What is the Gera Hospital Mortality Index?

The Gera Hospital Mortality Index (GHMI) presents the NHS Summary Hospital-level Mortality Indicator (SHMI) in plain-English index points against a national baseline of 100. The SHMI is the ratio of the deaths that actually followed hospitalisation at a trust to the number expected given its patients; the GHMI simply multiplies that ratio by 100, so 100 = exactly as expected, above 100 = more deaths than expected, below 100 = fewer. Every figure is the real published NHS value for November 2024 to October 2025; only the x100 presentation is Gera’s.

What is the SHMI and who publishes it?

The Summary Hospital-level Mortality Indicator (SHMI) is published by NHS England (NHS Digital). It reports, for each acute NHS trust in England, the ratio of observed deaths (in hospital or within 30 days of discharge) to the deaths expected given the age, sex, diagnosis and other characteristics of the patients treated. This edition covers November 2024 to October 2025 and was published on 12 March 2026.

Does a higher SHMI mean a hospital provides worse care?

No. NHS England is explicit that the SHMI is NOT a measure of quality of care. A higher-than-expected value is a "smoke alarm" that warrants investigation, not proof of poor care, and an "as expected" or "lower than expected" value is not proof of good care. Factors outside a hospital’s control — local population health and how palliative or hospice care is coded — affect the figure. Use it as a prompt to ask questions, never as a league table of hospital quality.

How many NHS trusts had higher-than-expected mortality?

In the November 2024 to October 2025 SHMI release, of 118 trusts, 11 were banded "higher than expected", 99 "as expected" and 8 "lower than expected". Across all trusts there were about 286,875 deaths from roughly 9.4 million discharges. The banding is the NHS’s own; this page reproduces it and does not re-band any trust.

How is the SHMI calculated?

The SHMI is observed deaths divided by expected deaths. Expected deaths are modelled by the NHS from the patients each trust treats — their age, sex, admission method, diagnosis grouping and other factors — so trusts treating sicker patients are expected to have more deaths. A result of 1.00 means observed equalled expected. The NHS bands each trust using control limits around the expected count. Full methodology is on the NHS SHMI publication and summarised on our methodology page.

How often is the Hospital Mortality Index updated?

NHS England publishes the SHMI monthly, each edition covering a rolling 12-month period. Gera recomputes the index on the release it cites. This edition uses the November 2024 to October 2025 release (published 12 March 2026) and was last recomputed on 3 July 2026.

What does the index NOT show?

It does not measure quality or safety of care, and it is not adjusted for every possible difference between hospitals. Deaths in hospices are included in a supplementary SHMI but the headline figure treats palliative-care coding as a known limitation. It covers acute English NHS trusts only — not specialist, community or independent providers — and it is not clinical advice about where any individual should be treated.

Is this an official NHS ranking of hospitals?

No. The banding and every figure are the NHS’s own published data, but the ordering into index points is Gera’s presentation of that open data and GeraClinic is not part of, or affiliated with, the NHS. The NHS does not publish the SHMI as a league table and neither should it be read as one.

GeraClinic / Hospital Mortality Index

The Gera Hospital Mortality Index

A plain-English read of the NHS Summary Hospital-level Mortality Indicator (SHMI) — the ratio of deaths that actually followed hospitalisation at each acute NHS trust to the number expected given the patients it treats. We present it in index points against a national baseline of 100: 100 means deaths were as expected, above 100 means more than expected, below 100 fewer. For November 2024 to October 2025, 11 of 118 trusts recorded higher-than-expected mortality.

Reference period: November 2024 to October 2025· published 12 March 2026 · NHS England / NHS Digital · updated monthly · Open Government Licence v3.0 · England, acute trusts

What is the NHS hospital mortality rate by trust right now?

In the November 2024 to October 2025 NHS SHMI release, the Gera Hospital Mortality Index baseline is 100 (deaths nationally were as expected). Of 118 acute NHS trusts, 11 recorded higher-than-expected mortality, 99 as expected and 8 lower, across about 286,875 deaths. A higher figure is a "smoke alarm" for investigation, not proof of poor care (NHS England).

