Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, May 2019 - April 2020National statistics, Official statistics, Open data, Experimental statistics
- Publication Date:
- 10 Sep 2020
- Geographic Coverage:
- Geographical Granularity:
- NHS Trusts, Hospital Sites
- Date Range:
- 01 May 2019 to 30 Apr 2020
This publication of the SHMI relates to discharges in the reporting period May 2019 - April 2020.
The SHMI is the ratio between the actual number of patients who die following hospitalisation at the trust and the number that would be expected to die on the basis of average England figures, given the characteristics of the patients treated there. It covers patients admitted to hospitals in England who died either while in hospital or within 30 days of being discharged. Deaths related to COVID-19 are excluded from the SHMI.
To help users of the data understand the SHMI, trusts have been categorised into bandings indicating whether a trust's SHMI is 'higher than expected', 'as expected' or 'lower than expected'. For any given number of expected deaths, a range of observed deaths is considered to be 'as expected'. If the observed number of deaths falls outside of this range, the trust in question is considered to have a higher or lower SHMI than expected.
The SHMI is not a measure of quality of care. A higher than expected number of deaths should not immediately be interpreted as indicating poor performance and instead should be viewed as a 'smoke alarm' which requires further investigation. Similarly, an 'as expected' or 'lower than expected' SHMI should not immediately be interpreted as indicating satisfactory or good performance.
Trusts may be located at multiple sites and may be responsible for one or more hospitals. A breakdown of the data by site of treatment is also provided, as well as a breakdown of the data by diagnosis group.
Further background information and supporting documents, including information on how to interpret the SHMI, are available on the SHMI homepage (see Related Links). Information about the exclusion of COVID-19 from the SHMI can also be found on the same page. A link to the methodological changes statement which details the exclusion is also available in the Related Links section.
For the 125 trusts included in the SHMI from 1 May 2019 to 30 April 2020:
• There were approximately 8.9 million discharges, from which 285,000 deaths were recorded either while in hospital or within 30 days of discharge. This includes deaths from other causes as well as deaths related to the reason for the hospital admission.
• 11 trusts had a higher than expected number of deaths. Of these 11 trusts, 5 also had a higher than expected number of deaths for the same period in the previous year.
• 99 trusts had a number of deaths within the expected range.
• 15 trusts had a lower than expected number of deaths. Of these 15 trusts, 11 also had a lower than expected number of deaths for the same period in the previous year.
1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in a new contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication.
2. Please note that there has been a fall in the number of spells for all trusts between this publication and the previous SHMI publication, ranging from 2 per cent to 8 per cent. This is due to COVID-19 impacting on activity from March 2020 onwards and appears to be an accurate reflection of hospital activity rather than a case of missing data.
3. There is a shortfall in the number of records for University Hospital Southampton NHS Foundation Trust (trust code RHM) and Bradford Teaching Hospitals NHS Foundation Trust (trust code RAE). Values for these trusts are based on incomplete data and should therefore be interpreted with caution.
4. Day cases are excluded from the SHMI. However, some day cases for University College London Hospitals NHS Foundation Trust (trust code RRV) have been incorrectly classified as ordinary admissions meaning that they have been included in the SHMI. Values for this trust should therefore be interpreted with caution.
5. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of this page.
- Percentage of provider spells with COVID-19 coding
- SHMI admission method contextual indicators
- SHMI data
- SHMI deprivation contextual indicators
- SHMI depth of coding contextual indicators
- SHMI in and outside hospital deaths contextual indicator
- SHMI palliative care coding contextual indicators
- SHMI primary diagnosis coding contextual indicators
- SHMI site change during spell contextual indicator
- SHMI statistical model data