More patients are dying from sepsis than anticipated at 28 NHS trusts in England, MailOnline can reveal.
Deaths from the silent killer at Tameside and Glossop NHS Foundation Trust are 38 per cent higher than expected over the past six years.
In real terms, 517 patients died from sepsis – a violent immune response to an infection – at the trust in Ashton-under-Lyne, well above the 373 deaths expected.
The NHS denies excess deaths are necessarily avoidable, saying the rate given for each trust is based solely on a national average.
Officials argue data a higher than expected number of deaths at any trust is just a ‘smoke alarm’, and not proof of poor care.
The UK Sepsis Trust’s chief executive, Dr Ron Daniels, said: ‘It’s unacceptable for survival from sepsis to remain a postcode lottery.’
The data comes as the heartbroken family of an economics student have told how she died suddenly of suspected sepsis.
Millie Wyles died on August 21 at St Thomas’s Hospital after medics desperately battled to save her for four days.
Deaths from the silent killer at Tameside and Glossop NHS Foundation Trust are 38 per cent higher than expected. In real terms, 517 patients died from the violent immune response to an infection at the trust in Ashton-under-Lyne, well above the 373 deaths predicted
NHS Digital releases its Summary Hospital-level Mortality Indicator, or SHMI, data every month for the previous calendar year.
The report looks at ‘excess deaths’ – the number of fatalities observed, compared to what would be expected according to national averages.
It compares the overall number of deaths from an array of conditions, including sepsis.
Eminent hospital death rates professor, Sir Brian Jarman, crunched the statistics together for each NHS trust in England over the past six years.
Data showed there were 117,439 recorded deaths from sepsis in hospital or within 30 days of discharge between April 2013 and March 2019.
There were around 3,750 more of such deaths than expected across all 28 of the trusts that recorded an excessive number of fatalities.
Dr Daniels added: ‘The figures are a cause for potential concern at the 28 trusts who seem to have a higher than average recorded mortality rate.
‘It’s important to note that practices in coding vary between hospitals, so this doesn’t necessarily mean all the hospitals named are worse than others.
‘But those trusts need to urgently examine their practices, their coding and identify whether there is a real cause of concern.’
East Kent Hospitals University NHS FT recorded the most excess sepsis deaths (416), with rates being 18.2 per cent higher than expected.
In terms of total excess septicaemia deaths, it was followed by United Lincolnshire Hospitals NHS Trust (331) and East Lancashire Hospitals NHS Trust (291).
NHS England said official data shows there were fewer observed deaths than was expected in 2018/19.
Sepsis, known as the ‘silent killer’, strikes when an infection such as blood poisoning sparks a violent immune response in which the body attacks its own organs.
It is the leading cause of avoidable death, killing at least 44,000 a year, and the Daily Mail has long campaigned for more awareness.
If caught early, the infection can be controlled by antibiotics before the body goes into overdrive – ultimately leading to death within a matter of minutes.
But the early symptoms of sepsis can be easily confused with more mild conditions, meaning it can be difficult to diagnose.
The NHS states it is ‘inappropriate’ for trusts to be ranked on their SHMI, and that an excess death count only warrants the need for further investigations.
Sir Brian did not take into account data from 20 trusts to name the worst offenders due to them not having data for the full six years.
He used the internationally recognised system, recommended by the Association of Public Health Observatories, called Byar’s confidence intervals.
A similar process helped uncover poor care at the Mid Staffordshire trust, one of the biggest scandals to ever hit the NHS.
However, the NHS uses another method, called overdispersion, which gives trusts slightly more leeway in terms of recording deaths.
Under that system, a trust is regarded as having a higher than expected number of deaths only if its SHMI is about 12 per cent or more above the national average.
In contrast, the Byar’s method is used internationally and classifies a much higher proportion of trusts as being significantly above the national average.
The NHS had used the internationally recognised Byar’s confidence intervals in the past.
A Department of Health and Social Care spokesperson said: ‘Sepsis is devastating but good progress is being made on identifying suspected cases and improving outcomes across the NHS.
