About this release

This release by Public Health Scotland (PHS) provides information on Hospital Standardised Mortality Ratios (HSMRs) for the period January 2017 to December 2021. 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 and month to show trends.

Main points

  • For the period January 2021 to December 2021 no hospitals had a significantly higher standardised mortality ratio than the national average.
  • For the period January 2021 to December 2021 one hospital had a significantly lower standardised mortality ratio than the national average: Western General Hospital (0.75).
Image caption HSMR for deaths within 30-days of admission, Jan 2021 to Dec 2021


Hospital mortality measures have an important role to play in stimulating reflection on the quality and safety of patient care. HSMRs are based on all acute inpatient and day case patients admitted to all specialties in hospital (apart from obstetrics and psychiatry which are excluded). 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 were attributable to failings in the quality of care.

The methodology has been updated to ensure the diagnosis ICD-10 codes for COVID-19, U07.1 to U07.7, are included in the model. For more information please refer to the HSMR COVID-19 Methodology Update paper.

During the pandemic hospitals have had to adjust their normal ways of working to react to this healthcare emergency. As a result, there will be changes in the volumes of activity in some of the groups used to calculate the HSMRs, for example less elective admissions. Any changes in crude mortality trends and HSMRs should be considered in this context.

Further Information

A Frequently Asked Questions document is also available. For more information on HSMR see HSMR section of our website. HSMRs published from August 2019 onwards cannot be compared to prior releases using a different methodology. For more information see Research and Development.

The next release of this publication will be 09 August 2022.

General enquiries

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

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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: 21 March 2024
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