These indicators are designed to accompany the SHMI publication.
The SHMI methodology does not make any adjustment for deprivation. This is because adjusting for deprivation might create the impression that a higher death rate for those who are more deprived is acceptable. Patient records are assigned to 1 of 5 deprivation groups (called quintiles) using the Index of Multiple Deprivation (IMD). The deprivation quintile cannot be calculated for some records e.g. because the patient's postcode is unknown or they are not resident in England.
Contextual indicators on the percentage of provider spells and deaths reported in the SHMI belonging to each deprivation quintile 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 the 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 some trusts due to COVID-19 impacting on activity from March 2020 onwards and this appears to be an accurate reflection of hospital activity rather than a case of missing data. Further information is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication.
3. A large proportion of records for Mid and South Essex NHS Foundation Trust (trust code RAJ) have missing or incorrect information for the main condition the patient was in hospital for (their primary diagnosis) and this will have affected the calculation of the expected number of deaths. Values for this trust should therefore be interpreted with caution.
4. 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 Hospital Episode Statistics (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.
5. There is a shortfall in the number of records for North Cumbria Integrated Care NHS Foundation Trust (trust code RNN) meaning that values for this trust are based on incomplete data and should therefore be interpreted with caution.
6. An issue with HES reference data has resulted in some records for Guy’s and St Thomas’ NHS Foundation Trust (trust code RJ1) being flagged as invalid. This has led to a shortfall in spells, meaning that values for this trust are based on incomplete data and should therefore be interpreted with caution.
7. 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.