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JSNAA

Summary Hospital Mortality Indicator (SHMI)

The Summary Hospital 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 includes deaths which occur in hospital and deaths which occur outside of hospital within 30 days of discharge. 

SHMI banding gives an indication for each non-specialist acute NHS trust in England how the observed number of deaths within 30 days of discharge from hospital compared to the national baseline:

SHMI Band

Band meaning

1

Higher than expected

2

As expected

3

Lower than expected

The SHMI can be used by trusts to compare their mortality outcomes to the national baseline, with some caveats.  Where a trust has an 'as expected' SHMI, it is inappropriate to conclude that their SHMI is lower or higher than the national baseline, even if the number of observed deaths is smaller or larger than the number of expected deaths.

The difference between the number of observed deaths and the number of expected deaths cannot be interpreted as the number of avoidable deaths for the trust.  Whether or not a death could have been prevented can only be investigated by a detailed case-note review, the SHMI is not a direct measure of quality of care.

The expected number of deaths for each trust is not an actual count of patients, it's a statistical construct which estimates the number of deaths that may be expected at the trust on the basis of average England figures and the characteristics of the patients treated there.

A 'higher than expected' SHMI should not immediately be interpreted as indicating bad performance, it should be viewed as a 'smoke alarm' which requires further investigation by the trust.  The SHMI cannot be used to directly compare mortality outcomes between trusts and it's inappropriate to rank trusts according to their SHMI.

Instead, the SHMI banding can be used to compare mortality outcomes to the national baseline.

It's important to note that South Tyneside Hospital has a palliative care unit which provides care for the terminally ill.  This inflates the rate of deaths at the hospital.  Between April 2016 and March 2017 in England just 1.8% of people that died in hospital (or within 30 days of leaving hospital) had received speciality palliative care, in South Tyneside the rate was 14.2%. 

South Tyneside SHMI

SHMI Value:

12 month period

SHMI value

SHMI banding

January 2015 - December 2015

1.16

1

April 2015 - March 2016

1.18

1

July 2015 - June 2016

1.17

1

October 2015 - September 2016

1.16

1

January 2016 - December 2016

1.14

1

April 2016 - March 2017

1.13

1

Number of deaths:

12 month period

Observed deaths

Expected deaths

January 2015 - December 2015

1,168

1,011

April 2015 - March 2016

1,169

992

July 2015 - June 2016

1,180

1,008

October 2015 - September 2016

1,191

1,027

January 2016 - December 2016

1,178

1,032

April 2016 - March 2017

1,141

1,006

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  • Joint Strategic Needs and Assets Assessment (JSNAA)
  • South Shields Town Hall
    Westoe Road
    South Shields
    Tyne & Wear
    United Kingdom
    NE33 2RL

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