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Study reveals Advancing Quality associated with 890 fewer deaths

Researchers evaluating the impact of the Advancing Quality programme in the North West have estimated hundreds of lives were saved within the first 18 months.

In a paper published in the New England Journal of Medicine, a team of economists and health experts from the Universities of Manchester, Nottingham, Birmingham and Cambridge found there has been a significant fall in mortality rates since the introduction of Advancing Quality.

The researchers investigated figures for in-hospital deaths within 30 days of admission for patients with pneumonia, AMI and heart failure 18 months before and after the introduction of Advancing Quality. They conclude that avoidable mortality rates fell by 6% in the North West, the equivalent of 890 deaths.

Lead author Matt Sutton, Professor of Health Economics in The University of Manchester’s Institute for Population Health, said:

“We examined a unique initiative in which a bonus system from the US was adopted only in North West of England. We found that while research has shown the US scheme had no effect on patient health, the same scheme in the NHS did and resulted in 890 lives being saved during the 18 month scheme.”

Julia Hickling, AQuA Director, said:

“This is really encouraging news and is testament to the dedication and commitment of clinical teams and NHS staff across the region. The fact that AQ is associated with 890 fewer deaths in just the first 18 months far exceeds even the most ambitious expectations we held for the programme and further demonstrates AQ’s value as a method for commissioning for outcomes.”

Advancing Quality was introduced in all North West hospitals providing emergency care in 2008 to improve standards and reduce variation. It is based on the Healthcare Quality Incentive Demonstrator project which was operated by Premier Incorporated in the United States. In late 2010, Clarity Informatics was contracted by AQ to continue the operation of data and other support services. Along with pneumonia, heart failure and AMI, it is also live in coronary artery bypass graft surgery, hip and knee replacement surgery, stroke, dementia and first episode psychosis.The programme is based on a set of quality standards which clinicians agree define and measure good clinical practice and should be delivered to every patient to ensure they receive the highest standard of care. Hospitals collect and submit data on these quality standards, which range from recording that the right antibiotics are given at the right time through to patients receiving written discharge instructions on how to prevent relapses.

Each NHS trust has an AQ team who work locally to drive improvements. AQuA hosts Advancing Quality collaborative and shared learning events throughout the year to give the teams the opportunity to come together to share examples of best practice and learn about the latest developments in the programme and the focus areas.

The results are publicly reported once a year via the Advancing Quality website and the latest results for Year 4 of the programme (April 2011 to March 2012) will be published Wednesday 14th November 2012.

The full New England Journal of Medicine article is available to subscribers via

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Notes to editors:

  1. For further information on Advancing Quality, see or contact Lindsay Kirby on 0161 206 8438 or
  2. Advancing Quality is the flagship programme of AQuA, an NHS membership body dedicated to helping NHS organisations in the North West provide high quality health care services and improved health. See the AQuA website for more information.
  3. Clarity Informatics is an internationally-renowned centre of excellence in the application of evidence-based health informatics. For further information, please contact Rebecca Brown of Clarity Informatics on 0845 113 1000 or Suzie Creighton of Castlegate on 0772 999 3721 or
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