Trust 'must improve heart surgery'

A hospital which had some of the highest death rates among heart patients in the UK has been told by health watchdogs it needs to do more to improve its practices.

In the 1980s, the Oxford Radcliffe Hospitals NHS Trust had one of the best cardiothoracic units in the country but since the late 1990s, concerns have been raised about the number of fatalities among patients undergoing routine bypass surgery.

The Healthcare Commission started investigating in November 2005 after it emerged that the number of trust patients who died between April 2002 and March 2005 after their first coronary artery bypass graft (CABG) was more than double the national average - 4.01% compared with 1.83%.

It found that once risk factors such as age or ill-health were taken into account, the rates were "just within acceptable statistical limits".

The trust, the commission said in its report, took on more of such high-risk patients than other trusts. But the investigation found that even with these patients taken into account, the death rates were still higher than average and spread across high and low risk patients.

The report said: "The cardiothoracic unit had rates of mortality for CABG that were higher than other comparable units and that should have prompted an open and questioning response to make certain that everything was being done to ensure the safety of patients.

"While there was evidence of this attitude in the nursing teams, the cardiothoracic surgeons believed that any data showing poor results were inaccurate and not properly adjusted for risk.

"So although they did react to the published results that showed their rates of mortality to be high, they did so by reviewing the data used rather than looking at possible shortcomings in their clinical care or techniques for the care and treatment of patients."

A spokesman for the Healthcare Commission said that instead of criticising the data, the trust should have looked more closely at the causes of the high mortality rates.

The trust's chief executive Trevor Campbell Davis said it would now focus on regaining its reputation as a leader in the field of heart surgery.

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