Skip Navigation
Search site

This is our old website. Most information can now be found on our new NHS Digital website. Let us know what you think.

Report looks at high or low mortality ratios across hospital trusts in England

27 January, 2015: The Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, July 2013 - June 2014 compares the actual number of patients who die following hospitalisation at a particular trust with the number that would be expected to die, based upon average England figures, given the characteristics of the patients treated there(2).

Fifteen NHS trusts in England have been categorised as having a 'lower than expected'3 mortality ratio according to a new report published by the Health and Social Care Information Centre (HSCIC). The report also shows that nine trusts have been categorised as having a 'higher than expected' mortality ratio and 113 trusts had an 'as expected' SHMI.

This indicator includes deaths occurring during a stay at a trust or within 30 days of discharge, providing an indication of whether the overall number of deaths at a particular trust was 'lower than expected', 'as expected' or 'higher than expected' when compared to the national baseline.

The SHMI can be used by hospital trusts to compare their mortality outcomes to the national baseline. However, it requires careful interpretation and must be viewed alongside other evidence, rather than as a stand-alone verdict on a hospital trust's performance.

It must not be used to directly compare mortality outcomes between trusts and it is inappropriate to rank trusts according to their SHMI.

Of the 137 trusts4 reported in the SHMI for the period July 2013 - June 2014 there were:

  • 15 trusts that had a 'lower than expected' SHMI. Of these, 11 were also in this category for the same period a year previously5.
  • Nine trusts that had a 'higher than expected' SHMI. Of these, three trusts were in this category for the same period a year previously6.

The 15 trusts with a 'lower than expected' SHMI for the period July 2013 - June 2014 were:

  • Barts Health NHS Trust
  • Cambridge University Hospitals NHS Foundation Trust
  • Chelsea and Westminster Hospital NHS Foundation Trust
  • Guy's and St Thomas' NHS Foundation Trust
  • Homerton University Hospital NHS Foundation Trust
  • Imperial College Healthcare NHS Trust
  • Kingston Hospital NHS Foundation Trust
  • London North West Healthcare NHS Trust
  • North Middlesex University Hospital NHS Trust
  • Royal Free London NHS Foundation Trust
  • Royal Surrey County Hospital NHS Foundation Trust
  • St George's Healthcare NHS Trust
  • The Hillingdon Hospitals NHS Foundation Trust
  • The Whittington Hospital NHS Trust7
  • University College London Hospitals NHS Foundation Trust

The nine trusts with a 'higher than expected' SHMI for the period July 2013 - June 2014 were:

  • Aintree University Hospital NHS Foundation Trust
  • Blackpool Teaching Hospitals NHS Foundation Trust
  • City Hospitals Sunderland NHS Foundation Trust
  • East and North Hertfordshire NHS Trust
  • Medway NHS Foundation Trust
  • North Tees and Hartlepool NHS Foundation Trust
  • Southport and Ormskirk Hospital NHS Trust
  • South Tyneside NHS Foundation Trust
  • Tameside Hospital NHS Foundation Trust

Today's report also provides additional contextual information on palliative care, method of admission, deaths in or out of hospital and deprivation8.

HSCIC chair Kingsley Manning said: "The SHMI gives trusts a way of comparing their mortality outcomes to the national baseline.

This information can then be used with other indicators and evidence as a prompt for trusts to undertake further investigations of their services where necessary."

The full report is at: http://www.hscic.gov.uk/pubs/shmijul13jun14

ENDS


Notes to editors

1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 220 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.

2. The risk of the patient dying in hospital or within 30 days of discharge is estimated from a statistical model based on the following variables: the condition for which the patient is in hospital, other underlying conditions from which the patient suffers, age, sex and the method of admission to hospital (elective/non-elective/unknown)

3. A SHMI is calculated for each trust and the baseline SHMI is 1. A trust will only have a SHMI of 1 if the number of patients who die following hospitalisation there is exactly the same as the number of patients expected to die based on the SHMI methodology.

To help users of the data understand the SHMI, trusts have been categorised into one of the following three bandings:

· Where the trust's SHMI is 'lower than expected'

· Where the trust's SHMI is 'as expected'

· Where the trust's SHMI is 'higher 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.

4. The total number of trusts has decreased by four from 141 in the same period a year previously to 137 due to the acquisition of Barnet and Chase Farm Hospitals NHS Trust by the Royal Free London NHS Foundation Trust, the establishment of the London North West Healthcare NHS Trust following the closure of Ealing Hospital NHS Trust and North West London Hospitals NHS Trust, the acquisition of Heatherwood and Wexham Park Hospitals NHS Foundation Trust by Frimley Health NHS Foundation Trust, and the closure of Mid Staffordshire NHS Foundation Trust.

Specialist trusts, mental health trusts, community trusts and independent sector providers are excluded from the SHMI because there are important differences in the case-mix of patients treated there compared to non-specialist acute trusts and the SHMI has not been designed for these types of trusts.

5. Barts Health NHS Trust, Cambridge University Hospitals NHS Foundation Trust, Chelsea and Westminster Hospital NHS Foundation Trust, Guy's and St Thomas' NHS Foundation Trust, Imperial College Healthcare NHS Trust, North Middlesex University Hospital NHS Trust, Royal Free London NHS Foundation Trust, St George's Healthcare NHS Trust, The Hillingdon Hospitals NHS Foundation Trust, The Whittington Hospital NHS Trust, University College London Hospitals NHS Foundation Trust.

6. Aintree University Hospital NHS Foundation Trust, Blackpool Teaching Hospitals NHS Foundation Trust, North Tees and Hartlepool NHS Foundation Trust.

7. There is a shortfall in the number of records in the Hospital Episode Statistics (HES) data which has been used to produce the SHMI for July 2013 - June 2014 for The Whittington Hospital NHS Trust. This has a negligible impact on the SHMI at national level. However, the SHMI for this trust will be based on incomplete data and should therefore be interpreted with caution.

8. The report uses the Index of Multiple Deprivation (IMD) version 2010 as a measure of deprivation. The IMD attempts to measure a broad concept of deprivation composed of several different domains, including income, employment, health deprivation and disability, education, skills and training, barriers to housing and services, crime, living environment. Where the press release refers to the 'most deprived areas' these are areas defined by the HSCIC as belonging to deprivation quintile 1, the most deprived quintile.

9. For media enquiries please contact media@hscic.gov.uk or 0300 30 33 888.

Close iCM Form