This indicator is designed to accompany the SHMI data at site of treatment level.
The SHMI is calculated at the level of the provider spell, which is a continuous period of time spent as a patient within a single trust (provider). A spell may be composed of more than 1 episode (a single period of care under 1 consultant). If a patient is moved between hospitals or sites within the same trust, the provider spell continues. Most spells consist of a single episode and so there is no complication when presenting SHMI data at site level because the entire provider spell occurred at a single site. However, spells consisting of multiple episodes may have occurred over multiple sites and only 1 of these sites can be associated with the spell. This has been chosen to be the site of the 1st episode in the spell. This may result in hospital deaths being attributed to a site other than the one in which they occurred, with an impact on the SHMI values presented for the sites concerned. This impact is likely to be greater for sites within trusts showing higher percentages for this contextual indicator.
This indicator is being published as an experimental statistic. Experimental statistics are official statistics which are published in order to involve users and stakeholders in their development and as a means to build in quality at an early stage.
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 The Princess Alexandra Hospital NHS Trust (trust code RQW), Guy’s and St Thomas’ NHS Foundation Trust (RJ1), King’s College Hospital NHS Foundation Trust (RJZ), and East Lancashire Hospitals NHS Trust (RXR). 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. 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.
6. 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.