Summary Hospital-level Mortality Indicator
The Summary Hospital-level Mortality Indicator (SHMI) reports mortality at trust level across the NHS in England using standard and transparent methodology. We have produced and published this quarterly as an experimental Official Statistic since October 2011.
Why are we producing the SHMI?
The Department of Health are committed to implementing the SHMI as the single hospital-level indicator for the NHS in England and have commissioned the Health and Social Care Information Centre to produce it. This decision was based on the recommendations from the national review of the Hospital Standardised Mortality Ratios (HSMR) with independent statistical modelling work commissioned by the Department of Health and carried out by the School of Health and Related Research (ScHARR) at the University of Sheffield.
- National review of the hospital standardised mortality ratio (external)
- An evaluation of the Summary Hospital Mortality Index (external)
Our commitment to openness and transparency
The documents published here are intended to ensure that the SHMI's specification is founded on a methodology that is completely open and transparent. We expect that the SHMI will need to be interpreted, understood and also reproduced by a range of different users, if necessary. Therefore, we have published a detailed specification document on the construction of the SHMI.
Our commitment to continuous improvement
Like all indicators managed by the Health and Social Care Information Centre, the SHMI will be subject to continuous review, using our Indicator Assurance Process. Outputs from these reviews will be reported to the National Quality Board, and will be available on our website.
Some of the important changes which have been made to date include:
- Increasing the robustness of the logistic regression models by using three years of past data to build the models rather than one year
- Inclusion of an additional field (YEAR_INDEX) to facilitate case-mix adjustment
- Updated Risk Modelling specifications to include logistic regression options for model convergence
- Removal of gender specific diagnosis groups as it is no longer required
- Exclusion of regular night attenders from the data set for consistency with excluding regular attenders
- Specify reference category as first category for all classification/case-mix variables for risk model
- Updated the SHMI banding requirements to report on one banding: 95% random effects model control limits for over-dispersion.
We welcome further comments on the SHMI, and any suggestions for improvement should be sent to clinical.indicators@hscic.gov.uk.
Read more about SHMI methodology
Indicator Specification: Summary Hospital-level Mortality Indicator methodology [804kb]
Indicator Specification: Percentage of admissions with palliative care coding [506kb]
Indicator Specification: Percentage of deaths with palliative care coding [591kb]
Indicator Specification: Deaths within 30 days for elective admissions [543kb]
Indicator Specification: Deaths within 30 days for non-elective admissions [533kb]
Indicator Specification: Provider spells split by deprivation quintile [531kb]
Indicator Specification: Deaths split by deprivation quintile [514kb]
