Learning from deaths

Thanks to advances in medicine over the past 100 years, we’re all living longer, healthier lives.

But despite the new technology and medical breakthroughs, people die in hospital every day of the year. Typically, we expect between 60 and 70 people in our care will die each month.

Most of the time, these deaths are unavoidable – the consequences of major trauma such as road traffic accidents, as well as other serious conditions like heart attacks.

Some people die because their illness is incurable. Others have just come to the end of their natural life and the most important thing is that they have a dignified and respectful death, ideally at home surrounded by their loved ones.

How we measure mortality

Measuring mortality rates (that is the rate of deaths) not only helps the NHS better understand the risks inherent in care and treatment but can identify patterns where improvements could be made.

When it comes to measuring mortality rates, there are three main figures used:

  • Crude mortality rate: the rate from all causes of death in hospital
  • Hospital standardised mortality rate (HSMR): an indicator that measures whether the number of deaths in hospital is higher or lower than expected. HSMR is published on behalf of the NHS by the Dr Foster organisation
  • Summary hospital-level mortality indicator (SHMI): the ratio between the actual number of patients who die following treatment 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. SHMI is published by NHS Digital


Mortality rates for consultant surgeons. Through a national initiative supported by relevant medical Royal Colleges and doctors’ organisations, mortality rate information relating to individual surgeons across a number of clinical specialties is published routinely via the national MyNHS website.

How is the Trust performing?

The SHMI and HSMR figures for the Trust remain higher than expected. Our two highest local mortality-related diagnoses are for pneumonia and stroke.

The Trust is committed to bringing its SHMI score within the expected range by January 2021.

The Trust’s Associate Medical Director for Patient Safety is leading this work, giving assurance and reporting on progress each month to the Board’s Quality and Safety Committee.

The committee will make a report every month to start with and then every three months on progress to the Trust Board in line with national requirements.