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The BBC's Daniel Sandford
"The man who led the research was surprised by his findings"
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Patients' Association's Katherine Murphy
"It's the patient's right to have this information"
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Prof Sir Brian Jarman, report author
"We've trid to make the adjustments as accurate as we possibly can"
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Sunday, 14 January, 2001, 08:43 GMT
Postcode lottery in death rates

A new study of the NHS in England suggests that a patient's chances of survival can be affected largely by where they live.

Walsall NHS Trust in the West Midlands had the highest death rate in England, while University College London Hospitals had the lowest, the survey suggests.

Three-quarters of the hospitals with the lowest death rates were in the south of England and inner London was found to have the lowest mortality rate of any region.

The guide, compiled by the Sunday Times and Dr Foster, an independent publisher of healthcare information, has been welcomed by the British Medical Association and the NHS Confederation.

Health Secretary Alan Milburn
Alan Milburn: "Secret society"
Health Secretary Alan Milburn said the NHS had to accept that its users had a right to information about its performance.

"The NHS has acted like a secret society. It has to recognise that people now expect to be treated like consumers," said Mr Milburn.

The survey found that 17 patients in Walsall were dying for every 10 who died in the London hospitals trust.

'Proud of hospital

The trust's chief executive, John Rostill, said its board would be meeting on Sunday to discuss the report.

He told BBC Radio 5 Live: "I think it's terrible that the headlines say 'Death rates reveal worst hospital'.

"I think the general public in Walsall are rightly proud of their hospital. We are a very good hospital and I wouldn't want this particular figure to be seen out of perspective.

Highest mortality ratios (average 100)
Walsall Hospitals 119
Mid Essex Hospitals 117
Sandwell Healthcare (W.Mids) 117
Heatherwood and Wexham Park Hospitals 115
West Cumbria Healthcare 115
George Eliot Hospital (W.Mids) 114
Mid Cheshire Hospital 114
"Clearly we have got to do a lot more work on it."

The index was based on research by Sir Brian Jarman, emeritus professor at Imperial College, and took into account distorting factors of age, sex diagnosis, emergencies and length of stay.

The mortality ratio is a measurement of deaths adjusted for certain factors such as the mix of cases handled.

The best hospitals employed more than six times the number of doctors per bed as others, researchers found.

Sir Brian said: "We have tried to be as fair as we can. One thing is clear. We need more doctors."

'Accurate measure'

Sir Donald Irvine, president of the General Medical Council, described the guide as "the most authoritative and accurate measure of hospital standards".

The A-Z guide gives patient death rates and doctor-bed ratios for 174 NHS hospital trusts in England.

The guide's authors stress that it is not an overall league table of the best and worst hospitals, but instead gives a strong impression of the strengths and weaknesses of each establishment.

Lowest mortality ratios (average 100)
UCLH (London) 68
Bart's and The London 70
Ropyal Free Hampstead 79
Royal West Sussex 81
Chelsea and Westminster 82
Guy's and St Thomas's 82
Airedale (W.Yorks) 84
The analysis of more than 100 million hospital admissions over 10 years showed that overall mortality rates were falling and most hospitals performed around the average.

But a number of hospitals departed significantly from the average, with a 75% variation in death rates across England.

Oxford Radcliffe Hospitals NHS Trust was the best staffed trust, with 70 doctors for every 100 beds.

The worst staffed was the North Devon Healthcare Trust with 11.

A Department of Health spokeswoman said the information used to compile the guide was already in the public domain, in the form of clinical indicators published by the department.

If necessary, an external investigation team would be brought in to look at the situation in Walsall, he said.

A spokeswoman for University College London Hospitals said: "Given the very difficult case mix that is referred to UCLH, this is a testament to the hard work of the staff and the high standards of clinical excellence."

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See also:

14 Jan 01 | Health
Walsall defends its record
10 Jan 01 | UK Politics
Labour short on two 'early pledges'
19 Dec 00 | Health
'Thousands more GPs needed'
15 Nov 00 | Health
NHS inspectorate shows its teeth
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