Revealed: Seven trusts remain death rate outliers for second year in a row

Seven trusts in England have experienced higher than average patient mortality rates for two years in a row, according to newly published data from the Health and Social Care Information Centre (HSCIC).

The Summary Hospital-level Mortality Indicator (SHMI) is the ratio between the actual number of patients who die in hospital at the trust or within 30 days of hospitalisation 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 figures show that in 2015, 15 trusts had a higher than expected SHMI, of which seven were also higher than expected in 2014: Blackpool, East Sussex, Medway, North Tees and Hartlepool, South Tyneside, Tameside and Wye Valley.

Dr Deepak Dwarakanath, medical director at North Tees and Hartlepool NHS FT, said: “Naturally these figures are a cause for concern and we have had a number of external organisations working with us to understand these figures and to suggest areas for improvement.

“So far we have been assured we are doing everything that could be expected of any healthcare organisation. However we are continuing to investigate why our mortality ratio is higher than expected.”

He added that North Tees and Hartlepool is unusual because it sees nearly 20% of emergency medical patients in the ambulatory care unit, meaning that they aren’t counted in inpatient figures.


SHMI value Jan–Dec 2015

SHMI value Jan-Dec 2014

Blackpool Teaching Hospitals NHS Foundation Trust



East Sussex Healthcare NHS Trust



Medway NHS Foundation Trust



North Tees and Hartlepool NHS Foundation Trust



South Tyneside NHS Foundation Trust



Tameside Hospital NHS Foundation Trust



Wye Valley NHS Trust




The results also show that 107 trusts had an as expected SHMI and 14 had a lower than expected, of whom 10 were also lower than expected outliers in 2014.


SHMI value Jan–Dec 2015

SHMI value Jan-Dec 2014

Barts Health NHS Trust



Cambridge University Hospitals NHS Foundation Trust



Chelsea and Westminster Hospital NHS Foundation Trust



Guy’s and St Thomas NHS Foundation Trust



Imperial College Healthcare NHS Trust



King’s College Hospital NHS Foundation Trust



Royal Free London NHS Foundation Trust



Royal Surrey County Hospital NHS Foundation Trust



The Whittington Hospital NHS Foundation Trust



University College London Hospitals NHS Foundation Trust




The data did not indicate a correlation between levels of deprivation and SHMI ratio.

Six of the higher than expected outliers had a mean IMD (Index of Multiple Deprivation) Overall Rank over all finished provider spells for patients which was lower than the national average, indicating a higher level of deprivation, but so did seven of the lower than expected outliers.

However, Professor Mark O’Donnell, medical director at Blackpool Teaching Hospitals NHS FT, said the influence of deprivation was still worth considering.

“Any discussion around SHMI figures must recognise a number of factors including the health of the local population,” he said. “Although there are pockets of affluence, the population of Blackpool is one of the most deprived in England. Furthermore, levels of HIV infection, drug misuse, alcohol misuse and antidepressant prescribing are amongst the highest in England and male life expectancy is the lowest in England.’’

He said that Blackpool Teaching Hospitals was “working extremely hard” to reduce mortality rates and was in the top 25% of improving trusts nationally

The SHMI is one of a core set of indicators which must be included in a trust’s Quality Account, which is an annual report produced by each NHS healthcare provider. However, the HSCIC stressed that it is not a measure of quality on its own or a measure of avoidable deaths.

Dr Shaz Wahid, medical director at South Tyneside NHS FT, said that the trust had already hired the North of England Commissioning Support Unit to carry out an internal review of the figures.

The results, which were also published and approved by the North East Quality Observatory Service, found that South Tyneside’s SHMI is normal when deaths of patients in St Benedict’s Hospice, who did not otherwise receive care from South Tyneside, are excluded.

“There is absolutely no evidence that services in South Tyneside District Hospital are unsafe, nor that there are excessive deaths in the hospital,” Dr Wahid said. “We can assure people that the death rates in South Tyneside are not raised but, also, that we have robust systems within the hospital to constantly review all deaths to ensure care is of the best standard.”

Have you got a story to tell? Would you like to become an NHE columnist? If so, click here.



There are no comments. Why not be the first?

Add your comment

national health executive tv

more videos >

latest news

View all News


NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental ... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Bei... more >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’ve witnessed. Staff have gone above and beyond, whole hospitals and trusts have flexed virtually at will to meet demand and pressures and we’ve... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us throu more > more last word articles >


Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual... more >

the scalpel's daily blog

Covid-19 can signal a new deal with the public on health

28/08/2020Covid-19 can signal a new deal with the public on health

Danny Mortimer, Chief Executive, NHS Employers & Deputy Chief Executive, NHS Confederation The common enemy of coronavirus united the public side by side wi... more >
read more blog posts from 'the scalpel' >

healthcare events

events calendar


September 2020

mon tue wed thu fri sat sun
31 1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 1 2 3 4
5 6 7 8 9 10 11

featured articles

View all News