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3 March 2016, 16:15
The Queen Elizabeth Hospital in Birmingham's been told it's heart surgery death rates are to be monitored after higher than expected death rates.
Inspectors the CQC say the Trust has along history of high death rates in the department compared to other hospitals.
University Hospitals of Birmingham NHS Foundation Trust, which runs the hospital, has been told to send weekly results to the CQC about its outcomes for adult heart patients.
An independent team from the Royal College of Surgeons is also conducting a review to determine what improvements are needed.
Calculations by the Guardian suggest 17 people may have died over a three-year period who should have survived.
Professor Sir Mike Richards, chief inspector of hospitals at the CQC, said: "CQC carried out an inspection at the University Hospitals of Birmingham NHS Foundation Trust on 21 and 22 December in response to concerns that had come to light regarding mortality outliers in cardiac surgery services at the trust.
"Our inspectors found significant concerns particularly with regard to the safety, effectiveness and responsiveness of the service.
"Following our inspection we have told the trust to take immediate action with regard to the service and have been monitoring individual patient safety and outcome data on a weekly basis.
"We asked the trust to commission an external review to identify all the actions it needs to take to address the concerns which we have identified. This review is currently underway.
"A full report detailing our inspection findings will be published shortly.''
According to the Guardian, data posted on the Society for Cardiothoracic Surgeons' website last September - the most recent available - shows the hospital has been a "red outlier'', with death rates outside an acceptable range, over the three years from April 2011 to March 2014.
In those three years, the unit has operated on 1,713 patients, the website showed.
Calculations suggest 17 patients over the period should have survived surgery but did not.
Since September, there has been disagreement over the figures between the trust, the Healthcare Quality Improvement Partnership (HQIP) and the CQC.
The trust has said the figures are misleading and include data for Ian Wilson, a heart surgeon sacked by the hospital trust in 2013 for allegedly fraudulently altering death rate data to make it look better. He is currently facing a General Medical Council (GMC) disciplinary hearing.
The trust also argued that data from private work carried out by its surgeons should be included.
The trust has also disagreed with the National Institute for Cardiovascular Outcomes Research (NICOR), which analyses data submitted by heart surgeons around the country.
A statement from the trust said: "The trust took action as early as June 2013 when internal data identified a cluster of deaths between September 2011 and September 2012 related to one surgeon. The individual was suspended and subsequently dismissed.''
It said that last July, following a review of internal data, cardiac consultant surgeons from the trust met with its medical director to establish a Quality Improvement Programme "in recognition of changes that needed to be made to the cardiac surgery service''.
It said none of the cardiac surgeons currently working at the hospital were "outliers for mortality outcomes''.
The statement added: ``The trust had concerns about the data NICOR chose to include/exclude in their analysis which we have articulated to them and they have ignored: Namely, the cluster of deaths attributable to the subsequently dismissed surgeon was included but 130 zero-mortality NHS cases carried out by our surgeons at the Priory Hospital as an NHS waiting list initiative, were not included.
"Patient safety remains our number one priority.''