BBC Scotland, in their BBC Breakfast insert today, making much of NHS Grampian as ‘troubled‘, misses these key statistics below.

The Hospital Standardised Mortality Ratio is a reliable measure of the extent to which a hospital is operating normally and safely. The large Aberdeen Royal is only 0.04% above the Scottish average of 1. Smaller hospitals can have less predictable figures but, again Dr Gray’s is within the normal, safe, range shown below:

From Hospital Standardised Mortality Ratios January 2025 to December 2025 published today, the above chart and:

No hospitals [including those of NHS Grampian] had a significantly higher standardised mortality ratio than the national average.

HSMR acts as a signal, highlighting hospitals where mortality is higher or lower than predicted. This prompts hospitals to review their care processes, check for possible issues and identify areas for improvement.

In Scotland, the national HSMR is set at 1.00. A hospital with an HSMR less than one has fewer deaths observed than predicted within 30 days of admission, whereas an HSMR greater than one indicates more observed deaths than predicted in the same period. https://www.publichealthscotland.scot/publications/hospital-standardised-mortality-ratios/hospital-standardised-mortality-ratios-january-2025-to-december-2025/

The above funnel chart allows the presentation of hospitals with widely varying sizes on one illustrative image. Aberdeen Royal is one of the blue dots well within the warning and control limits and those to the left are the tiny ‘county’ hospitals such as those in the Borders and the Western Isles. The Aberdeen Royal had an HMSR of 1.04 and 70 more deaths than predicted. Aberdeen Royal is thus, objectively, not ‘troubled’ , as much as BBC Scotland might wish it was.

Things are very different in England, with a clear postcode lottery:

Look above at the clustering of high high mortality (mid blue) in the north and of low mortality (pale blue) in the more affluent south.

Look below at the 10 English hospitals with significantly higher, above 1.2, mortality rates:

Blackpool, 1.31, had 600 more deaths than predicted. Medway 1.29, had 400 more deaths than predicted. All ten are in the North other than one in Norfolk and one in Coventry.

While, in Scotland, you need not worry where you are treated, there are hospitals in England you might want to avoid.

Source: https://digital.nhs.uk/data-and-information/publications/statistical/shmi/2026-04