Read about our Hospital standardised mortality ratio (HSMR) and Standardised hospital mortality indicator (SMHI)

Mortality rates

Hospital standardised mortality ratio (HSMR)


The HSMR score is produced by Dr Foster Intelligence. It allows us to look at our mortality performance in a way that can be compared and contrasted with other hospitals.

The HSMR score is worked out by looking at performance in the NHS and adjusting the mortality risk in a spell of patient care for risk factors such as their age, gender and health conditions. The HSMR uses risk models to provide the number of ‘expected deaths’ per trust per month, compared with the number of actual deaths at the trust. This helps to produce the level of risk, called the ‘relative risk figure’ for each trust, which shows how each trust performs against the NHS average.

We report on our HSMR indicator every month, three months in arrears. We measure our mortality performance against the Shelford Group – a group of ten leading NHS Trusts in England

Standardised hospital mortality indicator (SMHI)


The SHMI score is produced by the NHS Health and Social Care Information Centre. The score looks at deaths which have occurred at the trust, as well as the number of patients who have died up to 30 days post-discharge.

The SHMI score is worked out by looking at performance in the NHS and adjusting the mortality risk in a spell of patient care for risk factors such as their age, gender and health conditions. Like the HSMR, the SHMI uses risk models to provide the number of ‘expected deaths’ per trust per month, compared with the number of actual deaths at the trust. This helps to produce the level of risk, called the ‘relative risk figure’ for each trust, which shows how each Trust performs against the NHS average.

We report on this indicator every quarter, six months in arrears.

HSMR scores are included in the quick overview of monthly performance indicators

HSMR and SHMI scores are included in the full scorecard published bi-monthly.