I’ve stolen a really interesting graph from this weeks ‘Private Eye’, (don’t you dare yawn).
Their medical correspondent calls it the ‘death graph’, and I’ve posted it because it illustrates very well the effects of ‘coding’ in the NHS, or as big Phil from customer relations puts it;
It’s Ok, Boss -
I’ll Cooka Da books
You can take a look at my various postings about coding by going through the archive.
But, for example, if someone is coded as breaking a femur, emergency heart attack or stroke, if that patient dies it is unexpected and it makes the hospitals statistics look worse – it’s an indication that something is going wrong. Patients should survive those problems. Then alarm bells ring.
So, if someone comes in with a broken femur, dies, but also happens to have a terminal illness - alter the codes to palliative care…. and you are in the clear!
The dark blue line is the average for England – it goes from about 3 or 4 % in 2004 to about 17% in 2010. That’s pretty disturbing, because there is no reason for that to happen – unless the books are being cooked. It also means that this is happening everywhere, to some extent.
What’s worse are the lines for George Elliot, Mid Staffs, Walsall, and the average of all three. They all show a massive jump in the percentage of ‘Palliative care’ deaths for each hospital, something that just couldn’t happen. It happened when they discovered the advantages of changing the way their coding is done.
Walsall went from the national average of a few per cent to nearly 80% - so nearly everyone who died would have died anyway – pretty convenient.
It’s what Professor Jarman of ‘Dr Foster’ described as only possible if the hospitals had become ‘giant hospices’.
Being angry isn’t really enough for this because it means they covered up the figures instead of doing something about the problem. They also made money doing it.
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