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National Statistics

Summary Hospital-level Mortality Indicator (SHMI) - Deaths associated with hospitalisation, England, October 2015 - September 2016 [NS]

19:44 August 22, 2017 - 09:30 March 23, 2017
Publication date: March 23, 2017
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The Summary Hospital-level Mortality Indicator (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. 

It covers all deaths reported of patients who were admitted to non-specialist acute trusts in England and either die while in hospital or within 30 days of discharge.  This publication of the SHMI relates to discharges in the reporting period October 2015 to September 2016.

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 SHMI is not a measure of quality of care.  A higher/lower than expected number of deaths should not immediately be interpreted as indicating poor/good performance and instead should be viewed as a ‘smoke alarm’ which requires further investigation. 

Further background information and supporting documents, including information on how to interpret the SHMI, are available on the SHMI support and guidance page (link below).

Key facts

For the 136 trusts included in the SHMI from 1 October 2015 to 30 September 2016:
  • There were approximately 8.9 million finished provider spells, from which 286,000 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, 8 also had a higher than expected number of deaths for the same period in the previous year.
  • 111 trusts had a number deaths within the expected range.
  • 15 trusts had a lower than expected number of deaths.  Of these 15 trusts, 9 also had a lower than expected number of deaths for the same period in the previous year.


  1. There is a shortfall in the number of records in the Hospital Episode Statistics (HES) data for discharges in the reporting period October 2015 – September 2016 for Royal Free London NHS Foundation Trust (provider code RAL).  Further details are provided in the HES data quality notes (link below). This has a negligible impact on the SHMI at national level. However, the SHMI values for this trust should be interpreted with caution.  

  2. 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.



Date Range: October 01, 2015 to September 30, 2016
Geographical coverage:
Geographical granularity:
NHS Trusts

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