Date lodged: 25 May 2017
To ask the Scottish Government what action it is taking in response to reports that the Royal Alexandria and Vale of Leven hospitals have recorded higher than average mortality statistics over the last four years.
Answered by: Shona Robison 12 June 2017
Shona Robison: Across Scotland, HSMR have dropped by 8.4% over a 32 month period. The Scottish Patient Safety Programme is helping us significantly reduce hospital mortality and reduce avoidable harm at every stage of care.
Hospital Standardised Mortality Ratios (HSMR) data is closely monitored by the Scottish Government and Healthcare Improvement Scotland (HIS) to see whether any NHS Board is giving particular cause for concern.
HIS initiates a dialogue with an NHS board if one of its hospitals is identified as having a significantly high HSMR i.e. it being more than three standard deviations above the Scottish average or significantly increasing (calculated using run chart rules). These engagements are designed to ensure that the HSMR data can be interpreted meaningfully, drawing on local knowledge – while also ensuring that the data is taken seriously and acted upon as appropriate, with support and advice being provided for the NHS board.
HIS has opened such a dialogue with NHS Greater Glasgow & Clyde (NHS GGC), about a high HSMR for the Royal Alexandria Hospital/Vale of Leven Hospital (combined), on three occasions (November 2010, October 2014, and July 2016). As part of these interactions, NHS GGC has reported on the actions it has carried out to understand and respond to this HSMR data, including how this has helped inform on-going work designed to improve the quality of clinical care. HIS reviewed these actions plans and, following further engagement with NHS GGC, concluded that NHS GGC has taken a positive and appropriate approach.
HSMR monitors expected mortality over time and does not work comparing one quarter with another. The latest published data for Vale of Leven/RAH Hospitals indicated that there has been a rise in the hospital HSMR from the previous quarter only and does not represent a 9% increase in mortality, this is a misunderstanding of HSMR statistics. The trends for these two hospital is a 4.5% reduction since January 2014.
HIS will continue to monitor the HSMR data for the Royal Alexandria Hospital/Vale of Leven Hospital, and consider this with national partner organisations alongside other sources of data/intelligence. In the event that this combined intelligence raises significant concerns about the quality of care, then HIS will follow up.