Last night on BBC’s regional Look North programme, there was a segment on the visit of inspectors this week to North Cumbria University Hospitals NHS Trust. According to Look North, the inspection visit forms part of the government’s targeting of 14 hospitals for supposed issues with their mortality rates ‘in the wake of the Mid Staffs scandal’.
The Trust’s board issued a statement to the effect that it ‘welcomed’ the inspection as an opportunity to identify and address any issues – echoing its statement to the BBC last December when it was first targeted:
The process we are going through now is looking at where we can improve. We’ve identified specific areas which we are about to look at and embark on an action plan to implement changes.
I understand why the Trust feels it needs to respond in this way for PR purposes, but in my opinion it’s exactly the wrong approach.
The rapid switch into ‘apology/defence mode’ by the Mid Staffs board was a significant part of the way in which the now-discredited ‘excessive’ mortality statistics were allowed to be used uncontested by media and politicians to denigrate and demonise that Trust and its staff. One of the clear lessons that came out of Mid Staffs’ harrowing (and ongoing) experience was that if you think you’re innocent, it’s far better to come out fighting than to bend over and ‘welcome’ the attack on you.
Moreover, North Cumbria does not have a mortality rate issue. As I pointed out in March, the 14 hospitals are being targeted for supposed high mortality rates according to the deeply-flawed HSMR statistical method, but no less than 9 of these do not have high mortality rates according to the much stronger and more widely-accepted SHMI system.
North Cumbria is one of these 9 Trusts.
The Department of Health and its advisors are fully aware of this fact – it’s hardly a secret – but are choosing to proceed with these inspections anyway. The decision to target hospitals that have no cause to be targeted reveals other, darker motivations – motivations that have nothing to do with patient safety or quality of care.
Last December’s statement to the BBC by the Trust’s Mike Walker was along the right lines:
I don’t think it is correct to say that people are dying in the hospitals when they shouldn’t be. A review of all our deaths over the past year has shown that over 90% of the patients received completely appropriate care as described by our clinical team.
But now the Trust appears to have decided that its best approach is to act as if it’s delighted to go under the microscope in what is without question a politically-motivated and cynical series of inspections instigated by a government determined to misuse a completely false (and assiduously cultivated) public perception of what happened at Mid Staffs.
The government is targeting 14 hospitals in this wave of inspections, and 50 in the next. That’s 10% and 36% respectively of England’s hospitals. Most of these hospitals, as demonstrated by ‘the nine’, do not have mortality rate issues according to the more reliable statistical method.
Passivity and ‘grin and bear it’ is not the right response. Hospital Trusts and their local communities need to stand and fight – and being prepared to robustly challenge the government’s preference for a statistical method known to be less accurate is a good place to start.
And it’s time that any media who don’t have a hidden agenda of ending the NHS for their political and financial masters needs to step up, too, and start changing the narrative. Putting the story right on Mid Staffs would be a good place to start on that.