Sussex NHS trusts above average for chemotherapy mortality, according to study

The study, conducted by Public Health England (PHE) and Cancer Research UK, looked at the number of deaths of patients undergoing chemotherapy in the first 30 days of treatment and raises questions about the future of cancer care. Researchers looked at data on patients undergoing both curative and palliative (lessening of pain) treatment for non-small cell lung cancer and breast cancer in England in 2014. While sample sizes were small, in some cases trusts in Sussex had death rates that were considerably higher than the national average. For non-small cell lung cancer, the study found a national crude mortality rate of 2.7 per cent for curative treatment and 9.4 per cent for palliative treatment. Western Sussex Hospitals NHS Foundation Trust had a 7.1 per cent (1 death out of 14 patients) mortality rate for curative and 14 per cent rate for palliative rate (7 deaths out of 50), both above the figure for England overall. Dr George Findlay, Medical Director at Western Sussex Hospitals NHS Foundation Trust, said: “As the report identifies, cancer treatment and the use of chemotherapy is very complex and there are a number of influential factors, including patient wishes, their stage of disease and their age, which is particularly pertinent to our population. “Across all our services we are committed to continually improving mortality rates and thanks to this ongoing work we are very proud to rank within the top 20 per cent of the country’s best performing trusts in terms of overall mortality. “The excellent end-of-life care our patients receive was also singled out earlier this year for special recognition by the Care Quality Commission who rated this service in particular as ‘outstanding’, contributing to our trust’s overall ‘outstanding’ rating.” Surrey and Sussex Healthcare NHS Trust posted one of the highest death rates in the country for curative treatment at 25 per cent, although this came from one death out of four total patients. In a statement included in the report, a spokesperson for Surrey and Sussex Healthcare said: “The relevant senior clinical team have reviewed the patient information and all relevant information and data. This is as a result of one patient dying out of four treated. “This was a patient with significant co-morbidities and the cause of death was unrelated to the chemotherapy regime.” For palliative treatment, the figure for the trust was 11.8 per cent. Brighton and Sussex University Hospitals NHS Trust had a zero per cent death rate in curative cases (zero out of 15), but an above average six out of 47 patients died (12.8 per cent) in palliative cases. Brighton and Sussex University Hospitals were approached for comment. Jem Rashbass, National Director for Disease Registration in Public Health England and one of the authors of the report, said: “It is important to emphasise that while there are clearly risks that come with chemotherapy, the number of deaths in the first 30 days is very small and there is no evidence that they are excessively clustered in one or two providers.” For breast cancer, the figures from Sussex trusts were much better, though some were still above the average figures of 0.3 per cent for curative and 7.5 per cent for palliative treatment. Western Sussex Hospitals NHS Foundation Trust had no deaths in the first 30 days for curative treatment, out of a total of 131 patients treated, but a 14.8 per cent rate for palliative care (9 deaths out of 61), almost double the overall England score. Surrey and Sussex Healthcare NHS Trust also had a zero per cent rate for curative cases, but did post an above average 10.7 per cent rate for palliative treatment (3 out of 28). Brighton and Sussex University Hospitals scored among the best in the country for breast cancer treatment, with zero patients in 174 dying in the first 30 days of curative treatment, and two in 81 (2.5 per cent) for palliative treatment. Mr Rashbass added: “These findings based on detailed information from thousands of patients across England will help us make better judgements of the balance of benefits and risks associated with high cost, potentially toxic medication.” The study was originally published in The Lancet Oncololgy journal.