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 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
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.
THE 10 WORST (AND BEST) TRUSTS
The worst trusts (% above expected sepsis death rates)
The best trusts (% below expected sepsis death rates)
Tameside and Glossop Integrated Care NHS Foundation Trust: 55%
Wrightington, Wigan and Leigh NHS Foundation Trust: 43%
The Dudley Group NHS Foundation Trust: 35%
Hull and East Yorkshire Hospitals NHS Trust: 30%
Southend University Hospital NHS Foundation Trust: 29%
United Lincolnshire Hospitals NHS Trust: 27%
East Lancashire Hospitals NHS Trust: 25%
Aintree University Hospital NHS Foundation Trust: 25%
Mid Yorkshire Hospitals NHS Trust: 24%
Central Manchester University Hospitals NHS Foundation Trust: 23%
University Hospitals of North Midlands NHS Trust: 39%
Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust: 37%
Poole Hospital NHS Foundation Trust: 35%
Brighton and Sussex University Hospitals NHS Trust: 29%
Oxford University Hospitals NHS Foundation Trust: 24%
Buckinghamshire Healthcare NHS Trust: 23%
Derby Teaching Hospitals NHS Foundation Trust: 23%
Cambridge University Hospitals NHS Foundation Trust: 22%
West Suffolk NHS Foundation Trust: 21%
Mid Essex Hospital Services NHS Trust: 20%
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 MID-STAFFS NHS SCANDAL
Up to 1,200 people needlessly died at Stafford hospital, ran by Mid-Staffordshire NHS Trust, due to poor care between 2005 and 2009.
In what is one of the worst care scandals in living memory, patients were left lying in their own excrement and so thirsty that they were reduced to drinking water from vases.
The Francis report, the inquiry into the hospital’s workings in 2013, found that box ticking bureaucrats prioritised targets over basic levels of care.
It later emerged that just one senior nurse was in charge of 84 beds at the scandal-hit hospital. The findings prompted significant changes in hospital care.
But not a single individual will be prosecuted in connection with the scandal, police admitted last year – despite a three-year investigation.
Stafford Hospital has been renamed County Hospital, and is now run by a different trust.
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.’
|Provider trust||Sepsis death rate||Death differences||Observed deaths||Expected deaths|
|TAMESIDE AND GLOSSOP INTEGRATED CARE NHS FOUNDATION TRUST||1.55||significantly high death rate||50.1||141||90.88|
|WRIGHTINGTON, WIGAN AND LEIGH NHS FOUNDATION TRUST||1.43||significantly high death rate||79.5||263||183.524|
|THE DUDLEY GROUP NHS FOUNDATION TRUST||1.35||significantly high death rate||121.9||468||346.121|
|UNITED LINCOLNSHIRE HOSPITALS NHS TRUST||1.27||significantly high death rate||164.0||761||596.962|
|EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST||1.22||significantly high death rate||201.3||1128||926.711|
|SOUTHEND UNIVERSITY HOSPITAL NHS FOUNDATION TRUST||1.29||significantly high death rate||88.9||400||311.138|
|HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST||1.30||significantly high death rate||68.0||296||228.046|
|EAST LANCASHIRE HOSPITALS NHS TRUST||1.25||significantly high death rate||83.7||413||329.322|
|MID YORKSHIRE HOSPITALS NHS TRUST||1.24||significantly high death rate||78.5||406||327.541|
|AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST||1.25||significantly high death rate||65.6||328||262.413|
|BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST||1.22||significantly high death rate||71.8||396||324.169|
|BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST||1.19||significantly high death rate||78.9||491||412.081|
|NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST||1.21||significantly high death rate||68.9||399||330.136|
|DONCASTER AND BASSETLAW TEACHING HOSPITALS NHS FOUNDATION TRUST||1.22||significantly high death rate||58.0||323||264.965|
|COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST||1.20||significantly high death rate||63.7||390||326.349|
|GREAT WESTERN HOSPITALS NHS FOUNDATION TRUST||1.17||significantly high death rate||60.3||419||358.742|
|CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||1.23||average||25.7||137||111.313|
|WALSALL HEALTHCARE NHS TRUST||1.21||average||42.2||240||197.771|
|WYE VALLEY NHS TRUST||1.21||average||22.3||128||105.665|
|BARNSLEY HOSPITAL NHS FOUNDATION TRUST||1.21||average||37.7||219||181.321|
|SOUTH TYNESIDE NHS FOUNDATION TRUST||1.21||average||25.1||147||121.939|
|NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST||1.18||average||23.9||154||130.053|
|CROYDON HEALTH SERVICES NHS TRUST||1.16||average||33.8||241||207.151|
|MID CHESHIRE HOSPITALS NHS FOUNDATION TRUST||1.16||average||36.6||270||233.389|
|GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST||1.16||average||41.2||307||265.751|
|HOMERTON UNIVERSITY HOSPITAL NHS FOUNDATION TRUST||1.15||average||8.0||60||52.047|
|WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST||1.14||average||50.5||399||348.531|
|WARRINGTON AND HALTON HOSPITALS NHS FOUNDATION TRUST||1.14||average||22.7||188||165.327|
|BOLTON NHS FOUNDATION TRUST||1.13||average||53.8||455||401.158|
|SHREWSBURY AND TELFORD HOSPITAL NHS TRUST||1.13||average||43.1||371||327.947|
|EAST SUSSEX HEALTHCARE NHS TRUST||1.13||average||46.2||407||360.825|
|UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST||1.13||average||29.9||267||237.136|
|ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS NHS TRUST||1.12||average||48.3||454||405.67|
|KINGSTON HOSPITAL NHS FOUNDATION TRUST||1.12||average||28.3||271||242.699|
|NORTH CUMBRIA UNIVERSITY HOSPITALS NHS TRUST||1.11||average||21.8||214||192.226|
|KING’S COLLEGE HOSPITAL NHS FOUNDATION TRUST||1.11||average||33.5||346||312.472|
|COLCHESTER HOSPITAL UNIVERSITY NHS FOUNDATION TRUST||1.10||average||37.7||399||361.323|
|THE ROYAL WOLVERHAMPTON NHS TRUST||1.10||average||30.4||334||303.591|
|UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST||1.09||average||26.0||317||290.991|
|MEDWAY NHS FOUNDATION TRUST||1.08||average||21.9||281||259.053|
|LUTON AND DUNSTABLE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST||1.08||average||23.4||313||289.628|
|SURREY AND SUSSEX HEALTHCARE NHS TRUST||1.07||average||21.9||315||293.149|
|KETTERING GENERAL HOSPITAL NHS FOUNDATION TRUST||1.07||average||10.1||147||136.887|
|HARROGATE AND DISTRICT NHS FOUNDATION TRUST||1.07||average||6.9||101||94.07|
|CALDERDALE AND HUDDERSFIELD NHS FOUNDATION TRUST||1.07||average||11.9||190||178.091|
|BURTON HOSPITALS NHS FOUNDATION TRUST||1.07||average||7.7||125||117.313|
|THE PRINCESS ALEXANDRA HOSPITAL NHS TRUST||1.06||average||10.8||178||167.176|
|THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST||1.06||average||16.0||266||249.997|
|ASHFORD AND ST PETER’S HOSPITALS NHS FOUNDATION TRUST||1.06||average||18.1||304||285.933|
|EAST CHESHIRE NHS TRUST||1.06||average||9.7||172||162.343|
|SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST||1.06||average||11.8||211||199.171|
|GEORGE ELIOT HOSPITAL NHS TRUST||1.06||average||6.6||120||113.37|
