Hospital Dr News

Expert questions 13,000 needless deaths claim

Widespread reports of 13,000 preventable deaths at NHS trusts should be ignored, an expert argues.

Professor David Spiegelhalter challenged media reports that there had been 13,000 ‘avoidable’ deaths as 14 NHS hospital trusts suggesting they have been misconstrued.

The Keogh Report, published in July, investigated 14 trusts that had “higher than expected” mortality rates between 2005 and 2012. Before its release there were sensational headlines talking of the large numbers of “needless deaths”.

The Winton Professor for the Public Understanding of Risk at the University of Cambridge says there is a fragile basis for these statistics on bmj.com.

He points out that comparing mortality rates with an expected number of deaths based on a calculation of average national performance will inevitably lead to “around half of all trusts [having] ‘higher than expected’ mortality”.

“It would be absurd to label all these as outliers”, the professor argues. Yet the press widely chose to report the statistics by interpreting a higher than expected number of deaths as ‘needless’.

He explains that the ‘13,000’ is the difference between the total observed and expected number of deaths across all 14 trusts, over a seven year period, using a particular measure developed by the Dr Foster Unit.

However the Keogh report did not feature these statistics, and explicitly stated that it would be “clinically meaningless” and “academically reckless” to attempt to quantify avoidable deaths in this way.

Professor Spiegelhalter concludes by asking what can be done, and reveals that a new national indicator of avoidable hospital deaths is being commissioned by Keogh.

In the meantime, he recommends describing possible outliers as ‘above the expected range’, and avoiding talking about “numbers of deaths”.

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6 Responses to “Expert questions 13,000 needless deaths claim”

  1. @Flattliner says:

    Sadly, I suspect that the majority of people would be shocked to discover that half of doctors are below average…

  2. Bob Bury says:

    In the past, some very senior politicians have found it unacceptable that some surgeons have results which are below average. We have to cope with media, politicians and a public who are all innumerate. And in many cases, just a bit stupid.

  3. Malcolm Morrison says:

    Well, we did have one Secretary of State who promised that he would ensure that “all NHS hospitals woudl be aabove average”!!

    Can we not send ALL politicians and journalists on a short, sharp course on ‘statistics’?

  4. Joe says:

    Articles have to be accompanied by declaration of conflicting interests; I prefer declaration of relevant interests.
    Could claims based on statistics regarding NHS disasters be accompanied by the age old warning:
    Beware, lies damn lies and statistics
    Even if it is stating the obvious!

  5. Tom Goodfellow says:

    There is a very good radio4 programme called “More or Less” run in conjunction with the Open Uni. It seeks to question a whole range of official statistics, debunking many of the spurious claims.

    I wrote to them about these “preventable death” statistics based on Mid Staffs where, depending on which newspaper you read, the “aviolable” deaths ranges from several hundred to 1500 (Sunday Times).

    I don’t know if they have looked into this or not. Worth a listen if they have.

  6. tom goodfellow says:

    Yes they did today – a very balanced piece. Worth a listen

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