Aug 24, 2023Liked by Mr Law, Health and Technology
I see the Daily Mail are now reporting on more numbers!! Is this to whip up a further frenzy in light of the article on Miscarriage of justice gaining momentum ?
I would like to see a time series of the annual number of deaths of neonatals at CoCH. I saw a list of numbers somewhere, and it was clear there was a big bump in 2015 and 2016, sorry, I forget where. Of course, the official numbers in any particular source mean nothing on their own, because of all the issues you discuss, and because they need to be related to the size and characteristics of the population they are an immediate part of, the admissions to the hospital or unit - but they do form public perception both in and outside the system. It was the same with Lucia de Berk, Ben Geen, and more such cases.
Q.: why and when was CoCH NICU upgraded to level-2 ? Was that not way beyond their abilities ? Who came up with that idea ? What improvements were made to make it possible ? Etc.
We understand that the level 2 designation was adopted by the hospital itself several years earlier. Maybe when this grading system was introduced. Also, they raised money to buy stuff. Lucy was the face on the campaign posters and brochures. Brearey was the neonatal lead. Staffing levels were never brought into line with the designation. At the same time they were busy getting rid of higher paid older nurses.
I wonder if something sensible could be said using a combination of Hospital Episode Statistics and ONS mortality data, but reporting it at CCG level if possible. That way it wouldn't matter what hospital the neonate died in, they could still be identified and included. The local authority public health teams tend to have data analysts with access to this stuff. Or the CCGs themselves might. But, no idea how feasible it is that they'd do it. It's important to take a public health type population approach to see if there are real differences rather than just changes in what hospital babies are going to.
Thank you, Scott. You point to the story about a "blip" in increased mortalities at the hospital. But is that not the mortality rate for the hospital as a whole? Not just the neonatal unit.
Agreed... and I don't claim it to be just for the neonatal unit. The point I was trying to make is that the hospital in 2014 had a bad rating, and that there were issues all over the hospital that led to the media identifying continued exess mortality for the whole facility early in the year that Lucy is supposed to have harmed all these babies. I think the overt suggestion is that excess mortality was something common to the whole hospital, and was not something that any one nurse was causing.
I have some experience - in the Netherlands - with incompetent care, incorrect diagnoses, etc. None of these recorded in official files - for a variety of reasons. Iatrogenic events cause about 25-30% of medical issues, it is said. Based on what I know, it could easily be higher.
I read some doctors asked for CCTV but that management decided against it. The problem with the way the NICU was structured/equipped was of course a major impediment to get proper images.
I see the Daily Mail are now reporting on more numbers!! Is this to whip up a further frenzy in light of the article on Miscarriage of justice gaining momentum ?
I would like to see a time series of the annual number of deaths of neonatals at CoCH. I saw a list of numbers somewhere, and it was clear there was a big bump in 2015 and 2016, sorry, I forget where. Of course, the official numbers in any particular source mean nothing on their own, because of all the issues you discuss, and because they need to be related to the size and characteristics of the population they are an immediate part of, the admissions to the hospital or unit - but they do form public perception both in and outside the system. It was the same with Lucia de Berk, Ben Geen, and more such cases.
Q.: why and when was CoCH NICU upgraded to level-2 ? Was that not way beyond their abilities ? Who came up with that idea ? What improvements were made to make it possible ? Etc.
We understand that the level 2 designation was adopted by the hospital itself several years earlier. Maybe when this grading system was introduced. Also, they raised money to buy stuff. Lucy was the face on the campaign posters and brochures. Brearey was the neonatal lead. Staffing levels were never brought into line with the designation. At the same time they were busy getting rid of higher paid older nurses.
That "honor" to be the face of the CoCH NICU campaign has cost her.
I wonder if something sensible could be said using a combination of Hospital Episode Statistics and ONS mortality data, but reporting it at CCG level if possible. That way it wouldn't matter what hospital the neonate died in, they could still be identified and included. The local authority public health teams tend to have data analysts with access to this stuff. Or the CCGs themselves might. But, no idea how feasible it is that they'd do it. It's important to take a public health type population approach to see if there are real differences rather than just changes in what hospital babies are going to.
Thank you, Scott. You point to the story about a "blip" in increased mortalities at the hospital. But is that not the mortality rate for the hospital as a whole? Not just the neonatal unit.
Agreed... and I don't claim it to be just for the neonatal unit. The point I was trying to make is that the hospital in 2014 had a bad rating, and that there were issues all over the hospital that led to the media identifying continued exess mortality for the whole facility early in the year that Lucy is supposed to have harmed all these babies. I think the overt suggestion is that excess mortality was something common to the whole hospital, and was not something that any one nurse was causing.
I have some experience - in the Netherlands - with incompetent care, incorrect diagnoses, etc. None of these recorded in official files - for a variety of reasons. Iatrogenic events cause about 25-30% of medical issues, it is said. Based on what I know, it could easily be higher.
I read some doctors asked for CCTV but that management decided against it. The problem with the way the NICU was structured/equipped was of course a major impediment to get proper images.