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Mortality Indicators

Cwm Taf Morgannwg University Health Board (CTUHB) continues to work collaboratively with colleagues across NHS Wales to establish better ways of measuring clinical performance & outcomes and to learn & improve the quality of care. In addition, all mortality data for the CTMUHB is subject to regular/continuous internal analysis. Our analysis has not found any evidence of systematic failure in health care leading to excess mortality. The analysis reports are regularly submitted to and scrutinised by the Quality & Safety Committee, the Executive Board and the Health Board and most recently a report was submitted to the Health Board meeting in November 2015.

The Crude mortality data for CTUHB remains high due primarily to:

  • The lack of alternative end of life care arrangements for many patients just prior to death (in 2015, 62.4% of deaths in Cwm Taf Morgannwg area occurred on hospital sites compared with 54.6% average for Wales as shown in Mortality Indicator Reference No. 20).
  • The population high rate of co-morbidities linked to higher rates of Deprivation as shown in Mortality Indicator reference No. 21). This is also linked to the higher than Wales average crude deaths rate per 1,000 population as shown in Mortality Indicator reference No. 2).

Cwm Taf Morgannwg UHB has established an effective system of scrutiny to monitor patient safety and mortality which also provides a rich environment for multi-professional learning leading to improving quality of care. This process was referenced in the Summary Findings & Recommendation of Professor Stephen Palmer Independent Review – Recommendation No. 26 “Cwm Taf Morgannwg Health Board has an impressive and high visibility clinical case notes mortality review process in place giving considerable reassurance to the Board that high Risk Adjusted Mortality Indicator (RAMI) are not indicators of poor care”. Professor Stephen Palmer report

Cwm Taf Morgannwg’s approach to monitoring safety and quality of care is based on the recommendations of Professor Stephen Palmer Report and include:

  • Establishing a systematic mortality review process
  • Progressive improvement is being achieved
  • Cwm Taf Morgannwg is expected to submit performance reports regularly to Welsh Government regarding the timescales for the reviews
  • Monitoring and benchmarking of condition-specific mortality
  • Participation in National Audits
  • Improving data quality via improved clinical engagement