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 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 East Lancashire Hospitals NHS Trust (trust code RXR) and The Princess Alexandra Hospital NHS Trust (trust code RQW). Values for these trusts 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. 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 80 spells in the current time period for Mid and South Essex NHS Foundation Trust (trust code RAJ) 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 is 5 or fewer and so the impact will be small.
6. A number of trusts 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 about this is available in the Background Quality Report.
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.