From Hospital Standardised Mortality Ratios April 2025 to March 2026, the above graph and this explanation:

Assessing patient safety and the quality of care delivered in hospitals is essential. The Hospital Standardised Mortality Ratio (HSMR) is a key indicator that measures hospital mortality. It compares the observed number of patient deaths associated with a hospital to the number predicted after adjusting for the case mix of patients. This adjustment accounts for factors such as age, underlying health conditions, and severity of illness, enabling hospitals to be compared fairly against the Scottish average.

No hospitals had a significantly higher standardised mortality ratio than the national average. The standardised mortality ratio for Borders General Hospital (1.26) is above the upper warning limit (above two standard deviations), which indicates a higher than predicted number of deaths.

Source: https://www.publichealthscotland.scot/publications/hospital-standardised-mortality-ratios/hospital-standardised-mortality-ratios-april-2025-to-march-2026/

Note that Borders General is quite a small hospital and so one or two extra deaths can distort the picture. Note also that QEUH Glasgow, a very large hospital, extreme right, is well within the normal range regardless of its challenging catchment with higher levels of poverty, drug and alcohol abuse, and crime. More than any other, QEUH’s performance tells you there is no postcode lottery in Scotland when it comes to hospital safety.

Dividing the actual number of deaths by the predicted number should, if all is well, give a score of near to 1. Borders General had a score of 1.26 and will face investigation and the also very small Dr Grey’s in Elgin and the tiny The Balfour in Orkney had scores of 1.14 and 1.23 but all of the other 24 including all of the large hospitals had scores very close to 1.

Things are different in England after two decades of right-wing governments and their austerity policies.

From Summary Hospital-level Mortality Indicator (SHMI) – Deaths associated with hospitalisation, England, March 2025 – February 2026, we see thirteen, often giant hospitals, with scores above 1.2 with five from 1.26 to 1.36 (Blackpool) each losing 7 to 800 patients more than expected. There are, also, another 20 or so above 1.1, losing around 300 more patients than expected.

Again, unlike in Scotland, there around eight to ten, in places like Chelsea and Westmnister, with scores around 0.7 and clearly resourced with the best staff and equipment to be able to save around 900 who would have been lost in what some call ‘The North.’ There is a clear postcode lottery here.

Source: https://digital.nhs.uk/data-and-information/publications/statistical/shmi/2026-07