13000 Deaths - Keogh
Discussion
http://news.sky.com/story/1115436/up-to-13000-need...
So much money being spent on the NHS, and then we hear more stories like this.
People should be put in prison for this.
So much money being spent on the NHS, and then we hear more stories like this.
People should be put in prison for this.
He has a point though.
If you ignore the headline grabbing figure, 13,000 possible excess deaths (with a very wide margin for error on that estimate) in 14 trusts over 8 years. So approx 100 excess deaths per trust per year, most of which will treat 10's of thousands of patients a year. The figure is also altered based on standardised mortality, code your co-morbidities wrong and you could create that 100 per year figure out of thin air very easily.
I'm not saying there aren't problems in the NHS but it is foolish to not treat this figure with a pinch of salt.
If you ignore the headline grabbing figure, 13,000 possible excess deaths (with a very wide margin for error on that estimate) in 14 trusts over 8 years. So approx 100 excess deaths per trust per year, most of which will treat 10's of thousands of patients a year. The figure is also altered based on standardised mortality, code your co-morbidities wrong and you could create that 100 per year figure out of thin air very easily.
I'm not saying there aren't problems in the NHS but it is foolish to not treat this figure with a pinch of salt.
Sevo said:
He has a point though.
If you ignore the headline grabbing figure, 13,000 possible excess deaths (with a very wide margin for error on that estimate) in 14 trusts over 8 years. So approx 100 excess deaths per trust, most of which will treat 10's of thousands of patients a year. The figure is also altered based on standardised mortality, code your co-morbidities wrong and you could create that 100 per year figure out of thin air very easily.
I'm not saying there aren't problems in the NHS but it is foolish to not treat this figure with a pinch of salt.
Except that, even within the sample, it's not quite like that. Smoothing out the above-expectation death rates isn't helpful when they're concentrated on two or three locations such as Stafford and Basildon & Thurrock. These centres of non-excellence need urgent action. Averaging the data massages away the reality of localised failure and is inappropriate. If you ignore the headline grabbing figure, 13,000 possible excess deaths (with a very wide margin for error on that estimate) in 14 trusts over 8 years. So approx 100 excess deaths per trust, most of which will treat 10's of thousands of patients a year. The figure is also altered based on standardised mortality, code your co-morbidities wrong and you could create that 100 per year figure out of thin air very easily.
I'm not saying there aren't problems in the NHS but it is foolish to not treat this figure with a pinch of salt.
I'm not surprised, the general consensus about stafford is there but for the grace of god...
All the hospitals have becomes obsessed about numbers and targets, it's the culture which has now been hammered into the nhs, so now the hospitals spend obscene amounts of money trying to hit targets rather then looking after patients. The people who run the hospitals ie the directors, managers and upper level nurses are rotten with laziness, corruption, incompetence, self promotion, cronyism. They play a political game to feather their own nests, secure their own position and make sure the s
t lands on someone else when it eventually comes. This is also sadly true of some of the new breed of senior docs.
I work in A&E which acts as a pretty good indicator of how well the hospital is run vs demand, they are all at breaking point, unless something major is done, we may get through this winter, we may even squeak through the next one, but in the next few years unless there is wholesale change, it will all collapse and we'll be looking at thousands of deaths.
I love the idea of the nhs, i love the idea of healthcare free at the point of delivery, but for the first time ever I'm not sure the NHS is the answer and is fit for use.
The irony of the targets is how pointless they are, they would make sense if there were true competition between hospitals, but for competition you need spare capacity. If the only supermarket in the town is Tescos and the nearest other supermarket is 20 miles away, people will go to the local store no matter how long the queues are.
The country as a whole needs to decide what it wants with the NHS, what should it provide, what shouldn't it, who pays what. We should have an open and frank discussion and then if necessary have a referendum. Once it's agreed, fund it appropriately and then insulate it from political meddling.
The other thing people have to realise is, everybody dies and all medical care ends in failure.
All the hospitals have becomes obsessed about numbers and targets, it's the culture which has now been hammered into the nhs, so now the hospitals spend obscene amounts of money trying to hit targets rather then looking after patients. The people who run the hospitals ie the directors, managers and upper level nurses are rotten with laziness, corruption, incompetence, self promotion, cronyism. They play a political game to feather their own nests, secure their own position and make sure the s
t lands on someone else when it eventually comes. This is also sadly true of some of the new breed of senior docs.I work in A&E which acts as a pretty good indicator of how well the hospital is run vs demand, they are all at breaking point, unless something major is done, we may get through this winter, we may even squeak through the next one, but in the next few years unless there is wholesale change, it will all collapse and we'll be looking at thousands of deaths.
I love the idea of the nhs, i love the idea of healthcare free at the point of delivery, but for the first time ever I'm not sure the NHS is the answer and is fit for use.
The irony of the targets is how pointless they are, they would make sense if there were true competition between hospitals, but for competition you need spare capacity. If the only supermarket in the town is Tescos and the nearest other supermarket is 20 miles away, people will go to the local store no matter how long the queues are.
The country as a whole needs to decide what it wants with the NHS, what should it provide, what shouldn't it, who pays what. We should have an open and frank discussion and then if necessary have a referendum. Once it's agreed, fund it appropriately and then insulate it from political meddling.
The other thing people have to realise is, everybody dies and all medical care ends in failure.
turbobloke said:
Except that, even within the sample, it's not quite like that. Smoothing out the above-expectation death rates isn't helpful when they're concentrated on two or three locations such as Stafford and Basildon & Thurrock. These centres of non-excellence need urgent action. Averaging the data massages away the reality of localised failure and is inappropriate.
