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 2024 - December 2024
Accredited official statistics, Official statistics, Open data, Official statistics in development
Summary
This publication of the SHMI relates to discharges in the reporting period January 2024 - December 2024.
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 118 trusts included in the SHMI from 1 January 2024 to 31 December 2024:
• There were approximately 9.4 million discharges, from which 289,000 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.
• 8 trusts had a higher than expected number of deaths. Of these 8 trusts, 5 also had a higher than expected number of deaths for the same period in the previous year.
• 98 trusts had a number of deaths within the expected range.
• 12 trusts had a lower than expected number of deaths. Of these 12 trusts, 9 also had a lower than expected number of deaths for the same period in the previous year.
Notes:
1. On 1st January 2025, North Middlesex University Hospital NHS Trust (trust code RAP) was acquired by Royal Free London NHS Foundation Trust (trust code RAL). This new organisation structure is reflected from this publication onwards.
2. There is a shortfall in the number of records for Northumbria Healthcare NHS Foundation Trust (trust code RTF), The Rotherham NHS Foundation Trust (trust code RFR), The Shrewsbury and Telford Hospital NHS Trust (trust code RXW), and Wirral University Teaching Hospital NHS Foundation Trust (trust code RBL). Values for these trusts are based on incomplete data and should therefore be interpreted with caution.
3. There is a high percentage of records with missing data for the Sex field for Guy’s and St Thomas’ NHS Foundation Trust (trust code RJ1) and University Hospitals Dorset NHS Foundation Trust (trust code R0D). Values for these trusts should therefore be interpreted with caution.
4. There is a high percentage of invalid diagnosis codes for Chesterfield Royal Hospital NHS Foundation Trust (trust code RFS), East Lancashire Hospitals NHS Trust (trust code RXR), Great Western Hospitals NHS Foundation Trust (trust code RN3), Harrogate and District NHS Foundation Trust (trust code RCD), Milton Keynes University Hospital NHS Foundation Trust (trust code RD8), Portsmouth Hospitals University NHS Trust (trust code RHU), Royal United Hospitals Bath NHS Foundation Trust (trust code RD1), University Hospitals Birmingham NHS Foundation Trust (trust code RRK), University Hospitals of North Midlands NHS Trust (trust code RJE), and University Hospitals Plymouth NHS Trust (trust code RK9). Values for these trusts should therefore be interpreted with caution.
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.
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: 8 May 2025 9:31 am