Recommendation F271: Improving and assuring accuracy
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
To the extent that summary hospital-level mortality indicators are not already recognised as national or official statistics, the Department of Health and the Health and Social Care Information Centre should work towards establishing such status for them or any successor hospital mortality figures, and other patient outcome statistics, including reports showing provider-level detail.
In brief (written by this site)
The Inquiry asked the department to secure national statistics status for hospital mortality indicators. In commentary of September 2024, published in February 2026, the Department of Health and Social Care and NHS England stated that the Summary Hospital-Level Mortality Indicator is published monthly as an Accredited Official Statistic, though other patient outcome statistics were not mentioned (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that the indicator appeared to be designated as an official statistic (The Thirlwall Inquiry legal team, May 2024). In August 2016, the Office for Statistics Regulation confirmed the designation of the indicator as a National Statistic (Ed Humpherson, Aug 2016).
Sources
AI-generated summary of the record on this page, checked by a second model and automatic checks, 5 Oct 2026. The record below is the sources' own words.
Government response
Accepted.
The Summary Hospital-level Mortality Indicator which reports mortality data at trust level across the NHS in England, has been produced and published by the Health and Social Care Information Centre as an experimental Official Statistic since October 2011 (The data can be accessed from www.hscic.gov.uk/SHMI).
The UK Statistics Authority’s independent review of patient outcome statistics referred to in relation to recommendation 270 includes in scope a review of the Summary Hospital- level Mortality Indicator, its accessibility to patients and the public, and its status as Official Statistics. We expect the review to recommend that the Summary Hospital-level Mortality Indicator is assessed by UK Statistics Authority against the Code of Practice for Official Statistics (January 2009) with a view to securing designation as National Statistics.
In July 2013, Professor Sir Bruce Keogh published his Review into the quality of care and treatment provided by 14 hospital trusts in England. In his report Sir Bruce announced that he had asked Professor Nick Black and Professor Lord Ara Darzi to undertake a study into the relationship between excess mortality rates and actual avoidable deaths. This study is expected to pave the way for the introduction of a new national indicator on avoidable deaths in hospital measured through case notes reviews.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say completed (27 February 2026)
Summary Hospital-Level Mortality Indicator reports on mortality at trust level across the NHS in England using a standard and transparent methodology. It is produced and published monthly as an Accredited Official Statistic by NHS England.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Closed”. Table row: section 18.2 No. 271, PDF page 569-570.
Department of Health and Social Care says in progress (11 February 2015)
The UK Statistics Authority’s review Official Statistics on Patient Outcomes in England recommended that Summary Hospital-level Mortality Indicator should be assessed against the Statistics Code. That assessment has begun. Professor Nick Black’s study has also commenced with preliminary results from the study expected in December 2014. The study is due to be completed in March 2015, after which findings will be published. Robust and accessible reporting of avoidable hospital deaths is not a simple matter, but the intention is to develop presentations and measures which can be understood and used by patients, and acted upon by clinicians and used by patients, and acted upon by clinicians and regulators, in a continual drive to reduce avoidable deaths.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was by the Government,
A report was published in July 2015 by the UK Statistics Authority and the Health and Social Care Information Centre which found that more work needed to be done before Summary Hospital-level Mortality Indicator could be designated as official statistics. It appears to now be so designated.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review colours its Extent of Implementation cell for this recommendation green, which it uses to mark evidence, identified by the legal team, that a recommendation has been clearly implemented. Table row: section 16.2 No. 271, PDF page 523-524.
UK Statistics Authority (8 August 2016)
On behalf of the Board of the Statistics Authority, I have reviewed these on the advice of the Assessment team and I am pleased to confirm the designation of Patient Outcome Statistics: Summary Hospital-Level Mortality Indicator: Deaths Associated with Hospitalisation; England as new National Statistics.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding - UK Statistics Authority
Finding