One of the things that puzzles and infuriates readers is the number of occasions that the same mistake is made in the Guardian, despite repeated corrections. It is also pretty annoying for the readers’ editor who has made the corrections and published them.
It shouldn’t happen. But it does. What follows is an attempt to explain, not excuse, how one particular persistent error has appeared regularly in the print and online versions of the Guardian.
On at least three occasions in the past two years the Guardian has published stories in which we have said, wrongly, that the Francis reports – there were two – into the care provided by Mid Staffordshire NHS foundation trust found up to 1,200 deaths over five years that could have been prevented.
Each time the story has been amended and footnoted. Each time a correction has been published in print and online.
However, on 16 October we committed a similar error when reporting that the Health and Safety Executive has brought charges against Mid Staffordshire NHS trust over the deaths of four elderly patients between 2005 and May 2014 at Stafford hospital.
The offending sentence, the error of which was reflected in an online picture caption, said: “The Mid Staffordshire trust was at the centre of one of the biggest scandals to hit the NHS when it emerged that an estimated 400-1,200 patients had died as a result of poor care between January 2005 and March 2009 at Stafford hospital.”
The re-appearance of this error quite reasonably irritated a number of readers, including doctors. One reader wrote: “Yet again the claim is made that “an estimated 400-1,200 patients had died” (slightly different wording online) at Stafford hospital.
“As you have previously confirmed, Robert Francis specifically denied these wild charges, which arise out of a total misunderstanding of mortality data. This charge, much of which dates back to the very time of the ‘scandal’ has obviously made you feel that yet again this lie can be repeated. I am very disappointed that letters of complaint to you do not percolate to the editorial staff and so the lie is repeated.”
So, how did it happen?
In 2009 the now defunct Healthcare Commission (HCC) published a highly critical report about a handful of elderly-care wards at Stafford hospital and the hospital’s accident and emergency unit. As my colleague Randeep Ramesh reported in 2013 “it was the hospital that was dubbed by the media as the ‘Killing Fields’ of the NHS”.
The figures of 400-1,200 deaths appeared in a draft but not the final HCC report. However, it was the draft report that was leaked and those figures were widely publicised in the media.
The figures derive from a set of statistics called hospital standardised mortality ratios. In his first report into the scandal in 2010 Sir Robert Francis said: “it is 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. Therefore, it is understandable that the HCC did not include such a figure in its report.”
He reiterated the point in 2013 and went further. Chapter 5 of his second report states the following referring to Mid Staffs: “To this day, there is no generally accepted means of producing comparative figures, and unjustifiable conclusions continue to be drawn from the numbers of deaths at hospitals and about the number of avoidable deaths.”
However, that doesn’t mean we can never report that these figures were ever made public – they are so much a part of the narrative it is helpful to explain to readers how they became public and what they mean.
Denis Campbell, the Guardian’s health correspondent, said: “It was indeed the Healthcare Commission, the statutory NHS care regulator at the time, that first came up with the … estimate that poor care contributed to between 400 and 1,200 deaths at Stafford hospital during the 50 months that the HCC investigated. Those involved in producing that figure say that it resulted from them using what at the time was an established method of calculating excess, or potentially avoidable, deaths among hospital patients.
“That estimate was leaked and, rightly or wrongly, became a key reference point in the huge swirl of reporting and commentary about the scandal of Mid Staffs.
“I believe that we should be able to include the 400-1,200 figure in stories, but only – crucially – if we reference that it was produced by the Healthcare Commission and explain that Sir Robert Francis QC’s report came up with a totally contrary view. That would be responsible, and would give readers the full story, and let them form their own judgment as to who was right. That, in my mind, is our job. To never, ever refer to it in our reporting would be absurd, given its provenance and centrality to the history of the scandal.”
The latest error arose because the reporter relied on a story written in February 2013, where the origins of the figures were not explained. Now both stories will be amended, footnoted and a correction published. We hope we won’t have to do it again.