Sepsis, known as the ‘silent killer’, strikes when an infection such as blood poisoning sparks a violent immune response in which the body attacks its own organs
‘SHMI data is one of a range of measures used by independent inspectors to rigorously monitor the quality and safety of care our hospitals provide to patients, and they do not hesitate to intervene if they have concerns.’
A spokesperson for NHS Improvement and NHS England, said: ‘Actually last year official NHS Digital figures show there were fewer hospital deaths from sepsis than expected.
‘And in the past few years, as the NHS has become more effective at spotting the infection quickly, although more cases are being recorded, the chances of dying from sepsis have fallen.
‘This progress will be boosted by our NHS Long Term Plan, which commits emergency departments to spotting the condition more quickly, will help patients get the right treatment at the right time and reduce avoidable use of antibiotics, to keep them as effective as possible in the future.’
Dr Neill Hepburn, medical director at United Lincolnshire Hospitals NHS Trust, said: ‘We remain committed to ensuring we provide the highest possible standard of care to all our patients.
‘We now employ dedicated sepsis nurses as well as placing sepsis boxes in departments where patients are most often identified with having the condition, so that they can be treated quickly.’
Professor Damian Riley, acting chief executive for East Lancashire Hospitals NHS Trust, said: ‘The Trust has worked hard in recent years to reduce mortality raises from all disease causes.
‘And we are pleased to report that our Summary Hospital Mortality Indicator (SHMI) – as independently reported – is classed as in the “as expected” range and is lower than it has been for several years.
‘Our medical audits show the Trust now performs well in terms of rapid administration of antibiotics and fluids for life-saving treatments for those patients suspected of having sepsis.
‘This is very reassuring for our patients, and confirms the considerable steps we have taken.’
Tameside and Glossop Integrated Care NHS Foundation Trust said it reviews every hospital death.
A spokesperson added: ‘The elevated septicaemia mortality figure is not related to the quality of care provided.
‘The Trust applies the latest Department of Health guidance relating to the coding of septicaemia, so that only the very sickest patients are included in this group.’
NAME OF NHS TRUST | DEATH RATES | OBSERVED DEATHS | EXPECTED DEATHS | DIFFERENCE IN DEATHS |
---|---|---|---|---|
ISLE OF WIGHT NHS TRUST | 0.94 | 505 | 538.14 | -33.14 |
BARTS HEALTH NHS TRUST | 0.89 | 1412 | 1579.30 | -167.30 |
ROYAL SURREY COUNTY HOSPITAL NHS FOUNDATION TRUST | 0.87 | 431 | 496.80 | -65.80 |
WESTON AREA HEALTH NHS TRUST | 0.93 | 403 | 434.96 | -31.96 |
YEOVIL DISTRICT HOSPITAL NHS FOUNDATION TRUST | 0.86 | 507 | 586.37 | -79.37 |
UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST | 0.88 | 554 | 627.84 | -73.84 |
BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST | 0.89 | 510 | 574.98 | -64.98 |
SOUTHEND UNIVERSITY HOSPITAL NHS FOUNDATION TRUST | 1.14 | 794 | 694.55 | 99.45 |
