Measures of Hospital Mortality Rates and Standards of Care (BBC News / BBC Radio 4’s “File on 4”)


A leading health academic, Professor Nick Black, has been asked by NHS England to review whether the two main measures of mortality – the hospital standardised mortality ratio (HSMR) and the summary hospital-level mortality index (SHMI) – are meaningful or accurate indicators of the quality of care in different hospitals.

Professor Nick Black has stated that these measures of hospital death rates should be ignored, due to their being potentially misleading due to local conditions, open to easy manipulation, and leading to invidious comparisons with an unjustifiable loss of public confidence in certain hospitals (for example those in areas without adequate hospice services locally or with a high local disease burden).

Dr Foster, which uses these death rates in compiling their “Dr Foster Hospital Guide”, asserts that these statistics – while not perfect – identify areas where there appears to be a greater risk of poor quality care; and as such they remain the best indicators available, for the present. The new review of these quality measures, conducted on behalf of NHS England, is due to report in late 2014.

Full Text Link


Triggle, N. (2014). NHS death rates ‘should be ignored’. London: BBC Health News, February 25th 2014.

About Dementia and Elderly Care News

Dementia and Elderly Care News. Wolverhampton Medical Institute: WMI. (jh)
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