True, to a degree. The "NHS kills 13,000" headline isn't helpful though, nor likely to be even close to accurate, as I described. Standardised Mortality figures are very easy to totally mess up, they should be used for surveillance to trigger further investigation, they shouldn't be used to extrapolate up to attention grabbing figures. Unless you are hoping to privatise the NHS and make you and your mates vast sums of money...The headline is there to sell papers. It no more galling than the "Envy of the World" crap we get peddled by the left each time.
Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.
I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.
Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.
I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.
I always worry about how they work out how many SHOULD die - because they need to know that as a fairly certain figure before they can state that 13,000 SHOULDN'T have died.
I am not that interested in debating the rights or wrongs of the NHS. I am more concerned about how these types of statistics are calculated and how base-line "OK death rate" figures are arrived at.
It's a pity "More or Less" is of the air at the moment.
I am not that interested in debating the rights or wrongs of the NHS. I am more concerned about how these types of statistics are calculated and how base-line "OK death rate" figures are arrived at.
It's a pity "More or Less" is of the air at the moment.
Eric Mc said:
I always worry about how they work out how many SHOULD die - because they need to know that as a fairly certain figure before they can state that 13,000 SHOULDN'T have died.
I expect it's simply empirical, with the baseline being the mortality for comparable cases in either a typical hospital or in the best performing hospitals. No different to calculating excess mortality in a heatwave by comparison to average mortality for the time of year.grumbledoak said:
The headline is there to sell papers. It no more galling than the "Envy of the World" crap we get peddled by the left each time.
Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.
I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.
Can't say I agree with this. If we had free only a&e I would either be bankrupt or dead.Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.
I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.
As for buying votes.. seriously?
vonuber said:
grumbledoak said:
The headline is there to sell papers. It no more galling than the "Envy of the World" crap we get peddled by the left each time.
Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.
I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.
Can't say I agree with this. If we had free only a&e I would either be bankrupt or dead.Bits of it are very good: A&E is fantastic and should be free at point of use. Much of the rest is poor: how many people would pay a plumber in full up front? And if he was the only plumber in town, what sort of service would you get? Quite. But what the NHS is mostly is 1.7 MILLION bought-and-paid-for Labour voters, and the Unions will fight tooth and nail to prevent any change there.
I don't love the idea of the NHS. I don't generally believe that collectivist ideas are "perfect ideas spoiled by people" - I believe that they are more often rotten ideas promoted by ruthless politicians to gain power for themselves: "Free at point of use" is just "Tragedy of the commons". IMO we should move to free A&E/walk-in, and private for everything else.
As for buying votes.. seriously?
And as for voting labour, I think not, the majority of my colleagues strike me as conservative voters, I'm a life long conservative (although currently re-evaluating that).
otolith said:
Eric Mc said:
I always worry about how they work out how many SHOULD die - because they need to know that as a fairly certain figure before they can state that 13,000 SHOULDN'T have died.
I expect it's simply empirical, with the baseline being the mortality for comparable cases in either a typical hospital or in the best performing hospitals. No different to calculating excess mortality in a heatwave by comparison to average mortality for the time of year.
- can, among other things, also predict GCSE grades in individual subjects for individual pupils based on a massive pile of individuals' parameters (personal, demographic and performance etc) going back to primary school.Other "predictive programmes" for schools' and pupils' outcomes are also available; I assume the same is true in terms of such services avalable for the NHS (if not its clients) (but I'm not sure on this point).
Sevo said:
He has a point though.
If you ignore the headline grabbing figure, 13,000 possible excess deaths.....
Excuse me, it says 'Up to 13,000 deaths'.If you ignore the headline grabbing figure, 13,000 possible excess deaths.....
The actual figure could be 7 deaths, but 13,000 sounds much better in the news.
At least they didn't say 'up to 13,000, or more' which is the usual vague drivel that is published.
aw51 121565 said:
otolith said:
Eric Mc said:
I always worry about how they work out how many SHOULD die - because they need to know that as a fairly certain figure before they can state that 13,000 SHOULDN'T have died.
I expect it's simply empirical, with the baseline being the mortality for comparable cases in either a typical hospital or in the best performing hospitals. No different to calculating excess mortality in a heatwave by comparison to average mortality for the time of year. - can, among other things, also predict GCSE grades in individual subjects for individual pupils based on a massive pile of individuals' parameters (personal, demographic and performance etc) going back to primary school.Other "predictive programmes" for schools' and pupils' outcomes are also available; I assume the same is true in terms of such services avalable for the NHS (if not its clients) (but I'm not sure on this point).
The whole financial system is based on such "maths" - and look what happened there.
Eric Mc said:
aw51 121565 said:
otolith said:
Eric Mc said:
I always worry about how they work out how many SHOULD die - because they need to know that as a fairly certain figure before they can state that 13,000 SHOULDN'T have died.
I expect it's simply empirical, with the baseline being the mortality for comparable cases in either a typical hospital or in the best performing hospitals. No different to calculating excess mortality in a heatwave by comparison to average mortality for the time of year. - can, among other things, also predict GCSE grades in individual subjects for individual pupils based on a massive pile of individuals' parameters (personal, demographic and performance etc) going back to primary school.Other "predictive programmes" for schools' and pupils' outcomes are also available; I assume the same is true in terms of such services avalable for the NHS (if not its clients) (but I'm not sure on this point).
The whole financial system is based on such "maths" - and look what happened there.
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