This publication of the SHMI relates to discharges in the reporting period March 2023 - February 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).

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This indicator is designed to accompany the SHMI publication. The SHMI includes all deaths reported of patients who were admitted to non-specialist acute trusts in England and either died while in hospital or within 30 days of discharge. Deaths related to COVID-19 are excluded from the SHMI. A contextual indicator on the percentage of deaths reported in the SHMI which occurred in hospital and the percentage which occurred outside of hospital is produced to support the interpretation of the SHMI. 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 East Lancashire Hospitals NHS Trust (trust code RXR) and The Princess Alexandra Hospital NHS Trust (trust code RQW). 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. Due to a problem with the process which links Hospital Episode Statistics (HES) data to the Office for National Statistics (ONS) death registrations data, some in-hospital deaths have been counted as survivals in a small number of trusts. This affects 80 spells in the current time period for Mid and South Essex NHS Foundation Trust (trust code RAJ) meaning that the number of observed deaths has been underestimated and so the results for this trust should be interpreted with caution. For the other trusts, the number of affected spells is 5 or fewer and so the impact will be small. 6. 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. 7. 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.

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These mortality indicators provide information to help the National Health Service (NHS) monitor success in preventing potentially avoidable deaths following hospital treatment. The National Confidential Enquiry into Patients Outcomes and Death (NCEPOD) have, over many years, consistently shown that some deaths are associated with shortcomings in health care. The NHS may be helped to prevent such potentially avoidable deaths by seeing comparative figures and learning lessons from the confidential enquiries, and from the experience of hospitals with low death rates. The indicators presented measure mortality rates for patients, admitted for certain conditions or procedures, where the death occurred either in hospital or within 30 days of the emergency admission or operative procedure. Data are presented for the 10 year period 2005/06 to 2014/15, and in separate breakdowns for females, males and persons For information on the definitions of what these indicators include, please see the relevant specification.

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England

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England

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