Sepsis deaths certain regions 55% higher than expected

Patients are twice as likely to die from sepsis in some hospitals as they are in others, statistics obtained by MailOnline reveal.

Sepsis death rates at Tameside and Glossop NHS Foundation Trust in Ashton-under-Lyne are 55 per cent higher than expected.

At the other end of the scale, sepsis has claimed 39 per cent fewer lives than officials predicted at the University Hospitals of North Midlands NHS Trust.

When compared, it means the chance of dying from sepsis in Tameside is about twice that of a similar patient treated at the Staffordshire site.

Eminent hospital death rates expert Professor Sir Brian Jarman, who helped expose the Mid-Staffordshire hospitals scandal, was behind the analysis.

His findings, disputed by the NHS, suggest a ‘postcode lottery’ of care is consigning hundreds, or even thousands, of patients to an early grave.

It also reveals a stark North-South divide, with most of the worst performing hospital trusts concentrated in the north of England.

The worrying data shows 16 hospital trusts across the country to have a ‘significantly high death rate’, with only four situated in the south.   

The figures heighten the The Mail’s ‘End The Sepsis Scandal’ campaign, which began last year in an attempt to reduce the number of missed cases of sepsis.

Scroll down to see how your trust rated 

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. 

A patient can rapidly deteriorate if sepsis is missed early on, so quick diagnosis and treatment is vital – yet this rarely happens. 

Professor Jarman used NHS data to come to his conclusion. It involved 134 hospital trusts in England, with four not having enough statistics to meet his criteria.

The worst performers 

Sepsis deaths at Tameside and Glossop NHS Foundation Trust have been higher than expected over the past three years, given the population it serves.

At this trust, 141 sepsis deaths were recorded over a three-year period – 55 per cent higher than the expected figure of 91.

In Wrightington, Wigan and Leigh NHS Foundation Trust, deaths have been 43 per cent higher than expected over the same time frame.

And a 35 per cent spike has been recorded at the Dudley Group NHS Foundation Trust, according to Professor Jarman’s analysis.

The best performers 

In terms of trusts seemingly leading the way in treating sepsis, University Hospitals of North Midlands NHS Trust leads the way.

Between 2014 and 2017 it recorded 39 per cent less deaths than expected. Some 184 people died of sepsis between the trust’s two hospitals.

The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust recorded 126 sepsis deaths, 37 per cent lower than the expected figure.

And Poole Hospital NHS Foundation Trust saw 35 per cent fewer sepsis deaths than projections estimated, with it claiming 167 lives in three years.

How were the findings calculated? 

The method Professor Jarman used to make the projections is recommended by the Association of Public Health Observatories.

He revealed the NHS has previously used the internationally recognised system, called Byar’s confidence intervals.

A similar process helped uncover poor care at the Mid Staffordshire trust, which was at the centre of one of the biggest scandals ever to hit the NHS.

However, the NHS uses another method, called overdispersion, which gives trusts more leeway, Professor Jarman added.

Under that system, a trust is regarded as having a high death rate only if its measure, called the Summary Hospital-level Mortality Indicator, or SHMI, is about 12 per cent or more above the national average.

In contrast, the Byar’s method is much stricter, classing anything with a SHMI of more than six or seven per cent above the national average as significantly high.

The expected deaths at each hospital trust is worked out by calculating how many deaths the trust would have if they had the English national average death rates.

The death rate is then calculated by dividing the actual deaths from sepsis by the expected deaths for sepsis, Professor Jarman explained. 

Only primary diagnoses of sepsis are recorded for the observed deaths, excluding thousands of cases where the violent immune response was partly responsible.

This explains why just 40,417 deaths were recorded over the three-year time frame – notably less than the 44,000 expected each year. 

What did the NHS say? 

Chris Roebuck, head of profession for statistics for NHS Digital, said, ‘We transparently publish our data in a variety of forms in order to enable others to conduct their own analysis, although we could not comment on this methodology with the information we have been provided.

‘The findings from any analysis of SHMI or its underlying data should act as a starting point for further investigation, rather than treated as a definitive view on quality of care. 

‘A variety of factors could influence Trusts’ figures, such as the way they record particular conditions. 

‘For example, we do know that sepsis has historically been recorded differently by different trusts with some clinicians coding for sepsis, while others code for the underlying infection, such as pneumonia.’