Recommendation 271

Status of mortality indicators

To the extent that summary hospital-level mortality indicators are not already recognised as national or official statistics, the Department of Health and the Health and Social Care Information Centre should work towards establishing such status for them or any successor hospital mortality figures, and other patient outcome statistics, including reports showing provider-level detail.

The Summary Hospital-level Mortality Indicator which reports mortality data at trust level across the NHS in England, has been produced and published by the Health and Social Care Information Centre as an experimental Official Statistic since October 2011.

The UK Statistics Authority’s independent review of patient outcome statistics referred to in relation to recommendation 270 includes in scope a review of the Summary Hospital-level Mortality Indicator, its accessibility to patients and the public and its status as official statistics.  It is expected that the review will recommend that the Summary Hospital-level Mortality Indicator is assessed by UK Statistics Authority against the Code of Practice for Official Statistics with a view to securing designation as national statistics.

In July 2013, Professor Sir Bruce Keogh published his Review into the quality of care and treatment provided by 14 hospital trusts in England. In his report Sir Bruce announced that he had asked Professor Nick Black and Professor Lord Ara Darzi to undertake a study into the relationship between excess mortality rates and actual avoidable deaths.  This study is expected to pave the way for the introduction of a new national indicator on avoidable deaths in hospital measured through case notes reviews.


The UK Statistics Authority’s review Official Statistics on Patient Outcomes in England recommended that Summary Hospital-level Mortality Indicator should be assessed against the Statistics Code. That assessment has begun.

Professor Nick Black’s study has also commenced with preliminary results from the study expected in December 2014. The study is due to be completed in March 2015, after which findings will be published.

Robust and accessible reporting of avoidable hospital deaths is not a simple matter, but the intention is to develop presentations and measures which can be understood and used by patients, and acted upon by clinicians and used by patients, and acted upon by clinicians and regulators, in a continual drive to reduce avoidable deaths.