Source:Summary Hospital-level Mortality Indicator (SHMI) — Deaths associated with hospitalisation, England, November 2024 - October 2025·as of November 2024 to October 2025updated monthly (last: 3 July 2026)

How to read this — a "smoke alarm", not a league table

The SHMI is NOT a measure of quality of care. NHS England is explicit that a higher-than-expected SHMI should be treated as a "smoke alarm" — a prompt to investigate, not evidence of poor care — and that an "as expected" or "lower than expected" value should not be read as proof of good care. Many factors outside a hospital’s control (local population health, the prevalence of palliative-care coding, deaths in hospices) affect the figure.

The banding on this page is the NHS’s own; we reproduce it and do not re-band any trust. Use the figures to ask informed questions, never as a verdict on the quality or safety of a hospital.

Gera Hospital Mortality Index100 = baselineEngland, Nov 2024 – Oct 2025 — 100 = deaths as expected nationally (SHMI x 100)How this index is calculated

The index is simply the official SHMI ratio multiplied by 100, so a lay reader can see how far a trust sits above or below the national expectation at a glance (a trust at 112 had roughly 12% more deaths than expected). The SHMI value, the banding and the death counts are all the real published NHS figures; only the x100 presentation is Gera’s, and it is set out in full in the methodology.

Trusts in the SHMI

118

acute NHS trusts, England

Higher than expected

band 1 — smoke alarm

As expected

band 2 — most trusts

Lower than expected

band 3

Deaths (all trusts)

286,875

in hospital or within 30 days

Discharges

9.4m

finished provider spells

Expected deaths

286,870

modelled by the NHS

National baseline

100

deaths as expected = 100

Trusts with higher-than-expected mortality (11)

These 11 trusts were banded higher than expected by the NHS in the November 2024 to October 2025 release — their observed deaths fell above the upper control limit of the range expected for their patients. As NHS England states, this is a prompt for investigation, not evidence of poor care.

NHS trusts banded higher than expected, SHMI November 2024 to October 2025 (highest first)
Trust	Mortality Index	SHMI	Observed deaths	Expected deaths
University Hospitals of Morecambe Bay NHS Foundation Trust	139.6	1.396	1,895	1,360
The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust	134.7	1.347	1,620	1,200
Medway NHS Foundation Trust	129.0	1.290	1,835	1,420
County Durham and Darlington NHS Foundation Trust	128.8	1.288	3,320	2,575
East Cheshire NHS Trust	125.8	1.258	895	715
Blackpool Teaching Hospitals NHS Foundation Trust	125.2	1.252	2,355	1,880
East Lancashire Hospitals NHS Trust	122.6	1.226	2,555	2,085
University Hospitals Coventry and Warwickshire NHS Trust	121.2	1.212	2,920	2,410
University Hospitals Plymouth NHS Trust	120.6	1.206	2,610	2,165
University Hospitals of North Midlands NHS Trust	119.6	1.196	4,350	3,635
Calderdale and Huddersfield NHS Foundation Trust	118.0	1.180	2,490	2,110

Trusts with lower-than-expected mortality (8)

These 8 trusts were banded lower than expected. NHS England cautions that a lower figure should not automatically be read as good care — coding of palliative care and local population differences also drive it.

NHS trusts banded lower than expected, SHMI November 2024 to October 2025 (lowest first)
Trust	Mortality Index	SHMI	Observed deaths	Expected deaths
Imperial College Healthcare NHS Trust	71.8	0.718	2,165	3,015
Kingston and Richmond NHS Foundation Trust	72.6	0.726	1,140	1,570
Chelsea and Westminster Hospital NHS Foundation Trust	75.5	0.755	1,710	2,260
Homerton Healthcare NHS Foundation Trust	78.3	0.783	585	750
University College London Hospitals NHS Foundation Trust	80.6	0.806	1,075	1,335
University Hospital Southampton NHS Foundation Trust	82.8	0.828	2,855	3,445
London North West University Healthcare NHS Trust	84.0	0.840	2,615	3,115
Royal Surrey NHS Foundation Trust	84.2	0.842	1,365	1,620

Every NHS trust (118), by mortality index

All 118 acute NHS trusts in the SHMI, highest index first. Select any trust for its full figures and how to read them. Remember: the ordering is a presentation of the official ratio, not a ranking of hospital quality.

