A new paper published in The Lancet (Respiratory Medicine) shows that the rate of in-hospital deaths from COVID-19 in NHS hospitals in England fell during the first wave of the pandemic as a result of rapid learning by clinicians leading to improved treatment of patients.

The study, entitled Patient factors and temporal trends associated with COVID-19 in-hospital mortality in England, was written by a group of authors including four from the Getting It Right First Time (GIRFT) programme.

The aim was to provide a comprehensive account of all hospitalised patients with COVID-19 in England during the early phase of the pandemic and identify the factors that influenced mortality as the pandemic evolved. Hospital Episode Statistics data was analysed for all adult patients in England who were hospitalised between March 1 and May 31 2020 who had a diagnosis of COVID-19 on admission or during their stay. 

The study found that COVID patients became less likely to die in hospital over the time period, reflecting the impact of changes in hospital strategy and clinical processes. It calls for the reasons behind the observed improvement in mortality to be further investigated to inform the response to future outbreaks.

The authors of the paper are:

• Mr Annakan Navaratnam: head and neck surgery specialty registrar and honorary fellow for the GIRFT programme
• Professor Tim Briggs: GIRFT Chair and national director of clinical improvement for NHS England and NHS Improvement
• Dr William Keith Gray: GIRFT senior research associate
• Dr Jamie Day: GIRFT chief information officer (retired)
• Professor Julia Wendon: executive medical director at King’s College Hospital NHS Foundation Trust

To our knowledge this is the most complete analysis of COVID-19-related hospital activity in any large region or whole country to date, and it is important that the reasons for this improvement in mortality should be thoroughly investigated to help guide and inform our response to any further outbreaks of the virus.

Annakan Navaratnam

Professor Briggs added: “GIRFT is continuing to support the NHS in its efforts to adapt operationally to the changing landscape. We recently published best practice guidance for managing adult COVID-19 patients based on the experiences during the first wave in the best-performing trusts.

“We’ve now held two webinars for NHS staff across the country to expand on these findings, with nearly 1,000 attendees in total. It is vital that this learning is shared as widely as possible to help meet the unique challenges we are facing.”