First clinical performance indicators for Wales show wide variation

The first set of clinical performance indicators for Wales were launched last week, showing wide variation in the three measures included.

Welsh health minister John Owen Jones, speaking at the launch of the data, explained why the introduction of performance indicators was necessary: “The tragic events at Bristol cannot be allowed to happen again. Patients and their GPs want to feel sure that their local hospital is up to scratch. We don't want a system where patients feel they have to travel far afield to get the best treatment. We need a system that collects and monitors information on clinical performance, provides an early warning if things are going wrong, and then helps to put things right.”

Mr Jones explained that the indicators are tools to enable doctors to identify potential problems at an early stage and, if necessary, act on them. “They are not a replacement for professional self regulation but they raise questions about clinical practice that doctors and NHS managers will need to investigate.”

The first set of indicators focused on three areas-death rates after heart attack, death rates after hip fracture, and the discharge rates for patients with hip fracture. A further three indicators are due to be published soon and are likely to deal with readmission rates within 28 days of discharge, discharges after a stroke, and death rates after an operation. Another nine are under consideration, including hernia recurrence, complications after surgery, and frequency of curettage of the uterus.

The first set of data to be published showed that across Wales, 18.7%of patients died in hospital after emergency admission with a heart attack. The rate varied between 13.5%in Ceredigion and Mid Wales and 22.8%in Gwynedd Hospitals trusts. During the same three year period, 7%of patients died after emergency admission with a hip fracture, with a range from 4.1%at Glan y Mor to 9.6%at the University Hospital of Wales. The third indicator showed that in the same period, 49%of patients admitted as emergency cases with hip fractures were discharged within four weeks. The range varied between 65%at Bridgend and District NHS Trust and 35%at Wrexham Maelor.

Welsh health minister John Owen Jones says indicators maintain public confidence