The NHS Next Stage Review highlighted the use of clinical indicators, such as hospital standardised mortality ratios (HSMRs) as useful tools.

The NHS Next Stage Review highlighted the use of clinical indicators, such as hospital standardised mortality ratios (HSMRs) as useful tools. The value of those indicators increases further when they are interpreted with other indicators - in turn, generating a greater contribution to the systematic measurement of quality in the NHS, and ultimately, assisting in improving the quality of care.

However, confidence in them and their effective use is complicated by the fact that different ways of measuring mortality ratios are used across the NHS. We play an independent central role in the collection, analysis, dissemination and standardisation of information on health and social care.

As the authoritative supplier of clinical indicators to the Indicators for Quailty Improvement (IQI) and NHS Choices websites, we have a responsibility to ensure that the underlying methodologies used to generate these indicators are demonstrably fit for purpose and follow transparent standards.

With this in mind, we have completed a detailed assessment of these indicators (including commissioning an external independent academic review by Leeds University) to ensure that the underlying methodologies of clinical indicators published via NHS Choices are demonstrably fit for purpose and follow transparent standards.

Following this review, we will shortly issue an invitation to tender for the production of clinical indicators for the NHS Choices website. In parallel, we will publish the new standardised methodologies together with the external Leeds University review. This will provide clear guidance to all who may wish to produce, interpret and use these indicators.

The published, independently-reviewed and transparent methodologies should become the NHS standard for the production of these clinical indicators. We will ensure that these methodologies remain open for continuous peer and academic review, in close liaison with the NHS.

If you have any questions or comments on this work, please contact us via 0845 300 6016 or enquiries@ic.nhs.uk.