Publication, Part of Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation

Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, January 2019 - December 2019

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

Publication Date:: 14 May 2020
Geographic Coverage:: England
Geographical Granularity:: NHS Trusts, Hospital Sites
Date Range:: 01 Jan 2019 to 31 Dec 2019

Summary

This publication of the SHMI relates to discharges in the reporting period January 2019 - December 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). Information about the impact of COVID-19 on the SHMI can also be found on the same page.

Highlights

For the 129 trusts included in the SHMI from 1 January 2019 to 31 December 2019:

• There were approximately 9.4 million discharges, from which 293,000 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.

• 10 trusts had a higher than expected number of deaths. Of these 10 trusts, 4 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.

• 15 trusts had a lower than expected number of deaths. Of these 15 trusts, 12 also had a lower than expected number of deaths for the same period in the previous year.

Notes:

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 are based on incomplete data and should therefore be interpreted with caution.

2. 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.

3. From the March 2020 publication onwards, the deprivation contextual indicators are calculated using the 2019 version of the Index of Multiple Deprivation (IMD) meaning that the results are not comparable with previous releases of these indicators (which used the 2015 version). Further information is available in the statement of methodological changes (see Related links).

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). However, as we received notification of these changes after data processing for this publication began, separate indicator values have been produced for this publication. Future publications in this series will reflect the updated organisation structures.

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 name and code is yet to be confirmed. However, as we received notification of these changes after data processing for this publication began, separate indicator values have been produced for this publication. Future publications in this series will reflect this new organisation structure and the confirmed organisation name once finalised.

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.