Gera Hospital Mortality Index for all 118 NHS trusts, November 2024 to October 2025
Trust	Index	SHMI	Banding	Observed	Expected
University Hospitals of Morecambe Bay NHS Foundation Trust	139.6	1.396	Higher than expected	1,895	1,360
The Queen Elizabeth Hospital, King's Lynn, NHS Foundation Trust	134.7	1.347	Higher than expected	1,620	1,200
Medway NHS Foundation Trust	129.0	1.290	Higher than expected	1,835	1,420
County Durham and Darlington NHS Foundation Trust	128.8	1.288	Higher than expected	3,320	2,575
East Cheshire NHS Trust	125.8	1.258	Higher than expected	895	715
Blackpool Teaching Hospitals NHS Foundation Trust	125.2	1.252	Higher than expected	2,355	1,880
East Lancashire Hospitals NHS Trust	122.6	1.226	Higher than expected	2,555	2,085
University Hospitals Coventry and Warwickshire NHS Trust	121.2	1.212	Higher than expected	2,920	2,410
University Hospitals Plymouth NHS Trust	120.6	1.206	Higher than expected	2,610	2,165
University Hospitals of North Midlands NHS Trust	119.6	1.196	Higher than expected	4,350	3,635
Calderdale and Huddersfield NHS Foundation Trust	118.0	1.180	Higher than expected	2,490	2,110
The Rotherham NHS Foundation Trust	116.2	1.162	As expected	1,540	1,325
Tameside and Glossop Integrated Care NHS Foundation Trust	115.8	1.158	As expected	1,460	1,260
Norfolk and Norwich University Hospitals NHS Foundation Trust	115.2	1.152	As expected	3,535	3,070
James Paget University Hospitals NHS Foundation Trust	115.1	1.151	As expected	1,590	1,380
Bradford Teaching Hospitals NHS Foundation Trust	114.9	1.149	As expected	1,815	1,580
The Princess Alexandra Hospital NHS Trust	114.7	1.147	As expected	1,490	1,300
Milton Keynes University Hospital NHS Foundation Trust	114.6	1.146	As expected	1,485	1,295
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust	114.4	1.144	As expected	2,770	2,420
South Tyneside and Sunderland NHS Foundation Trust	114.2	1.141	As expected	3,015	2,645
East Kent Hospitals University NHS Foundation Trust	114.1	1.141	As expected	3,445	3,020
George Eliot Hospital NHS Trust	113.8	1.138	As expected	1,350	1,185
Wye Valley NHS Trust	113.8	1.138	As expected	1,395	1,230
Royal Berkshire NHS Foundation Trust	113.3	1.133	As expected	2,035	1,795
Nottingham University Hospitals NHS Trust	113.0	1.129	As expected	4,340	3,840
Leeds Teaching Hospitals NHS Trust	112.1	1.121	As expected	4,000	3,565
Mid and South Essex NHS Foundation Trust	111.9	1.119	As expected	6,135	5,480
Epsom and St Helier University Hospitals NHS Trust	111.2	1.112	As expected	1,705	1,530
Worcestershire Acute Hospitals NHS Trust	111.0	1.110	As expected	3,165	2,850
Gateshead Health NHS Foundation Trust	110.6	1.106	As expected	1,490	1,350
Mid Yorkshire Teaching NHS Trust	110.6	1.106	As expected	2,945	2,665
Mid Cheshire Hospitals NHS Foundation Trust	110.5	1.105	As expected	1,595	1,445
Croydon Health Services NHS Trust	110.1	1.101	As expected	1,200	1,090
Bolton NHS Foundation Trust	108.5	1.085	As expected	1,725	1,590
East Suffolk and North Essex NHS Foundation Trust	106.8	1.068	As expected	4,420	4,140
East Sussex Healthcare NHS Trust	106.8	1.068	As expected	2,635	2,465
Sandwell and West Birmingham Hospitals NHS Trust	106.2	1.062	As expected	1,730	1,630
Royal United Hospitals Bath NHS Foundation Trust	105.6	1.056	As expected	2,005	1,900
