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Vaughan Gething, Cabinet Secretary for Health, Well-being and Sport

First published:
13 July 2016
Last updated:

This was published under the 2016 to 2021 administration of the Welsh Government

Stephen Palmer, then Professor of Epidemiology and Public Health at Cardiff University was asked by the previous Minister for Health and Social Services, to provide an independent review of the use of the Risk Adjusted Mortality Index (RAMI) in assessing the quality of care in Welsh hospitals. In his report, published in June 2014, Professor Palmer concluded RAMI data is not a reliable measure and could divert attention away from more meaningful approaches to measuring and improving hospital care. Professor Palmer recommended health boards used a wider range of performance indicators and metrics, specifically using the findings from national clinical audits and mortality case note reviews.

A Written Statement was published by the previous Welsh Government in April, which outlined the progress made in embedding the recommendations from the Palmer review. All health boards demonstrated good participation in national clinical audits, have systems for reviewing all deaths in acute hospitals and routinely use this information alongside a suite of quality and safety metrics including condition specific mortality indicators. This information is reported routinely to their boards.

The NHS can now clearly demonstrate it has implemented the range of actions recommended by Professor Palmer and these are now embedded within our overall NHS delivery and outcome frameworks. I have therefore determined that it is now appropriate to discontinue the quarterly publication of RAMI indicators for Welsh hospitals. This will take immediate effect.