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Summary Hospital-level Mortality Indicator

The Summary Hospital-level Mortality Indicator (SHMI) is an indicator which reports on mortality at trust level across the NHS in England using a standard and transparent methodology. It is produced and published quarterly as an experimental official statistic by the Health and Social Care Information Centre (HSCIC) with the first publication in October 2011.


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.


Why are we producing the SHMI?

Following the recommendations from the national review of the Hospital Standardised Mortality Ratio (HSMR), the Department of Health has commissioned the HSCIC to produce and publish the SHMI. As part of the review, the Department of Health also commissioned independent statistical modelling work, which was carried out by the School of Health and Related Research (ScHARR) at the University of Sheffield and their report is available to download below.


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.

pdf icon Indicator Specification: Summary Hospital-level Mortality Indicator methodology [812kb]

xls icon Amended AHRQ CCS ICD-10 lookup table May13 [339kb]

To support the interpretation of the SHMI, various contextual indicators are published alongside it and their specifications are also available to download.

pdf icon Indicator Specification: Percentage of provider spells with palliative care coding [508kb]

pdf icon Indicator Specification: Percentage of deaths with palliative care coding [592kb]

pdf icon Indicator Specification: Deaths within 30 days for elective admissions [544kb]

pdf icon Indicator Specification: Deaths within 30 days for non-elective admissions [535kb]

pdf icon Indicator Specification: Deaths split by those occurring in hospital and those occurring outside hospital [456kb]

pdf icon Indicator Specification: Provider spells split by deprivation quintile [533kb]

pdf icon Indicator Specification: Deaths split by deprivation quintile [516kb]


Our commitment to continuous improvement

The SHMI will be subject to continuous review and is currently going through the HSCIC's Indicator Assurance Process.

The SHMI Technical Working Group support and contribute to the technical work associated with the development and construction of the SHMI. Proceedings of the SHMI Technical Working Group are made publicly available.

SHMI Technical Working Group Proceedings

We welcome further comments on the SHMI, and suggestions for improvement should be sent to clinical.indicators@hscic.gov.uk.

pdf icon SHMI Methodology Specification Issues Log [508kb]

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