Somerset NHS Foundation Trust	105.2	1.052	As expected	3,075	2,920
Frimley Health NHS Foundation Trust	105.0	1.050	As expected	3,545	3,375
Royal Cornwall Hospitals NHS Trust	105.0	1.050	As expected	2,440	2,325
Barts Health NHS Trust	104.8	1.048	As expected	3,375	3,220
Sherwood Forest Hospitals NHS Foundation Trust	104.2	1.042	As expected	2,190	2,100
West Suffolk NHS Foundation Trust	104.2	1.042	As expected	1,600	1,535
Northampton General Hospital NHS Trust	103.3	1.033	As expected	2,000	1,935
Wirral University Teaching Hospital NHS Foundation Trust	103.3	1.033	As expected	2,005	1,940
United Lincolnshire Teaching Hospitals NHS Trust	103.1	1.031	As expected	3,555	3,450
Dartford and Gravesham NHS Trust	102.8	1.028	As expected	1,610	1,565
North Cumbria Integrated Care NHS Foundation Trust	102.3	1.023	As expected	2,025	1,980
Hull University Teaching Hospitals NHS Trust	101.8	1.018	As expected	3,505	3,440
University Hospitals Sussex NHS Foundation Trust	101.4	1.014	As expected	5,190	5,120
Northern Lincolnshire and Goole NHS Foundation Trust	100.9	1.009	As expected	2,460	2,435
Warrington and Halton Teaching Hospitals NHS Foundation Trust	100.9	1.009	As expected	1,400	1,390
Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust	100.6	1.006	As expected	1,670	1,655
Great Western Hospitals NHS Foundation Trust	100.4	1.004	As expected	1,920	1,915
Manchester University NHS Foundation Trust	100.3	1.003	As expected	4,205	4,190
Dorset County Hospital NHS Foundation Trust	100.1	1.001	As expected	1,250	1,250
Cambridge University Hospitals NHS Foundation Trust	99.4	0.994	As expected	2,365	2,380
South Warwickshire University NHS Foundation Trust	99.3	0.993	As expected	1,370	1,380
Mersey and West Lancashire Teaching Hospitals NHS Trust	99.2	0.992	As expected	3,575	3,610
South Tees Hospitals NHS Foundation Trust	98.8	0.988	As expected	2,730	2,765
Harrogate and District NHS Foundation Trust	98.5	0.985	As expected	990	1,010
Northumbria Healthcare NHS Foundation Trust	98.4	0.984	As expected	3,170	3,220
North West Anglia NHS Foundation Trust	97.7	0.977	As expected	2,855	2,925
Kettering General Hospital NHS Foundation Trust	97.6	0.976	As expected	1,720	1,765
West Hertfordshire Teaching Hospitals NHS Trust	97.1	0.971	As expected	2,020	2,080
King's College Hospital NHS Foundation Trust	97.0	0.970	As expected	2,880	2,970
Walsall Healthcare NHS Trust	97.0	0.970	As expected	1,915	1,975
Royal Devon University Healthcare NHS Foundation Trust	96.8	0.968	As expected	3,530	3,645
Torbay and South Devon NHS Foundation Trust	96.4	0.964	As expected	1,845	1,910
North Tees and Hartlepool NHS Foundation Trust	96.2	0.962	As expected	1,840	1,910
Guy's and St Thomas' NHS Foundation Trust	95.9	0.959	As expected	1,620	1,690
The Dudley Group NHS Foundation Trust	95.8	0.958	As expected	2,520	2,630
Portsmouth Hospitals University NHS Trust	95.7	0.957	As expected	3,110	3,250
Bedfordshire Hospitals NHS Foundation Trust	95.2	0.952	As expected	2,940	3,090
University Hospitals of Leicester NHS Trust	95.0	0.950	As expected	4,175	4,395
Lancashire Teaching Hospitals NHS Foundation Trust	95.0	0.950	As expected	2,415	2,545
Chesterfield Royal Hospital NHS Foundation Trust	95.0	0.950	As expected	1,925	2,025
