Mid Staffordshire Report Welcomed By HSMR Pioneer

Dr Foster's work on quality of care, including calculation of hospital standardised mortality rates (HSMRs), has played and will continue to play an important part in identifying and remedying failures in standards of care. We are pleased the report recognises the value of this work and endorse its recommendations.

The NHS leads the world in its commitment to the transparency of performance data. It was as a result of this commitment that Mid Staffordshire NHS Foundation Trust was highlighted as a failing hospital. There is still much work to do to improve patient safety and to understand why mortality rates vary so greatly between hospitals.

HSMRs are now accepted as an NHS standard for highlighting irregularities in performance, which can be used in conjunction with other indicators and information from patient groups to identify problem areas.

Roger Taylor, Research Director at Dr Foster said: "It is nearly twenty years since research first identified that lack of safety in medicine was costing thousands of lives every year. Since then progress has been made, but not at the speed patients have a right to expect. It is ten years since Dr Foster first start publishing hospital standardised mortality rates. While mortality rates have improved significantly over that period, there are still very wide unexplained variations between hospitals."

Dr Foster fully supports the recommendation for a single measure to be used across the NHS and we are pleased to accept Professor Sir Bruce Keogh's invitation to join the working group that will determine this. We also welcome the mortality statistics report by David Shahian and Sharon-Lise Normand, both of Harvard, who endorse the use of HSMRs alongside other warning flags.