About this release

This release by Public Health Scotland (PHS) provides information on Hospital Standardised Mortality Ratios (HSMRs) for the period January 2015 to December 2019. 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. Please note this release covers the period prior to Covid-19 pandemic.

Main points

  • For the period January 2019 to December 2019 no hospitals had a significantly higher standardised mortality ratio than the national average.
  • For the period January 2019 to December 2019 one hospital had a significantly lower standardised mortality ratio than the national average: Western General Hospital, NHS Lothian (0.78).
Image caption Chart 1: HSMR for deaths within 30-days of admission (funnel plot); January 2019 to December 2019p
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 (formerly ISD) has produced quarterly HSMRs for hospitals since December 2009.

The HSMR methodology used up until May 2019 was agreed in 2015/16. The purpose of the HSMR at that time was to measure change in mortality over time, and to enable acute hospitals to monitor their progress towards the Scottish Patient Safety Programme (SPSP) aim of reducing hospital mortality by a further 10% by December 2018.

The end of this phase of the Scottish Patient Safety Programme provided the opportunity to review the model methodology and subsequently update and refine it, ensuring that the methodology continues to be robust and that comparisons which are made against the national average continue to be appropriate and relevant for each point in time.

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 (ie that they should not have happened), or that they were unexpected, or attributable to failings in the quality of care.

Further information

The data and full report from this publication is available to download from this page (external website). 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). HSMRs published from August 2019 onwards cannot be compared to prior releases using a different methodology. 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

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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: 13 June 2022
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