Liverpool University Hospitals NHS Foundation Trust	94.9	0.949	As expected	3,660	3,860
The Shrewsbury and Telford Hospital NHS Trust	94.6	0.946	As expected	2,825	2,985
The Royal Wolverhampton NHS Trust	94.0	0.940	As expected	2,650	2,815
North Bristol NHS Trust	93.8	0.938	As expected	2,505	2,670
Surrey and Sussex Healthcare NHS Trust	93.7	0.937	As expected	1,895	2,025
Barking, Havering and Redbridge University Hospitals NHS Trust	93.7	0.936	As expected	2,685	2,865
East and North Hertfordshire Teaching NHS Trust	93.3	0.933	As expected	2,010	2,155
Northern Care Alliance NHS Foundation Trust	93.2	0.932	As expected	4,385	4,710
Airedale NHS Foundation Trust	92.8	0.928	As expected	1,005	1,080
Gloucestershire Hospitals NHS Foundation Trust	92.7	0.927	As expected	2,795	3,015
Barnsley Hospital NHS Foundation Trust	92.6	0.926	As expected	1,630	1,760
University Hospitals Birmingham NHS Foundation Trust	92.5	0.925	As expected	7,030	7,605
Salisbury NHS Foundation Trust	91.6	0.916	As expected	1,020	1,115
University Hospitals of Derby and Burton NHS Foundation Trust	91.0	0.910	As expected	4,620	5,080
Lewisham and Greenwich NHS Trust	90.8	0.908	As expected	2,260	2,490
Isle of Wight NHS Trust	90.7	0.907	As expected	890	985
Sheffield Teaching Hospitals NHS Foundation Trust	90.6	0.906	As expected	3,480	3,840
The Hillingdon Hospitals NHS Foundation Trust	90.6	0.906	As expected	885	975
York and Scarborough Teaching Hospitals NHS Foundation Trust	89.9	0.899	As expected	3,120	3,470
Maidstone and Tunbridge Wells NHS Trust	89.7	0.897	As expected	2,210	2,465
Oxford University Hospitals NHS Foundation Trust	89.3	0.893	As expected	3,160	3,540
St George's University Hospitals NHS Foundation Trust	88.8	0.888	As expected	1,735	1,955
Ashford and St Peter's Hospitals NHS Foundation Trust	88.2	0.882	As expected	1,480	1,675
Stockport NHS Foundation Trust	88.1	0.881	As expected	1,705	1,930
University Hospitals Bristol and Weston NHS Foundation Trust	88.0	0.880	As expected	2,400	2,730
Countess of Chester Hospital NHS Foundation Trust	88.0	0.880	As expected	1,420	1,615
The Newcastle Upon Tyne Hospitals NHS Foundation Trust	88.0	0.880	As expected	2,825	3,210
Whittington Health NHS Trust	87.7	0.877	As expected	540	615
Hampshire Hospitals NHS Foundation Trust	86.1	0.861	As expected	2,325	2,700
Royal Free London NHS Foundation Trust	85.7	0.857	As expected	3,780	4,410
Buckinghamshire Healthcare NHS Trust	85.5	0.855	As expected	1,495	1,745
University Hospitals Dorset NHS Foundation Trust	85.4	0.854	As expected	3,550	4,160
Royal Surrey NHS Foundation Trust	84.2	0.842	Lower than expected	1,365	1,620
London North West University Healthcare NHS Trust	84.0	0.840	Lower than expected	2,615	3,115
University Hospital Southampton NHS Foundation Trust	82.8	0.828	Lower than expected	2,855	3,445
University College London Hospitals NHS Foundation Trust	80.6	0.806	Lower than expected	1,075	1,335
Homerton Healthcare NHS Foundation Trust	78.3	0.783	Lower than expected	585	750
Chelsea and Westminster Hospital NHS Foundation Trust	75.5	0.755	Lower than expected	1,710	2,260
Kingston and Richmond NHS Foundation Trust	72.6	0.726	Lower than expected	1,140	1,570
Imperial College Healthcare NHS Trust	71.8	0.718	Lower than expected	2,165	3,015

