Standardised Mortality Ratio (SMR)
CHKS provide a quarterly report for the Trust that comprises a review of the risk adjusted and crude
(average) mortality for all admissions. This analysis identifies a monthly risk adjusted mortality rate for
the Trust over a 12 month period, allowing the Trust to review trend changes on a monthly basis. The
report includes a number of methods and tools to analyse and present the information, one of which
is a funnel plot.
The funnel plot* below shows where the organisation sits in comparison to its external UK peers of
the top 40 GB hospitals (from the CHKS top 40 identified in the 2018 CHKS analysis) for the period
April 2019 to March 2020.
The funnel plot (RAMI 2018) illustrates that the RAMI is similar to the mean UK peer values and
within the upper and lower confidence limits for the Trust
* For the period there were a single digit number of cases with a confirmed COVID-19 diagnosis that
have been excluded from the analysis. Risk adjusted measures such as RAMI are not designed for
pandemic activity such as that observed during 2020. This is because this activity is not recorded
in the reference data to which RAMI makes its adjustments. As a result, the present RAMI measure
cannot accurately calculate an expected deaths figure for records with COVID-19 coding using the
present methodology. Risk adjusted reporting in the CHKS report therefore excludes any activity with
COVID-19 diagnoses codes.
Funnel Plot - RAMI, UK peer, April 2019 - March 2020
84 Goal 4: Raising the Standards