Patient safety findings provoke fierce debate

Dr Foster's Hospital Guide for 2009 has revealed that death rates in English NHS hospitals have fallen by seven per cent on last year, but that quality of care remains a postcode lottery. The Hospital Guide gives NHS hospital trusts a score out of 100 based on analysis of a range of "safety indicators", which include surgical errors, deaths, infection rates and staffing levels.

Table 1: Top 5 hospital trusts for patient safety (12 months to 2009)

Trust name	Safety score out of 100
University College London Hospitals NHS Foundation Trust	100
Cambridge University Hospitals NHS Foundation Trust	99.3
Guy's & St Thomas' NHS Foundation Trust	98.6
St George's Healthcare NHS Trust	97.3
Chelsea & Westminster Hospital NHS Foundation Trust	97.3

Table 2: Bottom 5 Hospital Trusts for Safety (12 Months to 2009)

Trust name	Safety score out of 100
Weston Area Health NHS Trust	4.1
University Hospitals Coventry and Warwickshire NHS Trust	3.4
The Lewisham Hospital NHS Trust	3.4
Scarborough and North East Yorkshire Health Care NHS Trust	2.1
Basildon and Thurrock University Hospitals NHS Foundation Trust	0

Patient safety reporting must be more transparent

The Hospital Guide 2009 reveals more than 200 cases where foreign objects such as swabs had been left inside patients' bodies after surgery and more than 5,000 cases where people admitted with low-risk conditions died in hospital.

The Guide also revealed that 39 per cent of hospitals still do not investigate all unexpected deaths or cases of serious harm that occur on their wards.

Although 98 per cent of trusts now provide incident reports to the National Patient Safety Authority (NPSA) - an increase of three per cent on last year - some trusts are still not reporting consistently.

Dr Foster believes that a safe hospital is one that has high numbers of safety incident reports, because this shows willingness among staff to share their concerns and encourages a re-examination of established system protocols.

Dr Foster's co-founder, Roger Taylor, tells BBC News: "Make safety information public"

Roger Taylor, Director of Product Strategy and Design and co-founder of Dr Foster explained some of the findings behind the Hospital Guide 2009 during a BBC News interview.

Taylor said: "Perhaps counter-intuitively, high levels of reporting are widely considered a good thing as it suggests an open and honest culture [at a hospital]."

"No hospital in the world would claim to be free of these kinds of errors, but what has been learned over the years is that recording what is happening, and making that information generally public, is the best way to start tackling the issues," concluded Taylor.

Listen to Roger Taylor's interview (3mins 40secs)

Hospital Guide findings cause public and political debate

Since the news about the patient safety lapses and high mortality rates at Basildon & Thurrock University Hospitals NHS Foundation Trust broke last week, public and political debate surrounding standards of care across the NHS has been fierce.

The Conservative Party has highlighted the contrast between Dr Foster's findings and the Care Quality Commission's (CQC) own assessments, while the CQC countered that they had already performed a comprehensive programme of monitoring.

Last Thursday, the CQC sent a task force into the Basildon & Thurrock NHS Trust after it uncovered major lapses in hygiene and unusually high death rates.

The CQC added that it was monitoring a small number of hospitals, but had no evidence that there was another trust in England where the kind of action they had taken at the Basildon & Thurrock NHS Trust would be necessary.

Health Secretary Andy Burnham has ordered an urgent review by regulators to find out whether any other trusts require "immediate investigation".