Review into the quality of care and treatment provided by 14 hospital trusts in England; overview report (Keogh Review)

Source: Independent review commissioned by the Department of Health and led by Professor Sir Bruce Keogh KBE

Link to main document

Publication format: PDF report

Date of publication: July 2013

Summary of driver:
The report is a review into the quality of care and treatment provided by hospital trusts with a high mortality rate. Fourteen trusts were selected on the basis that they had been outliers for the last two consecutive years on either the Summary Hospital-Level Mortality Index (SHMI) or the Hospital Standardised Mortality ration (HSMR). The final report covers in detail, areas for improvement in each of the 14 trusts as well as identifying common challenges facing the wider NHS. Keogh concludes that significant progress is to be made within two years.

There are 8 ambitions (listed below) – which are common challenges facing the wider NHS after working with these 14 hospitals.

• Progress towards reducing avoidable deaths in hospitals rather than relying on mortality statistics to judge the quality of care
• Boards and leaders of provider/commissioner organisations, patients and the public to have access to good quality data
• Patients/carers/members of the public to be treated as equals in assessment of NHS and confident that their feedback is taken on board and to see how this impacts on future patient care
• Patients and clinicians to become active participants in future Care Quality Commissions assessments
• The development and maintenance of a culture of professional and academic recognition
• Nurse staffing levels and skills mix will match caseload and severity of patients. This information to be reported transparently by trust boards
• The contribution made by junior doctors and student nurses within organisations and the harnessing of the knowledge and innovation they bring
• Recognition of the effect that positive and motivated staff have on patient outcomes

Suggestions include the following:
• All NHS organisations need to think about innovative ways to engage staff
• Patient and public engagement must be a central theme to those who plan/run/regulate hospitals
• Implementation of an early warning system, which has the relevant support/back up in place
• Adoption of systematic processes to ensure staff and patient involvement
• Embracing all feedback, concerns and complaints
• The creation of Quality Surveillance Groups to support the CQC
• Evidence based tools to be used to determine appropriate staffing levels and skill mix

Key features of driver: Each of the 14 trusts was reviewed and the process has three sections. Information gathering and analysis, the rapid response review and finally a risk summit and action plan, which sets out the plan of action that each Trust needed to take to improve and who is accountable. The report includes a summary of findings and actions for the 14 trusts involved.

Primary audience: Department of Health, HEE, NHS Trusts, other provider/commissioner organisations.

Impact on library policy/practice: Libraries could support staff with training. This might include:
• Critical appraisal sessions and Information skills training to help staff find and understand the evidence

Date last updated: November 2013
Due for review: November 2014
Group member responsible: LK


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