National average across all trusts: deaths were exactly as expected — the SHMI is built so the England average is 1.00 (index 100).

Gera Hospital Mortality Index: FAQs

What is the Gera Hospital Mortality Index?: The Gera Hospital Mortality Index (GHMI) presents the NHS Summary Hospital-level Mortality Indicator (SHMI) in plain-English index points against a national baseline of 100. The SHMI is the ratio of the deaths that actually followed hospitalisation at a trust to the number expected given its patients; the GHMI simply multiplies that ratio by 100, so 100 = exactly as expected, above 100 = more deaths than expected, below 100 = fewer. Every figure is the real published NHS value for November 2024 to October 2025; only the x100 presentation is Gera’s.
What is the SHMI and who publishes it?: The Summary Hospital-level Mortality Indicator (SHMI) is published by NHS England (NHS Digital). It reports, for each acute NHS trust in England, the ratio of observed deaths (in hospital or within 30 days of discharge) to the deaths expected given the age, sex, diagnosis and other characteristics of the patients treated. This edition covers November 2024 to October 2025 and was published on 12 March 2026.
Does a higher SHMI mean a hospital provides worse care?: No. NHS England is explicit that the SHMI is NOT a measure of quality of care. A higher-than-expected value is a "smoke alarm" that warrants investigation, not proof of poor care, and an "as expected" or "lower than expected" value is not proof of good care. Factors outside a hospital’s control — local population health and how palliative or hospice care is coded — affect the figure. Use it as a prompt to ask questions, never as a league table of hospital quality.
How many NHS trusts had higher-than-expected mortality?: In the November 2024 to October 2025 SHMI release, of 118 trusts, 11 were banded "higher than expected", 99 "as expected" and 8 "lower than expected". Across all trusts there were about 286,875 deaths from roughly 9.4 million discharges. The banding is the NHS’s own; this page reproduces it and does not re-band any trust.
How is the SHMI calculated?: The SHMI is observed deaths divided by expected deaths. Expected deaths are modelled by the NHS from the patients each trust treats — their age, sex, admission method, diagnosis grouping and other factors — so trusts treating sicker patients are expected to have more deaths. A result of 1.00 means observed equalled expected. The NHS bands each trust using control limits around the expected count. Full methodology is on the NHS SHMI publication and summarised on our methodology page.
How often is the Hospital Mortality Index updated?: NHS England publishes the SHMI monthly, each edition covering a rolling 12-month period. Gera recomputes the index on the release it cites. This edition uses the November 2024 to October 2025 release (published 12 March 2026) and was last recomputed on 3 July 2026.
What does the index NOT show?: It does not measure quality or safety of care, and it is not adjusted for every possible difference between hospitals. Deaths in hospices are included in a supplementary SHMI but the headline figure treats palliative-care coding as a known limitation. It covers acute English NHS trusts only — not specialist, community or independent providers — and it is not clinical advice about where any individual should be treated.
Is this an official NHS ranking of hospitals?: No. The banding and every figure are the NHS’s own published data, but the ordering into index points is Gera’s presentation of that open data and GeraClinic is not part of, or affiliated with, the NHS. The NHS does not publish the SHMI as a league table and neither should it be read as one.

Understand the NHS from the data up

The SHMI is one of several open NHS datasets Gera turns into plain-English, citable indices. If you are a clinician considering the UK, or a patient trying to make sense of the numbers, start with the honest, free guides.

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Related NHS data

Source

The Gera Hospital Mortality Index is built only from the real NHS SHMI release below — every figure on this page and its per-trust pages traces back to it. The x100 presentation is the Gera contribution and is fully specified on the methodology page; no value is invented and no trust is re-banded.

Contains public sector information published by NHS England and licensed under the Open Government Licence v3.0. Source: Summary Hospital-level Mortality Indicator (SHMI) — Deaths associated with hospitalisation, England, November 2024 - October 2025 (November 2024 to October 2025, published 12 March 2026).

Contains public sector information published by NHS England and licensed under the Open Government Licence v3.0. Underlying data: SHMI — Deaths associated with hospitalisation, England, November 2024 – October 2025 (NHS England, published 12 March 2026). Programme home: About the SHMI.

GeraClinic is a private telemedicine service and is not part of, or affiliated with, the NHS. This page presents open NHS data for information only; it is not clinical advice and not a measure of the quality or safety of care at any hospital.