This publication of the SHMI relates to discharges in the reporting period July 2013 to June 2014.
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 all deaths reported of patients who were admitted to non-specialist acute trusts in England and either die while in hospital or within 30 days of discharge.
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'.
Further background information and supporting documents are available on the SHMI homepage (see Related Links).
Key Facts
Of the 137 trusts included in the SHMI for the period from 1 July 2013 to 30 June 2014:
• 9 trusts had a 'higher than expected' SHMI, the same number of trusts as for the same period a year previously.
• Of these 9 trusts, 3 also had a 'higher than expected' SHMI for the same period a year previously.
• 15 trusts had a 'lower than expected' SHMI, compared to 17 trusts for the same period a year previously.
• Of these 15 trusts, 11 also had a 'lower than expected' SHMI for the same period a year previously.
• 113 trusts had an 'as expected' SHMI, compared to 115 trusts for the same period a year previously.
Notes:
1. There is a shortfall in the number of records in the Hospital Episode Statistics (HES) data which has been used to produce the January 2015 SHMI publication (covering discharges in the reporting period July 2013 - June 2014) for the following trusts: South Warwickshire NHS Foundation Trust (provider code RJC), Sherwood Forest Hospitals NHS Foundation Trust (provider code RK5) and The Whittington Hospital NHS Trust (provider code RKE). Further details are provided in the corresponding HES Admitted Patient Care data quality notes (see Related Links). This has a negligible impact on the SHMI at national level. However, the SHMI values for the affected trusts will be based on incomplete data and should therefore be interpreted with caution.
2. Following the closure of South London Healthcare NHS Trust (provider code RYQ) on 30 September 2013, the activity previously undertaken by this trust has now transferred to the following three trusts: King's College Hospital NHS Foundation Trust (provider code RJZ), Lewisham and Greenwich NHS Trust (provider code RJ2) and Oxleas NHS Foundation Trust (provider code RPG). King's College Hospital NHS Foundation Trust (RJZ) and Lewisham and Greenwich NHS Trust (RJ2) are reported in the SHMI. However, Oxleas NHS Foundation Trust (RPG) is a community trust and is therefore excluded from the SHMI.
As part of the Hospital Episode Statistics (HES) data cleaning processes, checks are carried out to ensure that all records have a trust code which is open and valid using reference data supplied by the Organisation Data Service (ODS). South London Healthcare NHS Trust (RYQ) is now listed as a closed trust by ODS. Therefore, all activity previously submitted by South London Healthcare NHS Trust (RYQ) for the financial year 2013-14 has not been included in the provisional 2013-14 HES data from the month 8 publication onwards. Further details are provided in the corresponding HES Admitted Patient Care data quality notes (see Related Links). The HSCIC's HES data quality team and ODS are working to implement rules to map the activity for closed organisations to the responsible providers as part of the HES data cleaning processes prior to the publication of finalised HES data for 2013-14.
This has a negligible impact on the SHMI at national level. However, because the SHMI is published to be reflective of current organisational structures, the SHMI values for King's College Hospital NHS Foundation Trust (RJZ) and Lewisham and Greenwich NHS Trust (RJ2) will be based on incomplete data and should therefore be interpreted with caution.
3. It has come to our attention that there may be several trusts who are unable to record still births with a discharge method of 'Baby was still born' on their patient administration system (PAS) and are instead coding these records with a discharge method of 'Died'. This means that such records will be included in the calculation of the SHMI where they should have been excluded. We are currently reviewing this issue with initial investigations suggesting that the impact on the overall SHMI value for affected trusts is small.
4. The HSCIC is aware that there may be an impact of the present SHMI methodology on the SHMI value for integrated acute and community trusts. This is because activity from both acute and community sites at integrated trusts is included in the calculation of the SHMI, while activity from trusts which only provide community services is excluded. The HSCIC is investigating ways in which community activity for integrated trusts can be identified in the underlying dataset and will continue to review this issue with the SHMI Technical Working Group.
5. The total number of trusts has decreased by four from the same period a year previously due to the acquisition of Barnet and Chase Farm Hospitals NHS Trust (provider code RVL) by the Royal Free London NHS Foundation Trust (provider code RAL), the establishment of the London North West Healthcare NHS Trust (provider code R1K) following the closure of Ealing Hospital NHS Trust (provider code RC3) and North West London Hospitals NHS Trust (provider code RV8), the acquisition of Heatherwood and Wexham Park Hospitals NHS Foundation Trust (provider code RD7) by Frimley Health NHS Foundation Trust (provider code RDU) and the closure of Mid Staffordshire NHS Foundation Trust (provider code RJD).
