Intended for healthcare professionals

Letters The death of death rates?

Time to abandon the use of HSMRs in the NHS

BMJ 2015; 351 doi: (Published 11 August 2015) Cite this as: BMJ 2015;351:h4308
  1. Jammi N Rao, public health physician and non-executive director, Heart of England NHS Foundation Trust1
  1. 1Gorway Lodge, Walsall WS1 3BB, UK
  1. jammi2801{at}

The latest evidence on the lack of correlation between avoidable mortality and the hospital standardised mortality ratio (HSMR) should lead us to abandon its use.1 2

The use of HSMRs has been questioned before, 3 4 and there remain serious theoretical objections that have never been adequately addressed by its proponents.5

As the chair of my trust’s …

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