A variety of programs have been introduced in UK hospitals to reduce patient deaths over the past decade and Advancing Quality - imported from the United States - was first to demonstrate a significant reduction in patient deaths. 

It was introduced in the North West region of England in 2008 and Advancing Quality was found to have reduced patient deaths by 890 in the first 18 months of the policy's introduction.  

A new analysis funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme and conducted by The University of Manchester says that the success is only short term. Yes, people will still die eventually and while the quality of care continued to increase over the following two years, there was no further reduction in patient deaths in the region covered by the program over that observed in the rest of England. 

The uthors looked at three conditions for which patients are admitted to hospital in an emergency; heart attack, pneumonia, and heart failure. Researchers from the University's Faculty of Medical and Human Sciences and Manchester Business School, along with the University of Warwick and University of Cambridge, examined deaths occurring within 30 days of admission to hospital, comparing the 24 hospitals in the North West with 137 in the rest of England.

Professor Matt Sutton, from The University of Manchester who led the previous study, said, "The earlier work found significant reductions in death rates in the short-term. Our latest research shows that in the longer-term, although death rates in the North West continued to fall, the reductions for the conditions linked to the incentives were no longer larger than the national trend."

Dr Søren Rud Kristensen, who led the current study, added, "These results suggest that the benefits of initiatives such as paying for performance may be temporary. Our findings could also be explained by the decision taken midway through the program to change the incentives from bonuses for good performance to fines for failing to achieve targets.

"But we also found evidence to suggest that unintended but desirable spill-over effects may have occurred. These include improvements in the quality of care provided to both patients treated in hospitals in other regions, as well as patients admitted in the North West for conditions not covered by the incentive program."



 Published in the New England Journal of Medicine. Source: University of Manchester