Have there been 13 000 needless deaths at 14 NHS trusts?

Before the release of the recent Keogh report into 14 NHS hospital trusts in England with apparently high mortality,1 the Sunday Telegraph and other newspapers reported that “13,000 died needlessly at 14 worst NHS trusts.”2

And yet the Keogh report, when published in July, was notable for its careful thoroughness and said nothing whatsoever about numbers of deaths. Indeed, when discussing the use of measures of mortality such as the standardised hospital mortality indicator (SHMI) and hospital standardised mortality ratio (HSMR), Keogh said: “It is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths. Robert Francis himself said: ‘It is in my view misleading and a potential misuse of the figures to extrapolate from them a conclusion that any particular number, or range of numbers of deaths were caused or contributed to by inadequate care’.”1

So where did the “13,000” come from? It is the difference between the observed and “expected” number of deaths in …