At St George’s we have a well-established Mortality Monitoring Committee in place to scrutinise our outcomes and the care we provide to patients. Where lessons need to be learned, these are identified, acted upon, and where best practice is observed, this is recognised and acknowledged. This group is chaired by the Associate Medical Director for Mortality and has multidisciplinary membership from all clinical divisions.
We use two measures of risk adjusted mortality to consider how our outcomes compare to the national average – the Summary Hospital-Level Mortality Indicator (SHMI)1 and the Hospital Standardised Mortality Ratio (HSMR)2.
The SHMI is produced by NHS Digital and was last published on 21st September. For the period April 2016 to March 2017 our score is 0.84 which is categorised as lower than expected, which means fewer patients died than would be expected. We are one of 17 trusts in this category and one of 11 trusts where lower than expected mortality has been observed for two consecutive years.
For the same period our HSMR is also significantly better than expected, with a score of 83.1, against a national average of 100.
In September we published our policy related to Learning from Deaths. It describes our processes for complying with the National Learning from Deaths Framework (March 2017) and outlines how the Trust responds to, and learns from deaths of patients who die under our management and care. It defines the categories of deaths in scope for case record review, the role of the Mortality Monitoring Committee in conducting and instructing case record review and in identifying and disseminating learning. This policy will be reviewed in March 2018 to ensure that our processes continue to support best practice and reflect national requirements.
1The SHMI is the ratio between the actual number of patients who die following hospitalisation 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. It covers all deaths reported of patients who were admitted to acute, non-specialist trusts and either die while in hospital or within 30 days of discharge.
2The HSMR is the ratio of the observed number of in-patient deaths to the expected number of in-hospital deaths, multiplied by 100. This covers 56 specific groups, which accounts for approximately 80% of in-hospital mortality.