Hospital Standardised Mortality Ratios
January 2024 to December 2024
Accredited official statistics
- Published
- 13 May 2025 (Latest release)
- Type
- Statistical report
- Author
- Public Health Scotland
About this release
This release by Public Health Scotland (PHS) provides information on Hospital Standardised Mortality Ratios (HSMRs) which are updated on a quarterly basis and reflect the HSMR for the latest 12-month reporting period January 2024 to December 2024. The associated crude mortality data is also presented by quarter and month to show trends from January 2020 to December 2024.
HSMR is a measure that compares the actual number of patient deaths in a hospital to the number predicted, after adjusting for the case-mix of patients. This adjustment accounts for factors (i.e. age, underlying conditions, illness severity) known to influence an individual’s risk of death, allowing hospitals to be compared against the Scottish average.
Main points
For the period January 2024 to December 2024:
- No hospitals had a significantly higher or lower standardised mortality ratio (SMR) than the national average.
- Two hospitals had an SMR below the lower warning limit: Raigmore (0.84) and Western General (0.82).
Background
HSMR is a risk-adjusted hospital mortality measure which has an important role to play in facilitating a critical examination of the quality of care and patient safety in Scottish Hospitals.
In Scotland, the national HSMR is set at 1.00. A hospital with an HSMR less than one has fewer deaths observed than predicted within 30 days of admission, whereas an HSMR greater than one indicates more observed deaths than predicted in the same period. However, a higher-than-expected number of observed deaths does not necessarily imply that those deaths were avoidable, unexpected, or due to shortcomings in the quality of care.
HSMRs are calculated using data from all acute inpatient and day-case admissions across all specialties in hospital, excluding obstetrics and psychiatry. The metric includes deaths occurring within 30 days of admission, whether they happen in hospital or in the community.
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 fewer elective admissions. Any changes in crude mortality trends and HSMRs should be considered in this context.
Further information
A technical document is available on how HSMR is calculated. A frequently asked questions document is also available. For more information see the 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 12 August 2025.
General enquiries
If you have an enquiry relating to this publication, please contact Cemre Su Lode at 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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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.