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Lanarkshire hospitals told to improve care after mortality rate review Lanarkshire hospitals told to improve care after mortality rate review
(about 1 hour later)
A Scottish health board has been told to improve the quality of care at three of its hospitals after a review into above-average mortality rates.A Scottish health board has been told to improve the quality of care at three of its hospitals after a review into above-average mortality rates.
Healthcare Improvement Scotland (HIS) has made 21 recommendations to NHS Lanarkshire over concerns about Wishaw, Monklands and Hairmyers Hospitals.Healthcare Improvement Scotland (HIS) has made 21 recommendations to NHS Lanarkshire over concerns about Wishaw, Monklands and Hairmyers Hospitals.
Inspectors said they could find no "definitive reasons" for the above-average mortality rates.Inspectors said they could find no "definitive reasons" for the above-average mortality rates.
But they said it may be down to poor quality of care and record-keeping.But they said it may be down to poor quality of care and record-keeping.
The review was commissioned by the Health Secretary Alex Neil in August following the publication of mortality data which showed that Monklands and Wishaw Hospitals had high ratios for the previous quarter. Health Secretary Alex Neil said he expected "urgent" improvements to be made at NHS Lanarkshire.
He had commissioned the review in August following the publication of mortality data which showed that Monklands and Wishaw Hospitals had high ratios for the previous quarter.
Records reviewedRecords reviewed
It was subsequently clarified that the higher ratio only applied to Monklands Hospital.
The review team, chaired by Robbie Pearson from HIS, listened to the experiences of more than 300 patients and carers, more than 200 health board staff and reviewed 152 patient records.The review team, chaired by Robbie Pearson from HIS, listened to the experiences of more than 300 patients and carers, more than 200 health board staff and reviewed 152 patient records.
Mr Pearson said: "Although the review team found a service where clinicians and managers are working hard to do the right thing, sometimes in a difficult environment, the team concluded that a broad range of improvements are necessary for NHS Lanarkshire to continue its commitment to delivering safe and effective patient care.Mr Pearson said: "Although the review team found a service where clinicians and managers are working hard to do the right thing, sometimes in a difficult environment, the team concluded that a broad range of improvements are necessary for NHS Lanarkshire to continue its commitment to delivering safe and effective patient care.
"This includes the need for stronger focus and leadership in implementing robust patient safety interventions and in the redesign of services."This includes the need for stronger focus and leadership in implementing robust patient safety interventions and in the redesign of services.
"The review team expects that the recommendations made in this report are to be used to provide guidance and support for those working in NHS Lanarkshire to help them to deliver the necessary improvements.""The review team expects that the recommendations made in this report are to be used to provide guidance and support for those working in NHS Lanarkshire to help them to deliver the necessary improvements."
The HIS inspectors report said it was "not possible to draw definitive reasons for the higher than average hospital standardised mortality ratio (HSMR)".The HIS inspectors report said it was "not possible to draw definitive reasons for the higher than average hospital standardised mortality ratio (HSMR)".
However, it said the review team had concluded that it may be contributed to by one, or a combination, of factors:However, it said the review team had concluded that it may be contributed to by one, or a combination, of factors:
Dr Simon Mackenzie, medical director for Quality Improvement, NHS Lothian, and clinical lead for the review team, said: "Although the review was triggered by concerns about mortality rates, it has entailed a detailed and broader assessment of the key factors relating to the quality and safety of care in the three acute hospitals. The report makes 21 recommendations for improvements at the three hospitals.
"The findings and recommendations offer NHS Lanarkshire guidance on a way forward having used the expertise and knowledge of senior clinicians from across Scotland, experts in healthcare, NHS leaders, junior staff and, importantly, the patients and staff, including the leadership team, in NHS Lanarkshire." These include NHS Lanarkshire strengthening its leadership and focus to improve the quality and safety of care; ensuring that nurse staffing levels are safe and adequate; ensuring medical staffing is more sustainable; and improving support for patients whose condition is deteriorating.
Dr Iain Wallace, NHS Lanarkshire's medical director said: "We regret any occasion where patient care has fallen short of the high standards we strive for.
"We accept the recommendations and recognise many of them as areas where we are already making improvements."
Dr Wallace said the report "identifies some challenges within emergency care services that we are already taking action to address".
"We have already changed the pattern of medical cover in late evenings and weekends," he said.
'Rapid improvements'
"With our clinical leaders we will develop a priority action plan to drive forward the changes necessary in line with the report findings which identify that models of care need to be built around patients, taking account of the workforce that is available."
Dr Wallace added: "No one is underestimating the need for rapid improvements to ensure local people have a high degree of confidence in their local health service and I am confident that we have the right people in place to deliver the changes required."
NHS Lanarkshire has set up an inquiry line - 0800 849 4129 - for anyone who wishes to discuss the standard of care they or a relative received.
Health Secretary Alex Neil said NHS Lanarkshire was "already making progress in a number of key areas".
He said: "Today I am announcing that we are providing a Governance and Improvement Support Team to work with NHS Lanarkshire to help them deliver the rapid and sustained improvements which are needed.
"I expect those improvements to be made urgently, and I have asked to be updated regularly.
"I have also asked for a formal review of progress against the recommendations by the end of March."
NHS Scotland clinical director Prof Jason Leitch said: "Although a high hospital standardised mortality ratio is not by itself a definitive measure of the quality and safety of care, it serves as an important prompt for further investigation.
"We should be clear that while the reduction in HSMR in Lanarkshire is to be welcomed and the safety programme is having a positive effect, we now need to see faster progress in line with the improvements made across the rest of Scotland.
"NHS Lanarkshire, working with this expert team, are now urgently working on an action plan to address the issues highlighted in the rapid review."