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Publication, Part of

Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, August 2021 - July 2022

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

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Summary

This publication of the SHMI relates to discharges in the reporting period August 2021 - July 2022.

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. Deaths related to COVID-19 are excluded from the SHMI.

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 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). Information about the exclusion of COVID-19 from the SHMI can also be found on the same page. A link to the methodological changes statement which details the exclusion is also available in the Related Links section.


Highlights

For the 121 trusts included in the SHMI from 1 August 2021 to 31 July 2022:

• There were approximately 8.2 million discharges, from which 249,000 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, 5 also had a higher than expected number of deaths for the same period in the previous year.

• 95 trusts had a number of deaths within the expected range.  

• 15 trusts had a lower than expected number of deaths.  Of these 15 trusts, 10 also had a lower than expected number of deaths for the same period in the previous year.

Interactive data visualisation

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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 was a fall in the overall number of spells from March 2020 due to COVID-19 impacting on activity for England and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication.

3. There is a shortfall in the number of records for Ashford and St Peter's Hospitals NHS Foundation Trust (trust code RTK), County Durham and Darlington NHS Foundation Trust (trust code RXP), Frimley Health NHS Foundation Trust (trust code RDU), Mid Cheshire Hospitals NHS Foundation Trust (trust code RBT), North Bristol NHS Trust (trust code RVJ), Royal Surrey County Hospital NHS Foundation Trust (trust code RA2), and Wrightington, Wigan and Leigh NHS Foundation Trust (trust code RRF). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 

4. 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: 4 January 2023 10:48 am