- I’ve used the more newsworthy percentage over four years to get a bigger headline in accordance with BBC Scotland’s editorial guidelines.
From the Information Services Division, NHS Scotland on 14th August 2018:
‘The Scottish HSMR [Hospital Standardised Mortality Rate] has decreased by 9.2% between January to March 2014 and January to March 2018.’
It’s only possible to consider this drop as evidence of improving performance if you can be sure that it is not, perhaps, the consequence of the underlying crude mortality rates also falling or, perhaps, a reduction in the scale of the demand or the complexity and difficulty of the conditions patients bring to hospital. You won’t be surprised, I’m sure, that this is not the case.
Lower crude mortality rates?
The above table shows that the challenge faced by Scottish hospital in terms of the underlying tendency to die of those being admitted has been pretty constant over the last ten years and has even been climbing again recently.
Less demand?
The above table shows that the demand over the last five years has been increasing across a range of measures and, in terms of the number of people coming forward, has increased dramatically.
Less complex and difficult conditions?
This is more difficult to demonstrate definitively but the notion is widely accepted. See this:
‘In Scotland we are living longer, healthier lives. But we want to remain healthier for longer and ensure that the benefits of longer, healthier lives are felt fairly by all sections of our society. This means that our health and social care services need to adapt to the challenges of a 21st century Scotland, to the issues of health inequality, increasing demand for services, multiple long-term conditions, complexity of care and resource pressures.’
http://www.healthsocialcare.scot/about/
So, I think we can say with some confidence that the 9.2% reduction in the Hospital Standardised Mortality Rate suggests evidence of a strong improving trend in Scottish hospitals. Over to you BBC Scotland.
Footnote: Why are crude mortality rates rising? Why are more Scots dying? Over to you Ruth.
Talking-up Scotland 
I am sure (UK) government benefit cuts are at least partly to blame for the rise in crude mortality rates. Cuts which the (Scottish) government do their best to ameliorate with the very limited funds they have. In short the Tories are better at killing people than the financially hamstrung SNP can prevent with their limited powers and finances.
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That seems a reasonable explanation.
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