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).

Legacy unique identifier: P00085

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To reduce deaths from stroke.

Mortality from accidental falls (ICD-10 W00-W19 equivalent to ICD-9 E880-888 excluding E887). To reduce deaths from accidental falls. Legacy unique identifier: P00085

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.

Update 2 March 2023: Following the merger of NHS Digital and NHS England on 1st February 2023 we are reviewing the future presentation of the NHS Outcomes Framework indicators. As part of this review, the annual publication which was due to be released in March 2023 has been delayed. Further announcements about this dataset will be made on this page in due course. Directly standardised mortality rate from cancer for people aged under 75, per 100,000 population. To ensure that the NHS is held to account for doing all that it can to prevent deaths from cancer in people under 75. Some different patterns have been observed in the 2020 mortality data which are likely to have been impacted by the coronavirus (COVID-19) pandemic. Statistics from this period should also be interpreted with care. Legacy unique identifier: P01733

To reduce deaths from epilepsy.

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. It includes deaths which occurred in hospital and deaths which occurred outside of hospital within 30 days (inclusive) of discharge. The SHMI gives an indication for each non-specialist acute NHS trust in England whether the observed number of deaths within 30 days of discharge from hospital was 'higher than expected' (SHMI banding=1), 'as expected' (SHMI banding=2) or 'lower than expected' (SHMI banding=3) when compared to the national baseline. 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. The SHMI is composed of 144 different diagnosis groups and these are aggregated to calculate the overall SHMI value for each trust. The number of finished provider spells, observed deaths and expected deaths at diagnosis group level for each trust is available in the SHMI diagnosis group breakdown files. For a subset of diagnosis groups, an indication of whether the observed number of deaths within 30 days of discharge from hospital was 'higher than expected', 'as expected' or 'lower than expected' when compared to the national baseline is also provided. Details of the 144 diagnosis groups can be found in Appendix A of the SHMI specification. 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), 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), 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.

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Legacy unique identifier: P00168

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To reduce deaths from stroke.

These indicators are designed to accompany the SHMI publication. The SHMI methodology includes an adjustment for admission method. This is because crude mortality rates for elective admissions tend to be lower than crude mortality rates for non-elective admissions. Contextual indicators on the crude percentage mortality rates for elective and non-elective admissions where a death occurred either in hospital or within 30 days (inclusive) of being discharged from hospital are produced to support the interpretation of the SHMI. Notes: 1. There is a shortfall in the number of records for East Lancashire Hospitals NHS Trust (trust code RXR), Harrogate and District NHS Foundation Trust (trust code RCD) and Northern Lincolnshire and Goole NHS Foundation Trust (trust code RJL). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 2. Data for Royal Surrey County Hospital NHS Foundation Trust (trust code RA2) has been suppressed from publication. This trust had submitted in error a high percentage of records with no secondary care diagnosis codes, this has made their SHMI values highly misleading. 3. 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 SHMI background quality report. 4. 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.

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. For discharges in the reporting period April 2024 - May 2024, almost all of the records for Wirral University Teaching Hospital NHS Foundation Trust (trust code RBL) have been submitted without an NHS number. This will have affected the linkage of the HES data to the ONS death registrations data and may have resulted in a smaller number of deaths occurring outside hospital within 30 days of discharge being identified for this trust than would have otherwise been the case. The results for this trust should therefore be interpreted with caution. 2. There is a shortfall in the number of records for North Middlesex University Hospital NHS Trust (trust code RAP), Northumbria Healthcare NHS Foundation Trust (trust code RTF), The Rotherham NHS Foundation Trust (trust code RFR), and The Shrewsbury and Telford Hospital NHS Trust (trust code RXW). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 3. 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. 4. 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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Legacy unique identifier: P00534

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