Hospital safety – a quick guide to the data

14 October 2013

As part of a move towards providing more transparent information on NHS patient safety and quality of care, 30 September 2013 saw the launch of the Welsh Government’s My Local Health Service website. The site currently provides data at Health Board level that includes:

  • hospital mortality rates, including Risk-Adjusted Mortality Index (RAMI), and mortality from heart attack, stroke and hip fracture;
  • hospital-acquired infections, and;
  • nurses per available bed.

The site allows useful comparison of information of data across Health Boards, though in some areas more context would be helpful. For example, information relating to nurses per available bed shows how one Health Board’s nurse to bed ratio compares to another’s, but doesn’t indicate what the ‘target’ or recommended ratio is.

The Welsh Government’s intention is to develop the site to include more detailed information at individual hospital and general practice level.

Some information – relating to infections and mortality – is already published at hospital level in Wales. From July 2013, information on the numbers and rates of healthcare associated infections is published on Health Boards’ websites. This followed the publication of Risk Adjusted Mortality Index (RAMI) data in March this year.

RAMI is the measure by which hospital mortality rates are currently monitored in Wales. It is however intended to be used by individual Health Boards to monitor progress over time, rather than for use as a comparator (differences in service configuration and data quality, for example, may result in wide variations in RAMI scores across different hospital sites).

Different measures of hospital mortality – the Hospital Standardised Mortality Ratio (HSMR) and the Summary Hospital-level Mortality Indicator (SHMI) – are in use in England, making cross-border comparison of performance even more difficult.

More detailed explanation of mortality indicators and their limitations is provided in a Welsh Government statistical article.

Article by Philippa Watkins