Revealed, the NHS hospital trusts plagued by abnormally high deaths. Is YOURS on the list of the worst affected?

Five NHS trusts are plagued by abnormally high death rates, MailOnline can today reveal.

Our investigation into hospitals suggests thousands of 'excess' fatalities may have occurred between them.

Deaths at one trust in Norfolk have been flagged as unusually high for almost five years.

Full results of our probe – based on the NHS's own mortality data – can be viewed below in our postcode search tool, which lets you see how your trust fares.

Although our analysis can't prove any deaths could necessarily have been avoided or were caused by poor care, experts warned our discovery was a huge red flag.

NHS chiefs publish in-depth fatality bulletins every month, tracking how many hospitalised patients die within 30 days of being discharged.

Under the summary hospital-level mortality indicator (SHMI), created in the wake of the Mid-Staffs scandal in the late noughties, officials then calculate how many deaths they would have expected for each facility. This is based on figures across England as a whole and the characteristics of the patients treated there.

A trust is given a 'higher than expected' score, or a banding of one, if the observed number of deaths exceeds the estimated range, or margin of uncertainty.

This should be viewed as a 'smoke alarm' which requires further investigation, officials insist.

NHS Digital, the agency which publishes SHMI updates, last week stated seven trusts had a higher than expected number of deaths for the year ending January 31, 2025.

MailOnline's investigation tracked the ranks of every trust since December 2018, when monthly updates were first released.

Five have logged the worst SHMI score for at least six consecutive months.

Norfolk and Norwich University Hospitals NHS Foundation Trust, which has a catchment area of a million patients and operates two hospitals, has had the top banding every month since March 2020, when Covid kicked off.

During the last year alone, that trust saw 535 more deaths than expected.

East Cheshire NHS Trust, which runs three hospitals in Congleton, Knutsford and Macclesfield, has had the worst SHMI score for 35 months in a row, dating back to March 2022. In the year to January 31, 2021, officials recorded 140 more deaths than expected.

The other three trusts named as having abnormally high deaths for at least six consecutive months were: County Durham and Darlington NHS Foundation Trust, Medway NHS Foundation Trust, and East Lancashire Hospitals NHS Trust.

Only trusts that remain in operation under their 2018 name were included in the analysis.

University of Cambridge statistician Dr Stephen Burgess told MailOnline: 'In any league table, someone will always be worst off.

'However, this isn’t simply an unlucky finding – the trusts at the bottom of the table are markedly worse than average.

'It is not possible to say whether there is some systematic error in the way that the number of expected deaths is computed for some trusts – large scale collection of data is a complex process.

'However, the figures don't make happy reading. Over half of the months with more reported deaths than expected are attributable to the bottom 10 worst performing NHS trusts.'

An NHS spokesperson said: 'The findings from any analysis of the Summary Health Mortality Indicator (SHMI) or its underlying data should act as a starting point for further investigation, rather than treated as a definitive view on quality of care.

'All hospital trusts need to examine, understand and explain their SHMI value, and use this information as a prompt to examine particular areas of patient care and take action if necessary.'

The NHS states it is 'inappropriate' for trusts to be ranked on their SHMI.

The index was introduced in 2011 by then-Health Secretary Andrew Lansley, who said he was determined to 'shine a light on poor performance' following the 'appalling events at Mid Staffs', often considered the worst hospital-care scandal of recent times.

Up to 1,200 patients died as a result of poor care between January 2005 and March 2009 at Stafford hospital, run by the now-defunct Mid Staffordshire NHS Hospital Trust.

The horrors, blamed on cost cutting and poor decision-making, were uncovered through a similar data analysis.

Lord Lansley, who served under David Cameron, said publishing the SHMI data 'will help us avoid a repeat of that tragedy'.

Sir Bruce Keogh, NHS medical director at the time, said 'no one indicator alone can give us a complete picture of a hospital’s performance'.

Explaining his logic, he added: 'For example, no-one would buy a car based only on the mileage or how many miles you get to the gallon – you would look at lots of information before making a decision. In the same way, to truly understand the quality of care at a hospital, you must look at this alongside other information.'

The report comes just two months after Keir Starmer sounded the death knell for NHS England.

The Prime Minister declared that the 'world's biggest quango' will be scrapped to restore 'democratic control' and slash red tape.

Over the course of two years, the body will be folded into the Department of Health, potentially cutting 10,000 jobs and freeing up cash for strapped frontline services.

Long waits in A&E are thought to have contributed to thousands of needless deaths.

Chancellor Rachel Reeves last week pledged to increase spending across the NHS by three per cent. It already gets in excess of £150billion annually.

What the five trusts said, in response to MailOnline's investigation

Norfolk and Norwich University Hospitals NHS Foundation Trust

Dr Bernard Brett, medical director for the Norfolk and Norwich University Hospitals NHS Foundation Trust, said: 'We have carried out a full and thorough review of our mortality data and we have seen an improvement in our SHMIs over the last year, which relates to more thorough data capture and improvements we have made in our care pathways for patients.

'There are a number of reasons for higher than expected SHMI scores and here in Norfolk we have an older population, many with significant long-term medical conditions, and a higher proportion of palliative care patients in our hospital. We have also identified important differences in how we capture and record data compared to other Trusts and there is an ongoing project to improve clinical data and coding quality and ensure that the complexity of the patients we look after is represented accurately in our data. We are working with our system partners to improve our palliative care pathways.

'Our Trust was one of the first in England to implement the Medical Examiner service and this team provides independent scrutiny of all deaths in the hospital. Whilst there are always opportunities to learn and improve, there are no indications from the Medical Examiner service that the Trust is an outlier for avoidable or unexpected deaths.

'The improvements we have made and continue to review are beginning to impact on the data we use for monitoring the number of patients who die following hospitalisation. This is something our Trust Board continues to closely monitor and is reported to regional and national colleagues.'

County Durham and Darlington NHS Foundation Trust

A spokesperson for County Durham and Darlington NHS Foundation Trust said: 'County Durham and Darlington NHS Foundation Trust is committed to providing high quality patient care and we take the monitoring and understanding of mortality data very seriously.

'The Trust has a well-established Mortality Review process and a fully embedded Patient Safety Incident Investigation (PSII) process to carefully identify and review cases to inform leaning and improvements. Our Medical Examiner Service also provides an additional layer of independent scrutiny across all in-hospital deaths. Regular reports are shared through our Open Trust Board in line with national guidance on learning from deaths.

'Interpreting mortality indicators such as SHMI is complex and a number of factors contribute to variations in these figures over time. The accuracy and completeness of clinical records can affect SHMI categorisations, and changes in practice, as well as local differences in how services are configured, can have an impact on reported figures. It is a broad statistical measure which should not be used in isolation to assess the quality of care provided.

'In addition to our Trust quality assurance processes, we also commission external reviews to provide further independent assurance around our processes and are focussed on transparency, continuous learning and improvement in delivering safe and compassionate care for all our patients.'

Medway NHS Foundation Trust

Yet to comment

East Lancashire Hospitals NHS Trust

Although a spokesperson did not give an official statement, a member of the communications team said on email: 'The data is incorrect and we have nothing further to add.'

They argued that the high number of 'invalid diagnosis codes' in the trust's figures meant the numbers should not be analysed. Nine other trusts were flagged as having a high percentage of invalid diagnosis codes but none were listed as having among the most 'excess' deaths.

East Cheshire NHS Trust

Yet to comment