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Summary Hospital-level Mortality Indicator research and development

The Summary Hospital-level Mortality Indicator (SHMI) methodology is subject to continuous review and development. Known issues are kept under review and are detailed in the SHMI methodology development log.

SHMI methodology development log


SHMI review

The SHMI is a complex indicator and there are a range of academic views on various aspects of the methodology. The SHMI is subject to continuous evaluation and the methodology is currently under review.

A SHMI Engagement Group consisting of stakeholders and users of the indicator have been convened to lead this work. They report to the National Medical Director at NHS England, Professor Stephen Powis. The group is chaired by Celia Ingham Clark, Medical Director for Clinical Effectiveness at NHS England.   

In the initial phase of the review, several tactical improvements to the methodology were recommended as well as some additional breakdowns of the data and presentational improvements. These tactical changes have been implemented from the May 2019 publication onwards, and further details are available in the update below. 

A longer term, more fundamental review of the methodology was paused due to the COVID-19 pandemic. In Spring 2021 this work resumed, and users will be kept informed as the next stage of the review progresses.

SHMI review update


Reports and further SHMI analysis carried out by NHS Digital

Reports and further analyses on the SHMI are provided below. These are grouped under the same topic headings as those used in the SHMI methodology development log for ease of reference.

Risk adjustment variables

Contextual Indicators

Publication resources

Other issues


SHMI Technical Working Group proceedings

The original SHMI Technical Working Group supported and contributed to the initial technical work associated with the development and construction of the SHMI. Meetings were held on a quarterly basis.

Members of the group included representatives from the Department of Health, Care Quality Commission, NHS Digital, Professional Association of Clinical Coders, Public Health England, King's Fund, University Hospitals Birmingham, Dr Foster Intelligence, Dr Foster Unit at Imperial College London, CHKS and Nuffield Trust.

Meeting dates:

Last edited: 6 July 2021 2:24 pm