|NORTHERN DEVON HEALTHCARE NHS TRUST||1.06||average||7.3||133||125.655|
|CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST||1.06||average||14.8||272||257.192|
|WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST||1.06||average||28.7||534||505.274|
|GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST||1.05||average||3.9||78||74.119|
|ST GEORGE’S UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||1.05||average||13.8||295||281.184|
|COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST||1.04||average||9.9||274||264.145|
|ROYAL CORNWALL HOSPITALS NHS TRUST||1.04||average||8.6||245||236.379|
|HAMPSHIRE HOSPITALS NHS FOUNDATION TRUST||1.03||average||11.1||359||347.865|
|SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST||1.03||average||12.8||436||423.215|
|NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST||1.03||average||10.5||427||416.543|
|YORK TEACHING HOSPITAL NHS FOUNDATION TRUST||1.02||average||15.8||685||669.249|
|DORSET COUNTY HOSPITAL NHS FOUNDATION TRUST||1.02||average||2.0||132||130.023|
|THE ROTHERHAM NHS FOUNDATION TRUST||1.01||average||1.0||90||89.002|
|ROYAL UNITED HOSPITALS BATH NHS FOUNDATION TRUST||1.01||average||3.9||363||359.081|
|HEART OF ENGLAND NHS FOUNDATION TRUST||1.01||average||3.3||604||600.689|
|UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST||1.00||average||1.0||253||252.006|
|NORTHAMPTON GENERAL HOSPITAL NHS TRUST||1.00||average||0.4||210||209.561|
|PORTSMOUTH HOSPITALS NHS TRUST||1.00||average||-0.1||474||474.125|
|THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST||1.00||average||-0.2||82||82.183|
|IMPERIAL COLLEGE HEALTHCARE NHS TRUST||1.00||average||-1.6||325||326.578|
|LANCASHIRE TEACHING HOSPITALS NHS FOUNDATION TRUST||0.99||average||-6.8||496||502.783|
|FRIMLEY HEALTH NHS FOUNDATION TRUST||0.98||average||-11.1||717||728.102|
|SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST||0.98||average||-3.1||191||194.145|
|SALFORD ROYAL NHS FOUNDATION TRUST||0.98||average||-5.7||315||320.713|
|ROYAL BERKSHIRE NHS FOUNDATION TRUST||0.98||average||-6.1||278||284.075|
|AIREDALE NHS FOUNDATION TRUST||0.98||average||-2.4||106||108.441|
|SHERWOOD FOREST HOSPITALS NHS FOUNDATION TRUST||0.97||average||-10.2||390||400.209|
|WESTON AREA HEALTH NHS TRUST||0.97||average||-3.3||123||126.34|
|BEDFORD HOSPITAL NHS TRUST||0.97||average||-7.1||212||219.084|
|NORFOLK AND NORWICH UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||0.96||average||-19.7||531||550.676|
|ROYAL FREE LONDON NHS FOUNDATION TRUST||0.96||average||-13.7||331||344.708|
|GATESHEAD HEALTH NHS FOUNDATION TRUST||0.96||average||-12.5||274||286.494|
|CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST||0.95||average||-7.2||149||156.204|
|UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST||0.94||average||-32.8||535||567.804|
|LEWISHAM AND GREENWICH NHS TRUST||0.94||average||-24.2||383||407.191|
|SOUTH TEES HOSPITALS NHS FOUNDATION TRUST||0.94||average||-38.9||593||631.897|
|EAST AND NORTH HERTFORDSHIRE NHS TRUST||0.94||average||-12.4||185||197.382|
|NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST||0.93||average||-14.3||200||214.271|
|WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST||0.93||average||-42.3||578||620.257|
|MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST||0.93||average||-15.4||204||219.445|
|ISLE OF WIGHT NHS TRUST||0.93||average||-16.5||210||226.521|
|ST HELENS AND KNOWSLEY HOSPITAL SERVICES NHS TRUST||0.92||average||-28.4||337||365.389|
|BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST||0.92||average||-11.8||137||148.775|
