The Care Quality Commission (CQC), which took over from the Healthcare Commission on 1 April 2009, has informed us that since July 2008, the Healthcare Commission considered 94 alerts. The reasons for the alerts were because data received by the Healthcare Commission suggested that the rates of mortality in relation to a number of specific clinical areas were statistically higher than otherwise would have been expected. Statistical alerts relating to mortality rates do not necessarily equate to problems with clinical care. The alerts could be caused as a result of poor data quality, chance events, differences in the complexity of conditions treated or there could be evidence of poor quality care.
Details of the alerts by patient group are contained in the following table:
Patient group Number Acute and unspecified renal failure 3 Acute bronchitis 3 Acute cerebrovascular disease 8 Acute myocardial infarction 2 CABG (complex, combined and repeat) 2 Cardiac arrest and ventricular fibrillation 1 Chronic obstructive pulmonary disease and bronchiectasis 2 Chronic renal failure 1 Chronic ulcer of skin 1 Complication of device, implant or graft 1 Coronary atherosclerosis and other heart disease 9 Deficiency and other anaemia 1 Elective cases (various groups) 1 Excision of lung 2 Fluid and electrolyte disorders 2 Fracture of neck of femur (hip) 1 Head injury with brain injury 1 Heart valve disorders 4 Hip replacement 1 Intestinal obstruction without hernia 3 Intracranial injury 1 Large intestinal disorders, aged below 70 years and without complications and comorbidities 1 Large intestinal disorders, aged over 69 years or with complications or comorbidities 5 Lobar, atypical or viral pneumonia without complications and comorbidities 1 Minor skin procedures 1 Multiple injury, aged below 70 years 1 Non-infectious gastroenteritis 4 Non-transient stroke or cerebrovascular accident, aged over 69 years or with complications or comorbidities 1 Operations on jejunum 1 Other circulatory disease 1 Other liver diseases 1 Other non-viral infections 1 Other operations on heart 2 Other psychoses 1 Perinatal mortality 1 Peripheral and visceral atherosclerosis 1 Peritonitis and intestinal abscess 2 Pleurisy, pneumothorax, pulmonary collapse 2 Pulmonary heart disease 3 Septicaemia (except in labour) 8 Spondylosis, intervertebral disc disorders, other back problems 1 Therapeutic endoscopic procedures on upper GI tract 1 Urinary tract infections 4 All patient groups 94
One of the CQC's first pieces of work is to review this programme and it will be publishing the action taken on these alerts as soon as this review has been completed.
The CQC will undertake a rigorous review of each alert it receives, drawing together all relevant information, including, for example, patient reported experiences. Consideration will be given to possible data anomalies and variations which could be producing the alert, and advice will be taken from clinicians and other experts. Where necessary, information about the alert will be sought from the organisations concerned.