These indicators are designed to accompany the SHMI publication.
As well as information on the main condition the patient is in hospital for (the primary diagnosis), the SHMI data contain up to 19 secondary diagnosis codes for other conditions the patient is suffering from. This information is used to calculate the expected number of deaths.
'Depth of coding' is defined as the number of secondary diagnosis codes for each record in the data. A higher mean depth of coding may indicate a higher proportion of patients with multiple conditions and/or comorbidities, but may also be due to differences in coding practices between trusts.
Contextual indicators on the mean depth of coding for elective and non-elective admissions are produced to support the interpretation of the SHMI.
Notes:
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 most trusts between this publication and the previous SHMI publication, ranging from 0 per cent to 4 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. Day cases and regular day attenders 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. Maidstone and Tunbridge Wells NHS Trust (trust code RWF) has submitted a number of records with a patient classification of ‘day case’ or ‘regular day attender’ and an intended management value of ‘patient to stay in hospital for at least one night’. This mismatch has resulted in the patient classification being updated to ‘ordinary admission’ by the HES data cleaning rules. This may have resulted in the number of ordinary admissions being overstated. The trust has been contacted to clarify what the correct patient classification is for these records. Values for these trusts should therefore be interpreted with caution.
4. There is a shortfall in the number of records for Bedfordshire Hospitals NHS Foundation Trust (trust code RC9) meaning that values for this trust are based on incomplete data and should therefore be interpreted with caution.
5. Airedale NHS Foundation Trust (trust code RCF) has submitted an increased number of delivery episode records. HES data cleaning rules have amended some of the records to birth episodes however, most records have not been changed. It is therefore considered likely that the increased number of delivery episodes (and corresponding reduction in ordinary episodes) is incorrect. Values for this trust should therefore be interpreted with caution.
6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page.