Hospital death rate down 14% since 2014 – beating government target

The hospital standardised mortality ratio has fallen 14% between January to March 2014 and October to December 2018.

Hospital death rates have dropped by 14% in four years, beating a Scottish Government target of a 10% cut. Health Secretary Jeane Freeman credited the drop to the Scottish Patient Safety Programme (SPSP) which aims to improve the safety and reliability of health and social care.

The latest official statistics indicate deaths within 30 days of being admitted to hospital, known as the hospital standard mortality ratio, fell 14% between January to March 2014 and October to December 2018.

The vast majority of the hospitals taking part in the patient safety programme, 26, showed a reduction in the death rate since January to March 2014, with 17 indicating a drop of more than 10%.

A total of three hospitals did not show a reduction since January to March 2014.

The NHS Scotland Information Services Division report indicates the standardised death ratio statistics between January to March 2011 and October to December 2018 “show clear seasonal patterns” with slightly higher ratios in the winter quarters from October to March.

"It is clear that, along with a number of other contributory factors, the Scottish Patient Safety Programme is helping us reduce hospital mortality and reduce avoidable harm at every stage of care" - Jeane Freeman MSP

There were 6,498 deaths within 30 days of hospital admission in Scotland in the final quarter of last year, 15% fewer than predicted, giving ratio of 0.85.

In this period none of Scotland’s hospitals had a standardised mortality ratio significantly above or below the national average. 

Inverclyde Royal Hospital in Greenock was above the upper warning limit for this three-month period as was the combined result for the Royal Alexandra Hospital in Paisley and the Vale of Leven Hospital in Alexandria.

The report highlights several possible factors contributing to the nationwide reduction in the ratio such as changes in underlying population-based mortality, care and treatment improvements, increases in available medical treatments, changes in the provision of palliative care and the completeness or accuracy of hospital discharge summaries.

Health Secretary Jeane Freeman welcomed the death rate drop (Andrew Cowan/Scottish Parliament/PA)

Health Secretary Jeane Freeman said: “In 2015/16, we set out our aim to reduce hospital mortality by 10% by December 2018 and I’m pleased to say that it has reduced by 14%.

“It is clear that, along with a number of other contributory factors, the Scottish Patient Safety Programme is helping us reduce hospital mortality and reduce avoidable harm at every stage of care.

“We are in regular contact with Healthcare Improvement Scotland who support health boards in managing hospital standardised mortality ratios and have been reassured by their reports on the quality of care provided in our hospitals.

“We welcome the progress being made and the hard work of NHS staff in driving down hospital mortality rates.”

A Royal College of Physicians of Edinburgh spokesman said: “The latest statistics indicate a continued national trend towards fewer hospital mortalities being recorded than what was predicted – with a 14% decrease in expected deaths between January 2014 and December 2018.

“We understand this to indicate that the Scottish health system is making progress in reducing mortality rates, for possible reasons including improvements in the quality of care and treatment and increases in available medical treatments and risk factor improvements.

“We do note however that people from more deprived areas have higher average levels of crude 30-day mortality, which cannot be resolved unless the underlying causes of this are fully explored and tackled head on.”