Talking-up Scotland

 

‘Hundreds of patients have died waiting to be discharged from hospital since ministers made a landmark pledge to eradicate bed blocking from the NHS. More than 680 people died in hospital care while waiting to leave between March 2015 and September last year.’ (Scotsman 5.1.17)

Back in August, BBC Scotland, even, reported this:

‘Meanwhile fewer people are dying in Scotland’s hospitals. Between 2014 and this year, hospital mortality fell by 4.5% which is 3 000 fewer deaths than predicted.’ Reporting Scotland Aug 2016

The Scottish Government’s Information Services Division also published this in 2016:

Hospital Standardised Mortality Ratios

• The HSMR for Scotland has decreased by 7.0% between January to March 2014 (first quarter after new baseline) and April to June 2016.
• No hospitals had significantly higher standardised mortality ratios in April to June 2016 than the national average.
• Eight of the 29 hospitals participating in the Scottish Patient Safety Programme have shown a reduction in excess of 10% since January to March 2014

So, are Scotland’s hospitals getting better or worse? You could easily get confused when Anas Sarwar gets started. You see there’s something missing. How many died in the previous six months? Why hasn’t he revealed this? Is it because it was just the same or lower and so no use to him in his half-witted propagandising attempt to link the deaths to an SNP policy?

Under the Scotsman article this letter writer (the perceptive Huntly Loon!) did a fine deconstruction of the story revealing its complete pointlessness:

‘I find these statistics puzzle me a bit. People do die in hospital. The elderly do die. Does this report imply that if there had not been bed blocking the 680 persons would have gone home to their own houses or into a care home and lived? Or would they have died soon after getting home? It is expected that hospital patients will go home when their treatment is complete, but may it not often be the case that they are so ill with so little life expectancy that they stay in hospital receiving palliative care until they actually die there. We will find that with the increase in life expectancy and the demographic that we are facing an increasing number of elderly will end their lives in hospitals. We have to prepare for that and fund it appropriately. The integration of health and social care which is now in place in Scotland since April 2016 is designed to reduce bed blocking and seamlessly care for the elderly in sheltered accommodation or in their own homes, should address part of the problem, but it is also to be recognised that in the closing days of their lives a great many elderly will be admitted to hospital with no anticipation of any recovery and to be allowed a proper cared for death.’

I couldn’t have put it better myself. To add to the Loon’s impeccable logic and reasoning, here’s some actual evidence from a piece of research on a sample of Scottish hospitals, published in Palliative Medicine 2014, Vol. 28(6) to put the figures into perspective

‘We identified 10,743 hospital inpatients on the census date. More were women (54.7%) than men (45.3%). Most (64.1%) were aged 65 years or older. A disproportionate number of admissions belonged to the two most deprived quintiles (50.1%), and more patients had been admitted to a medical (63.1%) than to a surgical specialty (36.8%). 2.9% had died within 7 days of the census date, 8.9% by 30 days, 16.0% by 3 months, 21.2% by 6 months, 25.5% by 9 months and 28.8% by 12 months. We have shown in the Scottish context that almost 1 in 10 patients in teaching or general hospitals at any given time will die during that admission. Almost 1 in 3 patients will have died a year later, rising to nearly 1 in 2 for the oldest groups.’

Now, Anas hasn’t shared any percentages with us but his 680 cases in nineteen months doesn’t look that big if, in only a sample of 10 743 patients of whom 64.1% were 65 and over, 28.8% or 3 094 of them were dead within the year. This survey only looked at 25 out of Scotland’s 300 hospitals. There are 157 000 staff in NHS Scotland but for some reason I can’t seem to find a total patient population at any one time. I did find that there were 1 612 011 cases altogether in 2015/16. Either way, Anas Sarwar ( Why does that sound painful? Is it just me? Ring of fire?), is talking through a hole in his bahookie again.

Sources:

http://www.scotsman.com/news/hundreds-of-patients-die-waiting-to-be-discharged-from-hospital-1-4332090

http://www.isdscotland.org/publications/

http://www.bbc.co.uk/news/uk-scotland-37164244

http://www.dailyrecord.co.uk/news/scottish-news/scottish-hospital-admission-deaths-fall-9308341

Palliative Medicine 2014, Vol. 28(6) 474–479, Imminence of death among hospital inpatients: Prevalent cohort study David Clark, Matthew Armstrong, Ananda Allan, Fiona Graham, Andrew Carnon and Christopher Isles at: http://journals.sagepub.com/doi/pdf/10.1177/0269216314526443