Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, July 2018 - June 2019National statistics, Official statistics, Open data, Experimental statistics
- Publication date:
- 14 Nov 2019
- Geographic coverage:
- Geographical granularity:
- NHS Trusts, Hospital Sites
- Date range:
- 01 Jul 2018 to 30 Jun 2019
This publication of the SHMI relates to discharges in the reporting period July 2018 - June 2019.
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.
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).
For the 130 trusts included in the SHMI from 1 July 2018 to 30 June 2019:
• There were approximately 9.3 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.
• 9 trusts had a higher than expected number of deaths. Of these 9 trusts, 4 also had a higher than expected number of deaths for the same period in the previous year.
• 108 trusts had a number of deaths within the expected range.
• 13 trusts had a lower than expected number of deaths. Of these 13 trusts, all of them had a lower than expected number of deaths for the same period in the previous year.
1. There is a shortfall in the number of records for Tameside and Glossop Integrated Care NHS Foundation Trust (trust code RMP) meaning that values for this trust will be based on incomplete data and should therefore be interpreted with caution.
2. A large proportion of records for East Sussex Healthcare NHS Trust (trust code RXC) have missing information for the condition the patient was in hospital for and other conditions the patient suffers from, and this will have affected the calculation of the expected number of deaths. Values for this trust 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. There is also a shortfall in the the number of records for this trust for April 2019. Values for this trust should therefore be interpreted with caution.
4. The following mergers took place on 1st October 2019: Cumbria Partnership NHS Foundation Trust (trust code RNN) merged with North Cumbria University Hospitals NHS Trust (trust code RNL). The new trust is called North Cumbria Integrated Care NHS Foundation Trust (trust code RNN). Aintree University Hospital NHS Foundation Trust (trust code REM) merged with Royal Liverpool and Broadgreen University Hospitals NHS Trust (trust code RQ6). The new trust is called Liverpool University Hospitals NHS Foundation Trust (trust code REM). However, as we received notification of these changes after data processing for this publication began, separate indicator values have been produced for this publication. The next publication in this series will reflect the updated 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.
- 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