care went downhill.
You can go looking for lots of reasons as to why, but ultimately the above is the root cause. Trusts wanting to look good on paper (financially) and the patient's needs are secondary.
Many procedures in the NHS have a tariff (how much the provider of the operation gets paid) and often the cost of carrying out a procedure for a hospital can be more than the tariff, so they make a loss on these. Other things make a profit, so it's often down to the local balance. If there are lots of people having cancer treatment then they can be making lots of money.
To demonstrate good financial management so they get freedom from local authority control they sacked lots of staff, their financial accounts then showed a surplus (or profit, but they're not allowed to call it that), meanwhile patient care went downhill.
You can go looking for lots of reasons as to why, but ultimately the above is the root cause. Trusts wanting to look good on paper (financially) and the patient's needs are secondary.
Many procedures in the NHS have a tariff (how much the provider of the operation gets paid) and often the cost of carrying out a procedure for a hospital can be more than the tariff, so they make a loss on these. Other things make a profit, so it's often down to the local balance. If there are lots of people having cancer treatment then they can be making lots of money.
This is a common trick, often done to maximise income. One hospital was coding lots of things as "General" to maximise income, but this also had the side-effect of making their data really hard to analyse.
skwalker1964
Active Member
She apparently called for it during a public meeting of the campaign group:
Admittedly, this appears to have been a 'rush of blood to the head' moment and she has since said that closure would be a bad thing - however, the thrust of her groups campaign might suggest that the former rather than the latter is nearer to her real opinion.
skwalker1964
Active Member
The name here is the key - Prof Jarman is the creator of the HSMR system, of which CHKS' method is a rival. For CHKS to be correcting errors arrived at via the HSMR method is unpalatable for Prof Jarman, especially when the Francis inquiry already exposed the serious flaws in his system. Perhaps understandably, he's extremely wedded to his system and wants it to be vindicated - but in responses to me on Twitter he has resorted to some very obvious statistical misdirections to support his point, so the credibility of his criticism of CHKS has to be considered suspect.
Withnail
Well-Known Forumite
M.D. said:
There is a most unflattering report on Sandra Haynes Kirkbright's role in this elsewhere.
Edit: emphasis mine