ROYAL FREE LONDON NHS FOUNDATION TRUST | 0.93 | 985 | 1059.62 | -74.62 |
NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST | 1.07 | 452 | 423.33 | 28.67 |
THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST | 0.97 | 369 | 379.58 | -10.58 |
KINGSTON HOSPITAL NHS FOUNDATION TRUST | 1.13 | 595 | 524.42 | 70.58 |
TAUNTON AND SOMERSET NHS FOUNDATION TRUST | 0.80 | 804 | 1003.66 | -199.66 |
DORSET COUNTY HOSPITAL NHS FOUNDATION TRUST | 1.08 | 338 | 311.90 | 26.10 |
WALSALL HEALTHCARE NHS TRUST | 1.02 | 662 | 652.10 | 9.90 |
WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST | 0.99 | 1251 | 1262.21 | -11.21 |
ST HELENS AND KNOWSLEY HOSPITAL SERVICES NHS TRUST | 0.94 | 1108 | 1184.45 | -76.45 |
MID CHESHIRE HOSPITALS NHS FOUNDATION TRUST | 1.09 | 734 | 671.27 | 62.73 |
NORTHERN DEVON HEALTHCARE NHS TRUST | 1.01 | 334 | 329.53 | 4.47 |
BEDFORD HOSPITAL NHS TRUST | 1.05 | 656 | 622.83 | 33.17 |
LUTON AND DUNSTABLE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST | 1.06 | 755 | 711.54 | 43.46 |
YORK TEACHING HOSPITAL NHS FOUNDATION TRUST | 1.11 | 1730 | 1565.50 | 164.50 |
HARROGATE AND DISTRICT NHS FOUNDATION TRUST | 1.00 | 276 | 276.38 | -0.38 |
AIREDALE NHS FOUNDATION TRUST | 0.93 | 406 | 436.72 | -30.72 |
THE QUEEN ELIZABETH HOSPITAL, KING’S LYNN, NHS FOUNDATION TRUST | 0.83 | 973 | 1171.57 | -198.57 |
ROYAL UNITED HOSPITALS BATH NHS FOUNDATION TRUST | 0.96 | 860 | 895.38 | -35.38 |
POOLE HOSPITAL NHS FOUNDATION TRUST | 0.66 | 394 | 598.17 | -204.17 |
MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST | 0.98 | 629 | 645.12 | -16.12 |
BASILDON AND THURROCK UNIVERSITY HOSPITALS NHS FOUNDATION TRUST | 0.99 | 1699 | 1721.84 | -22.84 |
EAST SUFFOLK AND NORTH ESSEX NHS FOUNDATION TRUST | 1.05 | 1485 | 1411.29 | 73.71 |
FRIMLEY HEALTH NHS FOUNDATION TRUST | 0.97 | 1583 | 1629.24 | -46.23 |
THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS NHS FOUNDATION TRUST | 0.54 | 299 | 553.84 | -254.84 |
ROYAL CORNWALL HOSPITALS NHS TRUST | 0.95 | 805 | 849.38 | -44.38 |
AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST | 1.07 | 948 | 885.18 | 62.82 |
BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST | 1.11 | 1360 | 1229.02 | 130.98 |
BARNSLEY HOSPITAL NHS FOUNDATION TRUST | 1.14 | 650 | 571.58 | 78.42 |
THE ROTHERHAM NHS FOUNDATION TRUST | 1.17 | 412 | 351.73 | 60.27 |
CHESTERFIELD ROYAL HOSPITAL NHS FOUNDATION TRUST | 0.98 | 670 | 686.63 | -16.63 |
NORTH WEST ANGLIA NHS FOUNDATION TRUST | 0.88 | 1305 | 1476.01 | -171.01 |
JAMES PAGET UNIVERSITY HOSPITALS NHS FOUNDATION TRUST | 0.97 | 538 | 554.69 | -16.69 |
WEST SUFFOLK NHS FOUNDATION TRUST | 0.84 | 839 | 996.52 | -157.52 |
CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST | 0.79 | 731 | 924.35 | -193.35 |
ROYAL DEVON AND EXETER NHS FOUNDATION TRUST | 0.93 | 631 | 675.03 | -44.03 |
UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST | 0.87 | 817 | 943.45 | -126.45 |
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST | 1.01 | 1211 | 1197.12 | 13.88 |
PORTSMOUTH HOSPITALS NHS TRUST | 0.95 | 1278 | 1349.88 | -71.88 |
ROYAL BERKSHIRE NHS FOUNDATION TRUST | 0.97 | 803 | 824.88 | -21.88 |
GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST | 1.01 | 300 | 297.16 | 2.84 |
CROYDON HEALTH SERVICES NHS TRUST | 1.06 | 829 | 785.05 | 43.96 |
ST GEORGE’S UNIVERSITY HOSPITALS NHS FOUNDATION TRUST | 1.00 | 773 | 771.35 | 1.65 |
SOUTH WARWICKSHIRE NHS FOUNDATION TRUST | 0.85 | 415 | 489.66 | -74.66 |
NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST | 1.18 | 1074 | 910.51 | 163.49 |
EAST CHESHIRE NHS TRUST | 1.06 | 410 | 387.02 | 22.98 |
COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST | 1.03 | 681 | 661.03 | 19.97 |
KING’S COLLEGE HOSPITAL NHS FOUNDATION TRUST | 1.03 | 1119 | 1083.15 | 35.85 |
SHERWOOD FOREST HOSPITALS NHS FOUNDATION TRUST | 0.92 | 1028 | 1111.60 | -83.60 |
UNIVERSITY HOSPITALS PLYMOUTH NHS TRUST | 0.87 | 751 | 867.29 | -116.29 |
UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST | 1.10 | 935 | 849.52 | 85.48 |
WHITTINGTON HEALTH NHS TRUST | 0.76 | 299 | 393.04 | -94.04 |
THE ROYAL WOLVERHAMPTON NHS TRUST | 1.10 | 909 | 826.92 | 82.08 |
WYE VALLEY NHS TRUST | 1.15 | 465 | 405.06 | 59.95 |
GEORGE ELIOT HOSPITAL NHS TRUST | 0.96 | 355 | 368.74 | -13.74 |
NORFOLK AND NORWICH UNIVERSITY HOSPITALS NHS FOUNDATION TRUST | 1.06 | 1514 | 1428.00 | 86.00 |
SALFORD ROYAL NHS FOUNDATION TRUST | 0.98 | 828 | 842.03 | -14.03 |
BOLTON NHS FOUNDATION TRUST | 1.06 | 1042 | 982.58 | 59.43 |
TAMESIDE AND GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST | 1.38 | 517 | 373.42 | 143.58 |
GREAT WESTERN HOSPITALS NHS FOUNDATION TRUST | 1.11 | 1123 | 1008.51 | 114.49 |
HAMPSHIRE HOSPITALS NHS FOUNDATION TRUST | 0.97 | 793 | 821.04 | -28.04 |
DARTFORD AND GRAVESHAM NHS TRUST | 0.95 | 642 | 674.72 | -32.72 |
THE DUDLEY GROUP NHS FOUNDATION TRUST | 1.19 | 1056 | 890.77 | 165.23 |
NORTH CUMBRIA UNIVERSITY HOSPITALS NHS TRUST | 1.07 | 681 | 636.16 | 44.84 |
KETTERING GENERAL HOSPITAL NHS FOUNDATION TRUST | 0.93 | 395 | 422.52 | -27.52 |
NORTHAMPTON GENERAL HOSPITAL NHS TRUST | 1.11 | 835 | 754.29 | 80.71 |
SALISBURY NHS FOUNDATION TRUST | 0.92 | 316 | 341.69 | -25.69 |
DONCASTER AND BASSETLAW TEACHING HOSPITALS NHS FOUNDATION TRUST | 1.06 | 882 | 834.12 | 47.88 |
MEDWAY NHS FOUNDATION TRUST | 1.10 | 910 | 829.43 | 80.57 |
ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS NHS TRUST | 1.16 | 1111 | 959.39 | 151.61 |
MID ESSEX HOSPITAL SERVICES NHS TRUST | 0.97 | 999 | 1031.28 | -32.28 |
CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST | 0.98 | 613 | 624.85 | -11.85 |
THE PRINCESS ALEXANDRA HOSPITAL NHS TRUST | 1.11 | 552 | 495.24 | 56.76 |
HOMERTON UNIVERSITY HOSPITAL NHS FOUNDATION TRUST | 0.94 | 199 | 212.20 | -13.20 |
GATESHEAD HEALTH NHS FOUNDATION TRUST | 0.97 | 673 | 690.73 | -17.73 |
LEEDS TEACHING HOSPITALS NHS TRUST | 0.99 | 1028 | 1039.12 | -11.12 |
WRIGHTINGTON, WIGAN AND LEIGH NHS FOUNDATION TRUST | 1.26 | 729 | 576.79 | 152.21 |
UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST | 1.01 | 1909 | 1886.31 | 22.69 |
UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST | 0.87 | 280 | 323.48 | -43.48 |
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST | 1.05 | 772 | 736.15 | 35.85 |
GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST | 1.12 | 975 | 873.45 | 101.55 |
