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The Keogh Mortality Review

Terms of reference

On February 6 2013, the Prime Minister announced that he had asked Professor Sir Bruce Keogh to review the quality of care and treatment provided by those NHS trusts and NHS foundation trusts that are persistent outliers on mortality indicators. A total of 14 hospital trusts were investigated as part of this review on the basis that they had been outliers for the previous two consecutive years on either the Summary Hospital-Level Mortality Indicator or the Hospital Standardised Mortality Ratio.

The review was guided by the NHS values set out in the NHS Constitution and underpinned by the following key principles:

  • Patient and public participation
    Patients and members of the public have played a central role in the overall review and the individual investigations, working in partnership with clinicians. The views of patients in each of the 14 hospitals, either directly or through representatives, were sought by the teams and reflected in their reports.
  • Listening to the views of staff
    Staff in the each of the 14 hospital trusts were supported to provide frank and honest opinions about the quality of care and treatment provided to patients in their hospital.
  • Openness and transparency
    All possible information and intelligence relating to the review and the individual investigations were made publicly available.
  • Co-operation between organisations
    The overall review and the individual investigations were built around strong co-operation between the different organisations that make up the health system, placing the interests of patients first at all times.

The investigations sought to determine whether there were any sustained failings in the quality of care and treatment being provided to patients at these trusts.

It identifed:

  1. whether existing action by these trusts to improve quality was adequate and whether any additional steps should be taken
  2. any additional external support that should be made available to these trusts to help them improve
  3. any areas that may require regulatory action to protect patients.

On July 16 2013 Professor Sir Bruce Keogh published a public report summarising the findings and actions resulting from the 14 investigations.

Page last reviewed: 17/03/2015

Next review due: 17/03/2017


The Keogh Mortality Review has been completed. The final reports on each trust and an overview report were published on July 16 2013. Submissions to the review team can no longer be considered.

If you want to make an official complaint about the NHS, please follow the NHS complaints procedure.

You may also wish to raise your concern through the Care Quality Commission (CQC). You can contact the CQC via telephone on 03000 61 61 61 or by emailing

Thanks to all who provided feedback to the Keogh Mortality Review. Your input has been hugely valuable and has helped to shape the recommendations.