Monday, 4 March 2013

Health coders working 'miracles'



It’s Ok, Boss -

I’ll Cooka Da books

–all over again !

This is an article from the mail online (Daily Mail) as updated in their Sunday edition.  A whistle-blower is claiming that she was hired to fix the death rates by putting admissions down as ‘palliative care’ that means that the only treatment is to make you comfortable until you die. Those deaths do not then count as part of the standard mortality rates.

What she says about the alleged fraud at Wolverhampton may be true or false (and it is denied), however this direct quote is really chilling; 

“Chief executive David Loughton said ‘every Trust in the country looked to Mid Staffs’ at the time to learn how to reduce death rates”

 – this is referring to the trust that had up to 1200 needless deaths and which chose to ‘sort out’ its statistics instead of saving lives.


Mail Online

PUBLISHED: 22:02, 1 March 2013 | UPDATED: 16:09, 2 March 2013  

A whistle-blower claimed last night that she was hired by an NHS hospital to fiddle its shocking death rates.

As hundreds of patients died needlessly, Sandra Haynes Kirkbright says she was headhunted by hospital bosses and asked to 'fix' the figures. She claims 'every rule in the book' was broken to try to improve mortality rates – without saving lives.

The data recorder says she was suspended after refusing to take part in a cover-up, and even claims she was ordered not to put her concerns in writing in case they reached the Press.

The astonishing allegations – which are denied by the hospital – have emerged days after the chief executive of another NHS Trust, in Bolton, was forced aside over a possible cover-up of high death rates. Experts have warned similar incidents could be happening in hospitals across the country.

The fresh allegations are yet another blow for NHS chief executive Sir David Nicholson, who refuses to resign despite widespread condemnation from MPs, doctors and patients since last month’s damning Mid Staffordshire report.

Mrs Haynes Kirkbright was hired by the Royal Wolverhampton Hospitals NHS Trust as a ‘health coder’, an administrative role which involves recording data detailing patients’ care in hospitals. Coders do not need medical qualifications, leading critics to argue that they have disproportionate power to affect how hospitals are seen to be performing.

Mrs Haynes Kirkbright, from Texas, said she was approached following concerns over the shocking number of weekend deaths, which had contributed to the Trust scoring one of the highest mortality rates in the country.

Damning: Mrs Haynes Kirkbright added that patient care at Wolverhampton was as bad or worse as at scandal-hit Stafford Hospital. She said she ‘wouldn’t even send a dog’ to Royal Wolverhampton Hospital and claims patient care was as bad or worse as at scandal-hit Stafford Hospital, where as many as 1,200 patients died needlessly. But instead of making efforts to improve care, bosses at the Trust were convinced that the high death rate could be ‘fixed’ by fiddling statistics, she said.

She claimed they offered to almost double her salary to £54,000 a year to distort mortality figures, mistakenly believing she had been doing the same at her former employer, Stafford.

‘They wanted me to fix it. But they didn’t want me to fix it properly,’ she said. She took the job in October 2011 – but said that when she realised what hospital bosses wanted her to do, she refused. However, she claimed others at the Trust were ‘breaking every rule in the book’.

For example, recording that a patient was being treated by the palliative care team means their death, effectively, does not alter the mortality rate, because it is classed as unavoidable.

She claims the Trust used any excuse to code patients’ deaths as unavoidable, even if they were never seen by palliative care doctors. The Trust angrily denies this claim – yet between 2009 and 2011, Wolverhampton’s death rate dropped by 13 per cent, from very worrying levels to the national average. This coincided with the number of deaths recorded as ‘palliative care’ soaring from 2.19 per cent to 20.3 per cent, about double the national average.

The whistle-blower said the Trust also hired an independent company in 2011 to advise coders on how to make deaths count for less on the mortality score – yet said she made sure this was not acted on. And she also claims she accused bosses of fraud as the Trust was making money by charging the local Primary Care Trust for expensive procedures they had not done.

In response, she says a senior figure warned her not to put allegations in writing because ‘the Press can get hold of it through Freedom of Information’. After four months at the Trust, Mrs Haynes Kirkbright was suspended for alleged bullying and harassment – which she denies. She says the real reason she was suspended was to silence her.

She is still suspended pending a disciplinary hearing, but decided to speak out despite fearing the repercussions. The Royal Wolverhampton NHS Trust strenuously denied Mrs Haynes Kirkbright’s allegations.

Chief executive David Loughton said ‘every Trust in the country looked to Mid Staffs’ at the time to learn how to reduce death rates – but denied hiring Mrs Haynes Kirkbright to ‘fiddle’ death rates.

‘We categorically deny the allegations,’ he said. ‘The suggestion of any wrongdoing is simply not true. Improvements in the hospital’s mortality rates have been audited and independently verified.’ The Trust admitted, however, they had been coding against national guidelines, but said they corrected this as soon as they became aware of the mistake. The Trust added that it was ‘categorically false’ to suggest palliative care patients had been coded incorrectly to alter overall death rates. They explained the fall by saying 200 fewer patients had died.


The trouble is, if the statistics are fixed, there is no way to monitor what is happening.

Neil Harris

(a don’t stop till you drop production)

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