A RISE in the number of deaths at Salisbury District Hospital has become a "major focus", according to hospital bosses.

Indicators show the mortality rate among inpatients is above the expected range.

Speaking at a trust board meeting last week about the issue, medical director Christine Blanshard said the data was being analysed in detail but causes were often complicated involving multiple external partners as well as the hospital.

She said: "We've got quite a good understanding about what some of the drivers are. It's a whole range of things.

"We know where the difficulties are, we know what the challenges are and we are working with people to address them. We are attacking it on multiple fronts."

Part of the issue is insufficiently detailed information about the patients diagnosis and pre-existing chronic medical conditions being recorded in the notes on admission.

Non-executive director Michael Marsh called it an "alarming figure" when seen in isolation but said there had been some assurance of why it appeared high and that action was now needed to ensure the data was more accurately recorded.

The hospital has already made care improvements, Dr Blanshard said, as a result of reviewing the number of deaths.

"An example is that urinary catheters are only put in when absolutely necessary, they are reviewed on a daily basis and are taken out very promptly once they're no longer necessary," she said.

She said more work was being done on reviewing the quality of care for patients and highlighted the need for more community support for people nearing the end of their lives.

She said: "I think our colleagues in primary care and community care are really good now at avoiding unnecessary admissions for patients they have been working with.

"What they're really struggling with is patients who are known to be nearing the end of their life who develop symptoms which are difficult to palliate in the community and the patient ends up in hospital and dies usually with 24 to 48 hours of coming in.

"The difference for us compared to other trusts in the south west is that while we have hospice beds, we don't have any community beds and therefore the facility to provide really good nursing care towards the end of people's lives when they may be being cared for by equally frail relatives."

She pointed out that while a rise in mortality may be a "smoke alarm" to look and identify where the problem with the quality of care was, research showed there was a "poor relationship" between the two.

Dr Blanshard said: "Of course it is really important to learn what can be improved in the care of patients who've died but it is important to remember they're a tiny minority of our patients - 97 per cent of patients who come into hospital get discharged and don't die."

The most recent figures relate to September where the HSMR, an indicator which compares the number of deaths in hospital with the expected number of deaths, was 119 - the expected level is 100.

It had been rising over the previous months from 109 in January 2016.