As with other national clinical audits, the NHFD has previously identified outliers for 30-day mortality as part of its annual reporting cycle. This means that the annual report published at the end of 2019 included an analysis of mortality during 2018, and that individual hospitals were contacted to be alerted to their potential outlier status an average of 12 months after the relevant patients had died.

The NHFD has been working with the University of Oxford’s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), to develop a completely new approach to identification of mortality outliers. Now, this work has led to the launch of the new case-mix adjusted mortality run charts. These will update quarterly, a few months in arrears to allow linkage to Office of National Statistics (ONS) mortality data.

The new charts will include a case-mix adjusted mortality line alongside the usual crude mortality line – and will include control limits, to give an immediate sense of how far from average local figures lie.



Access the charts here: www.nhfd.co.uk/charts

Details of the control chart process is attached below. Topics covered include:
• Background
• Casemix-adjusted mortality run-charts
• How will the new run charts work?
• Reviewing the quality of your casemix data
• Monitoring your casemix adjusted mortality
• Use your run chart to monitor performance

NHFD2020_30_day_mortality_outlier_runcharts_explanation.pdf