A report on 14 of the UK's hospital trusts with persistently high mortality rates has found that staff struggled to comprehend data to improve performances.
Professor Sir Bruce Keogh was asked by the Secretary of State for Health, and Prime Minister David Cameron, to conduct a review into the quality of care and treatment provided by the hospital trusts in question.
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There was scope for improvement in many areas, and one key area was in their use of data.
The report stated that only a few of the hospitals had a good understanding of the reasons for their high mortality figures. This contributed to them having weak or incomplete strategies for improving performance.
It said that the hospitals were often unaware of the data that was reported nationally on their own organisations, and challenged the validity of this, even if they provided the information themselves.
It pointed to three key areas which required action:
- The complexity of the data and the difficulties this presents for professionals, patients and the public who want to understand and use it;
- The shortage of key skills in data analysis and interpretation available to trust boards and management teams; and
- Consistency of metrics and information to be used to monitor quality on an ongoing basis.
Keogh said that the ambition for the hospitals is for the boards and leadership of provider and commissioning organisations to confidently and competently use data and other intelligence for "the forensic pursuit of quality improvement".
The trusts had often failed to cross-reference data from different sources to identify quality risks and target local improvement, the report said.
This was in a large part because the data is held in a fragmented way across the NHS and is difficult to use to benchmark performance.
Too often, the review teams witnessed boards using data for justification, Keogh said, to reassure them they were doing a good job, rather than attempting to understand the root cause of a problem or any inconvenient truths, thereby missing opportunities for improvement.
Key points in trying to improve the use of data, is for those that helped to pull together data packs produced for Keogh's review to continue to collaborate to produce a common, streamlined and easy to access data set on quality, which can then be used by providers, commissioners, regulators and the general public in their roles.
Keogh said that NHS England, the NHS Trust Development Authority and health care regulator Monitor should work together to streamline efforts to address any skills deficit among commissioners, NHS Trusts and NHS Foundation Trusts around the use of quantitative and qualitative data to drive quality improvement.
