Table 1

Timings of alert, letter and investigation by the Care Quality Commission (CQC) to assess the actions of an alerting hospital

Time in months, median (range)Events
0Cumulative risk-adjusted mortality rates within a hospital for a given condition or procedure exceed a set threshold.
3 (3–4)Mortality surveillance and alerting system, using administrative hospital inpatient data, detects the high mortality and triggers an alert. The alerting hospital and the CQC are notified by letter.
6 (3–7)The CQC assesses information it holds on the alerting hospital, and opens a case usually requesting (1) evidence of case note audit of the relevant patient groups and (2) evidence of actions taken to make improvements.
9 (6–14)The CQC investigations are completed (1) closing the case as the CQC is satisfied with the hospital’s actions or (2) referring the case for further investigations with local and regional teams.