Hospitals in the West Midlands altered the way they recorded patient deaths to improve their mortality rates, it has been claimed at a public inquiry.
Giving evidence into the probe into failings at Stafford Hospital, where between 400 and 1,000 people died because of appalling standards, Professor Brian Jarman, of the Dr Foster Unit, which produces mortality data for hospitals, said two West Midlands trusts had used coding to alter their data.
He named Stafford and Walsall as two trusts who began coding deaths as palliative care deaths leading to a drop in their Hospital Standardised Mortality Rates (HSMR).
In Stafford the HSMR has reached as high as 125, above the national standard of 100.
However, following a change in the coding rules in March 2007, which allowed palliative cases to be recorded, Walsall and Stafford palliative codes rose from eight percent to 46 per cent, compared with a national rise of six per cent to nine per cent.
In Walsall during 2008, 78 per cent of deaths were logged as palliative cases.
Prof Jarman told the inquiry: “There’s no doubt around a nine percent reduction (in HSMRs) would have been related to a change in palliative care coding.
“It was a factious change, not genuine, I don’t think it could represent reality.
“The only way they could get that to be genuine change is of they became terminal illness hospitals over night which I know they didn’t.”
Speaking after giving evidence, he said the change in 2007 was like giving hospital trusts a gun.
He said: “It’s like saying to them “you can do what you like.”
During his evidence Prof Jarman also said the actions of the Strategic Health Authority in trying to discredit the mortality figures instead of address them had driven him “wild.”
Following publication of mortality data for Stafford Hospital, the SHA commissioned a study from Birmingham University to challenge the figures.
Former SHA boss Cynthia Bower told the inquiry earlier she had commissioned the study because nobody had scrutinised the mortality data.
However Prof Jarman said the SHA could have approached him to discuss the figures.
He said: “People were dying, it’s not as if we were dealing with something financial or making widgets.
“The SHA should have come to us a we could have don a calculation for them to present our point of view.
“It’s disgusting.”
