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Publication, Part of

Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, May 2025 - April 2026

Accredited official statistics, Official statistics, Open data, Official statistics in development

Publication Date:
10 Sep 2026
Geographic Coverage:
England
Geographical Granularity:
NHS Trusts, Hospital Sites
Date Range:
01 May 2025 to 30 Apr 2026
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Page contents

Summary

This publication of the SHMI relates to discharges in the reporting period May 2025 - April 2026.

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. The SHMI 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 expected number of deaths is a statistical construct and is not a count of patients. The difference between the number of observed deaths and the number of expected deaths cannot be interpreted as the number of avoidable deaths or excess deaths for the trust.

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 1 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).

Highlights

For the 118 trusts included in the SHMI from 1 May 2025 to 30 April 2026:

• There were approximately 9.3 million discharges, from which 281,000 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, 6 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.  

• 8 trusts had a lower than expected number of deaths.  Of these 8 trusts, 7 also had a lower than expected number of deaths for the same period in the previous year.

Interactive data visualisation

SHMI interactive data visualisation

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Notes:

1. There is a shortfall in the number of records for Buckinghamshire Healthcare NHS Trust (trust code RXQ), Mid Cheshire Hospitals NHS Foundation Trust (trust code RBT) and Torbay and South Devon NHS Foundation Trust (trust code RA9). Values for these trusts are based on incomplete data and should therefore be interpreted with caution.

2. Due to a problem with the process which links Hospital Episode Statistics (HES) data to the Office for National Statistics (ONS) death registrations data, some in-hospital deaths have been counted as survivals in a small number of trusts. This affects 126 spells in the May 2025 to April 2026 time period for Wirral University Teaching Hospital NHS Foundation Trust (trust code RBL) meaning that the number of observed deaths has been underestimated and so the results for this trust should be interpreted with caution. For the other trusts, the number of affected spells (and hence the impact on the SHMI) is small.

3. There is a high percentage of invalid diagnosis codes for Blackpool Teaching Hospitals NHS Foundation Trust (trust code RXL), Bradford Teaching Hospitals NHS Foundation Trust (trust code RAE), Buckinghamshire Healthcare NHS Trust (trust code RXQ), County Durham and Darlington NHS Foundation Trust (trust code RXP), Nottingham University Hospitals NHS Trust (trust code RX1), Portsmouth Hospitals University NHS Trust (trust code RHU), The Princess Alexandra Hospital NHS Trust (trust code RQW), University Hospitals Birmingham NHS Foundation Trust (trust code RRK) and West Suffolk NHS Foundation Trust (trust code RGR). Values for these trusts should therefore be interpreted with caution.

4. There are variations between trusts in the recording of same day emergency care (SDEC). Where trusts are submitting SDEC activity as part of the Outpatient dataset or Emergency Care Data Set (ECDS) rather than the Admitted Patient Care (APC) dataset or are recording this activity as day cases within the APC data, these records will not be included in the SHMI. Trusts with SDEC activity removed from the SHMI data have seen an increase in their SHMI value. As all trusts are expected to transition to recording SDEC activity as admitted patients, the data will become more comparable over time and the impact on the SHMI will reduce.

5. On 1st July 2026, North Bristol NHS Trust (trust code RVJ) was acquired by University Hospitals Bristol and Weston NHS Foundation Trust (trust code RA7). The new organisation is called Bristol NHS Foundation Trust (trust code RA7). In this publication, data are still presented for the two separate organisations. Data will be presented for the new trust at a later date.

6. 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.

Last edited: 10 September 2026 9:31 am