Stafford Hospital - Are we seeing it straight

8/7/2019 Stafford Hospital - Are we seeing it straight

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How can we see what

is happening in the

health service?

What do we reallyknow?

Is it just about

Stafford ?



Lets start at the beginning!

� There must have been more words written

about Stafford Hospital than any other

hospital in the country. but:

� Do we know what happened?

� Do we know what we think we know?



What forms our

perception of Stafford

Hospital?

Press

Politics

Pressure Group

Expert opinion

Coding anomalies

Coding systems

The

Hospital

NHS

We cannot see what

happens in our hospital

directly.

We see it through aseries of filters.

For most people the

perception is formed by

what the press say.



The NHS as awhole

NHSIncreased pressures

from ageing society.

More complex and

costly treatments &

Greater patientexpectation.



StaffordHospital

StaffordHospital

NHS

Some specific

problems. Mainly

down to staffing

levels and mix in

relation to case load.Other more complex

problems.



DevelopingCoding systems

Developing

coding systems

Stafford

Hospital

NHS

The need to monitor

NHS quality leads to

the increased use of

coding systems.

All statistical systemsgive an imperfect

picture.

Dr Foster system has

some inherent

weaknesses.



Codinganomalies

Coding Anomalies

Developing

coding systems

Stafford

Hospital

NHS

Dr Foster system

imperfectly

understood. Coding

throughout the

country is of poorquality.

Stafford is no

exception



The HSMRfigures.

The HSMR figures

Coding Anomalies

Developing

coding systems

Stafford

Hospital

NHS

HSMR figures for

2007 put six West

Midlands Hospitals

into the spotlight.

SHA begins to try andfind out why.



Expert opinionon HSMR

Expert opinion on HSMR and

coding

The HSMR figures

Coding Anomalies

Developing

coding systems

Stafford

Hospital

NHS

The expert opinion is

that the high HSMR

figures for Stafford

are largely explained

by poor coding,intrinsic weakness of

statistical system and

caseload mix.



Emergence of pressure group

Emergence of pressure group

HSMR & interpretation

Coding

Stafford

Hospital

NHS

The Stafford Hospital

pressure group

emerges in 2008 due

to frustration of a

small group of patients with

complaints system

and staffing

shortages.



Experts

respond to

pressure group

Experts respond to pressure

group

Start of pressure group

HSMR & response

Coding

Stafford

Hospital

NHS

Contact with the

pressure group

prompts expert

investigation of their

concerns.



Politicalinterest

Political interest

response to pressure group

Pressure group

HSMR

Coding

StaffordHospital

NHS

Bill Cash supports

pressure group with

media campaign.



The Healthcare

commission

report

Healthcare commission report

Political and press interest


Pressure group

HSMR

Coding

StaffordHospital

NHS

The spotlight is on

the hospital as The

healthcare

commission

publishes its report



The Excessdeath figures

The Excess death figures




Pressure group

HSMR

Coding

Stafford

Hospital

NHS

Misinterpretation of

an unpublished

appendix to the HCC

report leads to

speculation of 400-1200 excess deaths

and sparks

international media

sensation.



PoliticalFootball

Political football





Pressure group

HSMR

Coding

Stafford

Hospital

NHS

The coverage of the

hospital dominates the

local press from release

of HCC report in 2009

through to the electionsof 2009 and 2010.

Political statements

heighten public anxiety.



Growth of thepressure group

Growth of the pressure group

Political football




Response to pressure group

Pressure group

HSMR

Coding

Stafford

Hospital

NHS

The level of publicity and

high level political

patronage leads to the

growth of the hospital

pressure group bothlocally and nationally.



Expert

response

More reports.

Expert response More reports.


Political football




Responce to pressure group

Pressure group

HSMR

Coding

Stafford

Hospital

NHS

The combined pressure

of press, pressure group,

& political football lead

to Alberti, Colin Thome,

and the Independentinquiry. From April 2009-

Feb 2010



Press continueto tell the story

Press interest grows



Political football





Pressure group

HSMR

Coding

Stafford

Hospital

NHS

At local level the hospital

story remains the

dominant story in the

press, with hundreds of

articles published.Most of these repeat or

imply the excess death

figures.



The build up to

the general

election

Build up to general election

The press continue to tell the story



Political football




Experts respond to pressure

group

Emergence of pressure

group

HSMR

Coding

Stafford

Hospital

NHS

The NHS becomes the

key theme of the 2010

election campaign.

Stafford is used by

ConservativeCommunications to

assert the failure of the

NHS under Labour.



Justifying

radical change

to NHS

Conservatives use Stafford to Justify Andrew Lansleys health bill.





Political football





Pressure group

HSMR

Coding

Stafford

Hospital

NHS

The Stafford Pressure

group are key speakers at

Conservative Party

Conference.

Stafford is used to justifycall for radical change to

NHS.

Inquiry is intended to

prove need for change.



The inquiry

The Inquiry

Conservatives use Stafford to Justify Andrew Lansleys health bill.





Political football





Pressure group

HSMR

Coding

StaffordHospital

NHS

The Inquiry is discovering

more about what

happened in Stafford,

and the difficulties

involved in seeing thequality of our hospitals.

Its findings may not

endorse the Health Bill.



What next forthe Press?

What next for the press?

The Inquiry

Conservatives use Stafford to Justify Lansleys health bill.





Political football





Pressure group

HSMR

Coding

Stafford

Hospital

NHS

The press coverage

remains high, but

remains focused on the

personal stories.

Public dont hear aboutthe issues.

Can the press help with

the challenge of

explaining?



What next forthe Hospital?

What next for the hospital

What next for the press?

The Inquiry

Conservatives use Stafford to Justify Lansleys health bill.





Political football





Pressure group

HSMR

Coding

Stafford

Hospital

NHS

We continue to need our

hospital.

The Hospital needs us to

see the story inperspective.



Stafford Hospital is my hospital.

The hospital has been in the spotlight for a complex mix of reasons.

Some of this is about real problems that needed to be addressed,

Some of it is because we could not see the truth directly.

We were seeing it through a series of filters.

The Inquiry is addressing the complex question of how we can monitor the quality of

our Health service.

The next question we will need to ask is this.

What is the quality that we want to see, and how are we prepared to fund it?

Documents

Stafford Hospital - Are we seeing it straight