|DARTFORD AND GRAVESHAM NHS TRUST||0.92||average||-20.0||220||239.977|
|EPSOM AND ST HELIER UNIVERSITY HOSPITALS NHS TRUST||0.92||average||-29.2||321||350.191|
|STOCKPORT NHS FOUNDATION TRUST||0.91||average||-21.1||220||241.08|
|PENNINE ACUTE HOSPITALS NHS TRUST||0.91||average||-20.8||216||236.802|
|CHESTERFIELD ROYAL HOSPITAL NHS FOUNDATION TRUST||0.90||average||-18.7||177||195.69|
|BASILDON AND THURROCK UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||0.90||average||-86.5||812||898.483|
|LEEDS TEACHING HOSPITALS NHS TRUST||0.90||average||-38.2||335||373.216|
|LONDON NORTH WEST HEALTHCARE NHS TRUST||0.90||average||-46.4||399||445.372|
|NORTH BRISTOL NHS TRUST||0.90||average||-26.8||229||255.845|
|PLYMOUTH HOSPITALS NHS TRUST||0.89||average||-41.7||340||381.716|
|NORTH WEST ANGLIA NHS FOUNDATION TRUST||0.88||average||-70.8||508||578.827|
|MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST||0.88||average||-35.5||251||286.51|
|BARTS HEALTH NHS TRUST||0.87||average||-52.2||364||416.214|
|SALISBURY NHS FOUNDATION TRUST||0.87||average||-19.1||123||142.063|
|UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST||0.86||average||-36.4||233||269.422|
|YEOVIL DISTRICT HOSPITAL NHS FOUNDATION TRUST||0.86||average||-29.3||176||205.267|
|UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST||0.85||average||-34.0||192||225.96|
|THE WHITTINGTON HOSPITAL NHS TRUST||0.85||average||-24.0||134||158.018|
|ROYAL DEVON AND EXETER NHS FOUNDATION TRUST||0.85||average||-36.5||202||238.461|
|SOUTH WARWICKSHIRE NHS FOUNDATION TRUST||0.84||average||-28.3||147||175.274|
|WEST HERTFORDSHIRE HOSPITALS NHS TRUST||0.84||average||-29.8||151||180.774|
|UNIVERSITY HOSPITAL OF SOUTH MANCHESTER NHS FOUNDATION TRUST||0.83||average||-31.6||149||180.585|
|UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST||0.81||average||-16.6||69||85.552|
|ROYAL SURREY COUNTY HOSPITAL NHS FOUNDATION TRUST||0.80||average||-30.2||123||153.249|
|JAMES PAGET UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||0.80||average||-36.8||146||182.827|
|CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||0.78||significantly low death rate||-43.6||158||201.592|
|IPSWICH HOSPITAL NHS TRUST||0.82||significantly low death rate||-59.8||273||332.794|
|NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST||0.88||significantly low death rate||-115.4||858||973.406|
|THE QUEEN ELIZABETH HOSPITAL, KING’S LYNN, NHS FOUNDATION TRUST||0.83||significantly low death rate||-75.9||368||443.905|
|TAUNTON AND SOMERSET NHS FOUNDATION TRUST||0.81||significantly low death rate||-68.7||288||356.728|
|MID ESSEX HOSPITAL SERVICES NHS TRUST||0.80||significantly low death rate||-67.8||274||341.759|
|WEST SUFFOLK NHS FOUNDATION TRUST||0.79||significantly low death rate||-62.9||237||299.877|
|OXFORD UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||0.76||significantly low death rate||-83.6||267||350.555|
|BUCKINGHAMSHIRE HEALTHCARE NHS TRUST||0.77||significantly low death rate||-134.2||462||596.222|
|BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST||0.71||significantly low death rate||-73.8||177||250.847|
|DERBY TEACHING HOSPITALS NHS FOUNDATION TRUST||0.77||significantly low death rate||-155.5||525||680.477|
|POOLE HOSPITAL NHS FOUNDATION TRUST||0.65||significantly low death rate||-89.5||167||256.488|
|THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS NHS FOUNDATION TRUST||0.63||significantly low death rate||-75.5||126||201.533|
|UNIVERSITY HOSPITALS OF NORTH MIDLANDS NHS TRUST||0.61||significantly low death rate||-115.6||184||299.588|