Investigation urged over 'significant' number of unexpected patient deaths at Vale of Leven hospital

Between January and March this year, 55 patients died compared to the 33 predicted under the Hospital Standardised Mortality Ratio (HSMR) calculator - 67 per cent more than expected. In July to September 2016, mortality was 65 per cent higher than predicted when 42 patients died compared to 25 predicted. Both differences were rated ‘red’ by ISD Scotland, indicating that they are well above the national average and considered statistically significant.

Jackie Baillie, Labour MSP for Dumbarton, said the figures were “worrying” and must trigger “a complete rethink from the health board and the Scottish Government on its record of underinvestment at the Vale”.

She added: “Significant cuts to staffing and bed numbers have been imposed on the Vale of Leven Hospital in the last decade – the number of NHS staff working at the hospital has been slashed by 30 per cent and bed numbers are down by 38 per cent. In the last year alone the Vale has lost ten beds and seventeen nurses and midwives. The uncertainty caused by the constant threat of cuts and service closures is damaging for staff morale and puts patient safety at risk.”

Official statistics published on Tuesday revealed that, combined, deaths at the Vale and Royal Alexandra Hospital in Paisley were 13 per cent higher than predicted in the first quarter of 2017. ISD Scotland does not routinely publish the hospitals’ data separately, but can do on request. The detailed breakdown shows that, individually, the Vale has been red-flagged twice out of the last five available quarters going back to the start of 2016. The RAH, which has an A&E department, has not been rated “red” at all during the period.

Scottish Conservative shadow health secretary Miles Briggs said: “It would appear mortality rates at the Vale of Leven are in fact higher than the official figures suggested earlier this week. That will be alarming for patients, families and staff, who deserve to know exactly what’s going on here."

The HSMR is a warning system designed to alert hospital bosses and the watchdog to potential failings in patient care. It uses an algorithm to calculate how many deaths would have been expected to occur based on factors such patient demographics and severity of illness. However, red flags do not necessarily mean that the excess patient deaths were avoidable.

A spokesman for Healthcare Improvement Scotland said it was too early to say what was behind the figures, but that it would be investigated. He added: “If a hospital is identified as having either a mortality ratio that is significantly high or that is rising, then we initiate a formal dialogue about this with the NHS board.”

The Vale of Leven was previously in the spotlight over a notorious outbreak of clostridium difficile between 2007 and 2008, which sickened 143 patients and contributed to the deaths of at least 34.

A spokeswoman for NHS Greater Glasgow and Clyde said an initial review of latest figures had not highlighted any issues relating to patient care.

She said: "We have robust clinical governance arrangements in place to continuously monitor the quality of care and services at all of our hospitals, including the Vale of Leven Hospital.

"After the release of previous quarterly reports, where there was a higher than predicted mortality, our clinical teams reviewed a number of deaths at the Vale of Leven and since the release of further information they have carried out a rapid review for the first quarter of this year. They have found no issues raising concern and will continue with a more detailed review."

She added that an "urgent analysis" would be carried out into the way data has been recorded for patients both on admission and in the event of their death to ensure its accuracy and improve data coding processes.