Sharing ideas on Risk, Human Performance, Teams and Leaders

Roger Taylor / Nick Black

DEBATE: All we need is HSMR data to see failing hospitals

Nick Black is professor of Health Services Research at the London School of Hygiene & Tropical Medicine & Chair of the NHS England Advisory Group for Clinical Audit & Enquiries. His main interests are the use of clinical databases for evaluation and audit of health services, patient-reported outcome measures (PROMs), the relationship between research and policy, and the history of health services. Since 2007 he has advised the NHS and the Care Quality Commission on avoidable hospital deaths, PROMs and national clinical audits and enquiries. In 2013 he was the first recipient of a new international Career Achievement Award for work on PROMs by the Medical Outcomes Trust, USA. Roger Taylor is Director of Research and Public Affairs at Dr Foster where he is responsible for public information, including the Dr Foster Hospital Guide. Roger was a co- founder of Dr Foster and has been a strong advocate for the role of greater transparency as a mechanism for consumer protection as well as a driver for quality improvement in public services. He is a board member of Ofqual, the regulator of qualifications in the UK and a trustee of CAADA, the domestic abuse charity. He is also a member of the Health Sector Transparency Panel and the Open Data User Group. His book on NHS reform, ‘God Bless the NHS’, was published by Faber and Faber in March 2013.

A lively debate between Roger Taylor (journalist, and Director of Research and Public Affairs and a co-founder of DrFoster) and Prof Nick Black (Professor of Health Services Research at the London School of Hygiene and Tropical Medicine) arguing the relevance of using the Hospital Standardized Mortality ratio (HSMR) as a metric to compare organizations. Roger Taylor pointed out that the HSMR is not a stand-alone metric of performance, but has a role as a screening tool rather than as a diagnostic tool to evaluate and compare the outcomes between organizations. Prof Black pointed out that the HSMR has not used in North America as a discriminating variable because of the lack of robust risk adjustment and lack of correlation with quality of care as an isolated index.