About this release

This release by Public Health Scotland (PHS) provides information on Hospital Standardised Mortality Ratios (HSMRs) for the period April 2015 to March 2020. These statistics are updated on a quarterly basis and reflect the HSMR for the latest 12-month reporting period when drawing comparisons against the Scottish average, whilst crude mortality data is presented by quarter to show trends. This release includes the first month of Scotland going into emergency measures due to COVID-19.

Main points

  • For the period April 2019 to March 2020 no hospital had a significantly higher standardised mortality ratio than the national average.
  • For the period April 2019 to March 2020 one hospital had a significantly lower standardised mortality ratio than the national average: Western General Hospital, NHS Lothian (0.79).

Image caption HSMR for deaths within 30-days of admission (Funnel Plot); April 2019 to March 2020p
This chart shows each hospitals HSMR for the latest 12 month period plotted on a funnel plot.


Hospital mortality measures have an important role to play in stimulating reflection on the quality and safety of patient care. PHS has produced quarterly HSMRs for hospitals since December 2009.

The HSMR is based on all acute inpatient and day case patients admitted to all specialties in hospital. The calculation takes account of patients who died within 30 days from admission and includes deaths that occurred in the community as well as those occurring in hospitals.

The Scottish HSMR is 1.00. If an HSMR value for a hospital is less than one, this means the number of deaths within 30 days of admission for this hospital is fewer than predicted. If an HSMR value for a hospital is greater than one, this means the number of deaths within 30 days for this hospital is more than predicted.

If the number of deaths is more than predicted this does not necessarily mean that these were avoidable deaths (i.e. that they should not have happened), or that they were unexpected, or attributable to failings in the quality of care.

The model methodology has been updated to ensure the emergency ICD-10 codes for COVID19, U07.1 and U07.2, assigned by the World Health Organisation in response to the global pandemic, are included within the primary diagnosis model adjustments. For more information please refer to the HSMR COVID-19 Methodology Update paper (external website).

During the pandemic hospitals have had to adjust their normal ways of working to react to this healthcare emergency at a local level. As a result, there will be changes in the volumes of activity in some of the case-mix groups used to calculate the predicted mortality within HSMR, for example reductions in elective admissions. In addition, some hospitals, and NHS Health Boards may see more activity than others. Any changes in unadjusted mortality trends, and higher HSMR mortality ratios should be considered in this context.

Further information

The data from this publication is available to download from this page. A Technical Document (external website) is available on how HSMR is calculated. A Frequently Asked Questions (external website) document is also available. For more information on HSMR see HSMR section of our website (external website). For more information see Research and Development (external website).

General enquiries

If you have an enquiry relating to this publication, please email phs.qualityindicators@phs.scot.

Media enquiries

If you have a media enquiry relating to this publication, please contact the Communications and Engagement team.

Requesting other formats and reporting issues

If you require publications or documents in other formats, please email phs.otherformats@phs.scot.

To report any issues with a publication, please email phs.generalpublications@phs.scot.

Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 07 October 2022
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