These indicators are designed to accompany the SHMI publication.
The SHMI methodology does not make any adjustment for patients who are recorded as receiving palliative care. This is because there is considerable variation between trusts in the way that palliative care is recorded.
Contextual indicators on the percentage of provider spells and deaths reported in the SHMI where palliative care was recorded at either treatment or specialty level 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 was a fall in the overall number of spells for England from March 2020 due to COVID-19 impacting on activity 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 Chelsea and Westminster Hospital NHS Foundation Trust (trust code RQM). Values for this trust are based on incomplete data and should therefore be interpreted with caution.
4. Frimley Health NHS Foundation Trust (trust code RDU) stopped submitting data to the Secondary Uses Service (SUS) during June 2022 and did not start submitting data again until April 2023 due to an issue with their patient records system. This is causing a large shortfall in records and values for this trust should be viewed in the context of this issue.
5. There is a high percentage of invalid diagnosis codes for Chesterfield Royal Hospital NHS Foundation Trust (trust code RFS), Milton Keynes University Hospital NHS Foundation Trust (trust code RD8), and West Suffolk NHS Foundation Trust (trust code RGR). Values for these trusts should therefore be interpreted with caution.
6. Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), East and North Hertfordshire NHS Trust (trust code RWH), Epsom and St Helier University Hospitals NHS Trust (trust code RVR), Frimley Health NHS Foundation Trust (trust code RDU), Imperial College Healthcare NHS Trust (trust code RYJ), Manchester University NHS Foundation Trust (trust code R0A), Norfolk and Norwich University Hospitals NHS Foundation Trust (trust code RM1), Sandwell and West Birmingham Hospitals NHS Trust (trust code RXK), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG) are now submitting Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS) rather than the Admitted Patient Care (APC) dataset. The SHMI is calculated using APC data. Removal of SDEC activity from the APC data may impact a trust’s SHMI value and may increase it. More information is available in the Background Quality Report.
7. On 1 July 2023 Southport and Ormskirk Hospital NHS Trust (trust code RVY) was acquired by St Helens and Knowsley Teaching Hospitals NHS Trust (trust code RBN). The new organisation is known as Mersey and West Lancashire Teaching Hospitals NHS Trust (trust code RBN). This new organisation structure is reflected from this publication onwards.
8. 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.