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST | 1.02 | 1128 | 1105.42 | 22.58 |
UNIVERSITY HOSPITALS OF DERBY AND BURTON NHS FOUNDATION TRUST | 0.86 | 1942 | 2257.16 | -315.16 |
OXFORD UNIVERSITY HOSPITALS NHS FOUNDATION TRUST | 0.85 | 904 | 1058.60 | -154.60 |
ASHFORD AND ST PETER’S HOSPITALS NHS FOUNDATION TRUST | 1.00 | 667 | 664.78 | 2.22 |
SURREY AND SUSSEX HEALTHCARE NHS TRUST | 1.05 | 845 | 802.85 | 42.15 |
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST | 1.00 | 1245 | 1239.67 | 5.33 |
UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST | 1.00 | 741 | 738.67 | 2.33 |
NORTH BRISTOL NHS TRUST | 0.85 | 747 | 876.02 | -129.02 |
EPSOM AND ST HELIER UNIVERSITY HOSPITALS NHS TRUST | 0.91 | 857 | 940.81 | -83.81 |
EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST | 1.18 | 2697 | 2281.05 | 415.96 |
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST | 1.06 | 977 | 919.08 | 57.93 |
SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST | 0.94 | 616 | 657.59 | -41.59 |
PENNINE ACUTE HOSPITALS NHS TRUST | 1.04 | 1212 | 1164.59 | 47.41 |
HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST | 1.23 | 928 | 755.92 | 172.08 |
UNITED LINCOLNSHIRE HOSPITALS NHS TRUST | 1.20 | 1968 | 1636.12 | 331.88 |
UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST | 0.96 | 2077 | 2169.46 | -92.46 |
MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST | 0.90 | 724 | 802.59 | -78.59 |
WEST HERTFORDSHIRE HOSPITALS NHS TRUST | 1.05 | 1006 | 956.61 | 49.39 |
EAST AND NORTH HERTFORDSHIRE NHS TRUST | 1.01 | 652 | 645.57 | 6.43 |
STOCKPORT NHS FOUNDATION TRUST | 0.96 | 684 | 711.84 | -27.84 |
WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST | 1.06 | 1119 | 1058.71 | 60.29 |
WARRINGTON AND HALTON HOSPITALS NHS FOUNDATION TRUST | 1.04 | 655 | 628.01 | 26.99 |
CALDERDALE AND HUDDERSFIELD NHS FOUNDATION TRUST | 1.03 | 788 | 763.60 | 24.40 |
NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST | 0.94 | 2162 | 2307.02 | -145.02 |
EAST SUSSEX HEALTHCARE NHS TRUST | 1.03 | 1184 | 1150.93 | 33.07 |
MID YORKSHIRE HOSPITALS NHS TRUST | 1.14 | 1139 | 999.16 | 139.84 |
BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST | 0.86 | 664 | 773.90 | -109.90 |
SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST | 1.06 | 554 | 523.08 | 30.93 |
BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST | 1.04 | 1090 | 1049.23 | 40.77 |
LANCASHIRE TEACHING HOSPITALS NHS FOUNDATION TRUST | 1.00 | 1567 | 1573.79 | -6.79 |
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST | 1.16 | 1180 | 1018.10 | 161.90 |
BUCKINGHAMSHIRE HEALTHCARE NHS TRUST | 0.83 | 880 | 1057.79 | -177.79 |
EAST LANCASHIRE HOSPITALS NHS TRUST | 1.24 | 1489 | 1197.98 | 291.02 |
SHREWSBURY AND TELFORD HOSPITAL NHS TRUST | 1.03 | 964 | 939.57 | 24.43 |
IMPERIAL COLLEGE HEALTHCARE NHS TRUST | 0.91 | 937 | 1034.46 | -97.45 |
WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST | 0.92 | 1519 | 1650.09 | -131.09 |
The death rates can be converted into percentages, with 1 being the baseline – meaning a figure of 1.2 shows death rates are 20 per cent higher than the national average. A figure of 0.8 shows death rates are 20 per cent lower than the national average |