NHS Digital Data Release Register - reformatted

Dr. Foster

Project 1 — DARS-NIC-368020-R5L2K

Opt outs honoured: No - data flow is not identifiable (Does not include the flow of confidential data)

Sensitive: Sensitive, and Non Sensitive

When: 2016/04 (or before) — 2021/05.

Repeats: Ongoing

Legal basis: Section 42(4) of the Statistics and Registration Service Act (2007) as amended by section 287 of the Health and Social Care Act (2012), Health and Social Care Act 2012 – s261(1) and s261(2)(b)(ii)

Categories: Anonymised - ICO code compliant


  • Summary Hospital-level Mortality Indicator (SHMI) data split by trust and diagnosis group
  • Office for National Statistics Mortality Data
  • Hospital Episode Statistics Admitted Patient Care
  • Summary Hospital-level Mortality Indicator


To produce/analyse statistics using births/deaths data solely to help the NHS perform its duties.

Yielded Benefits:

With the SHMI data provided, Dr Foster have been able to help their customers: - uncover and investigate some of the potential root causes of differences between the various mortality indicators and to investigate variations against peers. - Understand any variation between SHMI and HSMR at a summary level and what drives that variation. - Gain the insight they need to embed SHMI within their mortality management programme, alongside other mortality indicators, such as HSMR and Deaths after Surgery. - investigate and understand the impact of the inclusion of post-discharge mortality data (only available through the SHMI mortality indicator). - The ability to drill down and investigate by SHMI supergroup, CCS group or user-defined basket of diagnoses.

Expected Benefits:

Expected measurable benefits include: • Enable customers to measure, compare and benchmark mortality and alerting those who have higher than expected mortality levels to encourage efforts to investigate and address these. Our independent position is beneficial as it supports customer focus on information and data as opposed to anecdotal evidence. • Identify mortality trends across hospitals. • Instigate clinical audit and inform investigations related to quality of care, such as highlighting poor clinical coding or quality/efficiency concerns. • Validate other mortality indicators – such as HSMR and crude mortality. • Understand and quickly visualise SHMI & HSMR indicators side by side. How will these be measured: • By their nature our analytical tools allow the performance of customers to be monitored and trended over time. We are therefore able to indicate changes to quality and efficiency performance particularly in instances where trusts have been alerted and we have worked with them to understand the causes of worse than expected performance. When will these be achieved: • It is not possible to outline a specific target date for achievement of the benefits outlined above as they are reliant on a range of factors outside of Dr Foster immediate control. However, whenever there are areas of particular concern about performance against key indicators, we act immediately to make our customers aware and offer assistance in better understanding and addressing them. • In addition benefits are ongoing as these outputs are used within NHS Trusts internal monthly reporting and quality processes.


The Dr Foster Dashboard Tool Online application is available to NHS Acute Trusts, only which compares the two leading mortality indicators in England – the SHMI and the Dr Foster Hospital Standard Mortality Ratio (HSMR). All data is aggregated with small numbers suppressed in line with the HES analysis guide and there are no links to any identifiers. It enables users to uncover and investigate some of the potential root causes of differences between these indicators and to investigate variations against peers. Key outputs: • Overview of SHMI and Hospital Standard Mortality Ratio (HSMR) - summary charts, trends and breakdowns. • Graphical Dashboard comparing mortality measures side-by-side. • Analyse national position, regional comparisons and custom peer groups. • The ability to drill down and investigate by SHMI supergroup, Clinical Classification System (CCS) group or user-defined basket of diagnoses. Typical end users • Chief Executives • Medical Directors • NHS Managers • Information Analysts • Clinicians • Nurses


Landing On landing the SHMI dataset will be recorded on the Dr Foster Data Asset Register (DAR) and allocated a unique Asset Tag, in addition a Date of Destruction will be recorded along with Acknowledgements required in the publication of these data. Processing NOTE: Only named individuals will have access to process these data. Once logged in the Data Asset Register, it is handed over to a named individual who will load these data onto a secure central processing server located at Dorset Rise, a ‘SHMI’ Extract, Transform & Load process (documented) will then be run to transform record level data and then appended into a aggregated SQL database (aggregated at Provider & Diagnosis group level). Once processed the data will then be quality checked and upon completion published to the live client facing Dr Foster Dashboard Tool. Publication SHMI data, which has been available to Dr Foster since 2011, will only be made available to NHS Trusts via the Dr Foster Dashboard Tool. Note: This tool is provided Free of Charge to all NHS Trusts Destruction Raw SHMI data will be Blancco (CESG approved) file shredded with certificated evidence when Date of Destruction is applicable (identified on Dr Foster’s Data Asset Register via a monthly process).