Publication, Part of Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation
Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, January 2023 - December 2023
Accredited official statistics, Official statistics, Open data, Official statistics in development
SHMI methodological changes from May 2024
We have implemented various methodological changes from the May 2024 SHMI publication. Further information is available at http://digital.nhs.uk/pubs/methchanges.
9 May 2024 09:30 AM
Correction of Interactive Data Visualisation
The interactive data visualisation was updated on 12th December 2024. An issue was discovered with the Map slide where sites that share the same postcode were appearing with incorrect data. Only a small number of sites were affected. This has now been corrected.
12 December 2024 09:30 AM
Summary
This publication of the SHMI relates to discharges in the reporting period January 2023 - December 2023.
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. The SHMI covers patients admitted to hospitals in England who died either while in hospital or within 30 days of being discharged.
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 expected number of deaths is a statistical construct and is not a count of patients. The difference between the number of observed deaths and the number of expected deaths cannot be interpreted as the number of avoidable deaths or excess deaths for the trust.
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).
Highlights
For the 119 trusts included in the SHMI from 1 January 2023 to 31 December 2023:
• There were approximately 9.0 million discharges, from which 290,000 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.
• 10 trusts had a higher than expected number of deaths. Of these 10 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.
• 14 trusts had a lower than expected number of deaths. Of these 14 trusts, 11 also had a lower than expected number of deaths for the same period in the previous year.
Notes:
1. There is a shortfall in the number of records for East Lancashire Hospitals NHS Trust (trust code RXR), Guy’s and St Thomas’ NHS Foundation Trust (trust code RJ1), Harrogate and District NHS Foundation Trust (trust code RCD) and King’s College Hospital NHS Foundation Trust (trust code RJZ). Values for these trusts are based on incomplete data and should therefore be interpreted with caution.
2. 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.
3. There is a high percentage of invalid diagnosis codes for Barking, Havering and Redbridge University Hospitals NHS Trust (trust code RF4), Chesterfield Royal Hospital NHS Foundation Trust (trust code RFS), East Lancashire Hospitals NHS Trust (trust code RXR), Milton Keynes University Hospital NHS Foundation Trust (trust code RD8), Portsmouth Hospitals University NHS Trust (trust code RHU), and University Hospitals Plymouth NHS Trust (trust code RK9). Values for these trusts should therefore be interpreted with caution.
4. 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.
5. 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.
Data Sets
- SHMI COVID-19 activity contextual indicators
- SHMI admission method contextual indicators
- SHMI data
- SHMI deprivation contextual indicators
- SHMI depth of coding contextual indicators
- SHMI in and outside hospital deaths contextual indicator
- SHMI palliative care coding contextual indicators
- SHMI primary diagnosis coding contextual indicators
- SHMI site change during spell contextual indicator
- SHMI statistical model data
Resources
Last edited: 10 December 2024 1:35 pm