Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, March 2019 - February 2020National statistics, Official statistics, Open data, Experimental statistics
- Publication Date:
- 9 Jul 2020
- Geographic Coverage:
- Geographical Granularity:
- NHS Trusts, Hospital Sites
- Date Range:
- 01 Mar 2019 to 29 Feb 2020
This publication of the SHMI relates to discharges in the reporting period March 2019 - February 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 129 trusts included in the SHMI from 1 March 2019 to 29 February 2020:
• There were approximately 9.5 million discharges, from which 291,000 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.
• 104 trusts had a number of deaths within the expected range.
• 14 trusts had a lower than expected number of deaths. Of these 14 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. There is a shortfall in the number of records for Tameside and Glossop Integrated Care NHS Foundation Trust (trust code RMP) and University Hospital Southampton NHS Foundation Trust (trust code RHM). Values for these trusts are based on incomplete data and should therefore be interpreted with caution.
3. 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.
4. The following mergers took place on 1st April 2020:
Taunton and Somerset NHS Foundation Trust (trust code RBA) merged with Somerset Partnership NHS Foundation Trust (trust code RH5). The new trust is called Somerset NHS Foundation Trust (trust code RH5).
Luton and Dunstable University Hospital NHS Foundation Trust (trust code RC9) merged with Bedford Hospital NHS Trust (trust code RC1). The new trust is called Bedfordshire Hospitals NHS Foundation Trust (trust code RC9).
Weston Area Health NHS Trust (trust code RA3) merged with University Hospitals Bristol NHS Foundation Trust (trust code RA7). The new trust is called University Hospitals Bristol and Weston NHS Foundation Trust (trust code RA7).
Mid Essex Hospital Services NHS Trust (trust code RQ8) merged with Southend University Hospital NHS Foundation Trust (trust code RAJ) and Basildon and Thurrock University Hospitals NHS Foundation Trust (trust code RDD). The new trust is called Mid and South Essex NHS Foundation Trust (trust code RAJ).
Please note that separate indicator values have been produced for these organisations for this publication. From the August 2020 publication onwards, we will reflect these new organisation structures.
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