Friday, 24 March 2017

National statistics for stroke death rates show Royal Surrey has the lowest

Readers will know that it has been decided that there will be only two Hyperacute Units (HASUs) in West surrey i.e. St Peters and Frimley Park and that the HASU in the Royal Surrey will close. Those people in Guildford who have a stroke will now go to ST Peters and those south of Guildford e.g. Cranleigh will go to Frimley Park.

The rationale presented is that Surrey’s death rate is poor compared with places such as Inner London which has reorganised stroke services in to large centres and closed smaller ones. Thus Surrey should reorganise similarly.

This could be taken as implying that death rates in W Surrey hospitals are all worse than Inner London and, in so far as it is the HASU in Royal Surrey which will close, some may assume that it is the Royal Surrey’s death rate which is the worse. This is not so – read on.

NHS Digital is responsible for all national health statistics in the UK. Every year it publishes data on death rates within 30 days of emergency admission to hospital from stroke. The data is given for all providers (hospitals), Counties and Boroughs. Data is for every year since 2005/06 the latest being 2014/15 (the basis of figures below).

This data shows the death rate in inner London as 14,986 per 100,000. Surrey is 2.4% worse i.e. 15,347 (the consultation states 4.8% worse).

  • RSCH had 327 emergency admissions and 49 deaths. Death rate was 14,211. The deaths were 27% lower than would be expected looking at the country as a whole.
  • ASPH had 446 admissions and 70 deaths. Death rate was 14,843. Deaths were 20% lower than expected
  • FP had 827 emergency admissions and 132 deaths. Death rate was 16,412. Deaths were 9% lower than expected.
Thus, re death rates, RSCH was the best and both RSCH and ASPH death rates were lower than Inner London.

FP (which treats more than sufficient numbers to be counted as of optimum size, has most of the characteristics which are being sought e.g. 7 day 24 hour consultant presence and is a hospital rated excellent) had a very significantly worse death rate than Inner London.

RSCH is 5% better than Inner London, ASPH is 1% better and FP is 9.5% worse.

These figures do not in themselves alter the rationale for change based on London’s experience but it does show that the Royal Surrey was good at handling strokes despite whatever impression might otherwise be gained.

I am in active correspondence with the CCG about these figures but to date no explanation as the FP data has been received but note I am not knocking FP but really knocking on the head any impression that RSCH's performance has been inferior.

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