DEATH rates at Worcestershire’s three major hospitals and the standard of care provided to stroke patients have been flagged up as areas of concern in a report into the trust running the facilities.

In a Care Quality Commission (CQC) Intelligent Monitoring Report (IMR) published last week Worcestershire Acute Hospitals NHS Trust dropped from band six – those trusts considered the least at risk – to band four.

The quarterly report ranks each acute hospital trust according to more than 150 performance indicators. Those placed in the lower bands are considered to be the most at-risk and are prioritised for a CQC inspection.

The two main areas of concern outlined in the report were mortality rates at the three hospitals run by the trust – Worcestershire Royal Hospital, Kidderminster Hospital and Redditch’s Alexandra Hospital – as well as the standard of care given to patients who have suffered a stroke.

But the trust’s deputy chief executive Chris Tidman said the constantly-evolving nature of the IMR, with a number of new indicators introduced almost every quarter, meant it was difficult to compare this month’s report with its predecessors.

“The IMR is one element in a whole host of data that helps us to monitor our services and identify areas where we may need to have a greater focus,” he said.

“The trust continues to comply with all CQC regulations and, in common with all NHS trusts, will be inspected before the end of 2015 under the new CQC Hospital Inspection Programme.”

Mr Tidman said he did not agree the performance of the stoke unit at the Royal was a cause for concern.

“Since centralising stroke standards 12 months ago we have seen marked improvements in stroke outcomes and we are meeting all of our stroke standards,” he said.

“We are working to understand why there is a discrepancy between our performance measures and those reported in the IMR and to further validate our data.”

He added the trust was working to address concerns around the mortality rate.

“The Hospital Standardised Mortality Ratio (HSMR) is often seen as a smoke signal and a trigger to investigate further,” he said.

“Our HSMR is currently 108, which means that we see 108 deaths in hospital for every 100 expected deaths, which takes into account the characteristics of the local population.

“We continually monitor our mortality rates and review the diagnostic groups that show a higher than expected mortality ratio.

“The reasons for a higher HSMR are often due to the accuracy of coding patient’s conditions but where clinical or care issues are discovered, action is taken to improve them.”

The CQC was set up in 2009 and inspects hospitals, care homes, GPs, dentists and other healthcare services across England to ensure patients are getting safe, effective and high-quality care.

To view the report visit