(c) George Allison
Scottish hospital deaths fall by 14 % despite increased demand and rising crude mortality rates
From the Information Services Division, NHS Scotland on 14th May 2019:
‘HSMR Hospital Standardised Mortality Rate at Scotland level has decreased by 14.0% between January to March 2014 (first quarter after new baseline) and October to December 2018. Unadjusted hospital mortality had been falling from a level consistently around 3% prior to the baseline period used to calculate the HSMR; however since the end of this baseline period crude rates have seen a slow increase, exhibiting clear seasonal patterns leading up to the most recent winter period (October 2017 to March 2018.’
Rising crude mortality rates
Crude mortality rates are increasing yet hospital deaths are falling? This can be taken as evidence of improved practice and outcomes for NHS Scotland. Against the odds, they are reducing mortality.
The above data and table show that the challenge faced by Scottish hospitals in terms of the underlying tendency to die of those being admitted has been pretty constant over the last ten years and has even been climbing again recently. On top of that, hospitals have faced significant increases, up to 43% in only 5 years, in the demand for treatment.
Rising demand
The above table shows that the demand over the last five years has been increasing across a range of measures and, in terms of the number of people coming forward, has increased dramatically.
More complex and difficult conditions?
This is more difficult to demonstrate definitively but the notion is widely accepted. See this:
‘In Scotland we are living longer, healthier lives. But we want to remain healthier for longer and ensure that the benefits of longer, healthier lives are felt fairly by all sections of our society. This means that our health and social care services need to adapt to the challenges of a 21st century Scotland, to the issues of health inequality, increasing demand for services, multiple long-term conditions, complexity of care and resource pressures.’
http://www.healthsocialcare.scot/about/
So, I think we can say with some confidence that the 14% reduction in the Hospital Standardised Mortality Rate suggests evidence of a strong improving trend in Scottish hospitals. Over to you BBC Scotland.
Footnote: Why are crude mortality rates rising? Why are more Scots dying? Over to you Ruth.
Talking-up Scotland 
The Herrod headline was about the first rise in 50 years in deaths due to heart conditions. It was mentioned on Good Morning Scotland, but not on the BBC Scotland page, although there is a fairly nuanced article on the Health page. The report by the British Heart Foundation relates to the whole UK, but, was there a hint of glee when the Herrod pointed out that the increase in Scotland was TWICE the RATE of the UK’s?
Now, the BBC Health refers to the NUMBERS of deaths and attributes this partly to the rising population and reports that the trend,instead of continuing to fall has levelled out.
While the BHF is a reputable and worthy organisation it is as prone as other organisations to emphasise some statistics when making appeals for funding.
The Herrod report was not particularly overstating the argument, but the front page, apart from the death of Doris Day, all reflected badly on Scotland. It was an example of the drip-drip-drip approach.
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