Due to changes in the collection and availability of data on COVID-19 this page will no longer be updated. The webpage will no longer be available as of 11 May 2023. On-going, reliable sources of data for COVID-19 are available via the COVID-19 dashboard, Office for National Statistics, and the UKHSA

This page provides a weekly summary of data on deaths related to COVID-19 published by NHS England and the Office for National Statistics. More frequent reporting on COVID-19 deaths is now available here, alongside data on cases, hospitalisations, and vaccinations. This update contains data on deaths related to COVID-19 from:

NHS England COVID-19 Daily Deaths - last updated on 28 June 2022 with data up to and including 27 June 2022.


ONS weekly deaths by Local Authority - last updated on 16 August 2022 with data up to and including 05 August 2022.

Summary notes about each these sources are provided at the end of this document.

Note on interpreting deaths data: statistics from the available sources differ in definition, timing and completeness. It is important to understand these differences when interpreting the data or comparing between sources.

Weekly Key Points

An additional 24 deaths in London hospitals of patients who had tested positive for COVID-19 and an additional 5 where COVID-19 was mentioned on the death certificate were announced in the week ending 27 June 2022. This compares with 40 and 3 for the previous week. A total of 306 deaths in hospitals of patients who had tested positive for COVID-19 and 27 where COVID-19 was mentioned on the death certificate were announced for England as whole. This compares with 301 and 26 for the previous week. The total number of COVID-19 deaths reported in London hospitals of patients who had tested positive for COVID-19 is now 19,102. The total number of deaths in London hospitals where COVID-19 was mentioned on the death certificate is now 1,590. This compares to figures of 119,237 and 8,197 for English hospitals as a whole. Due to the delay between death occurrence and reporting, the estimated number of deaths to this point will be revised upwards over coming days These figures do not include deaths that occurred outside of hospitals. Data from ONS has indicated that the majority (79%) of COVID-19 deaths in London have taken place in hospitals.

Recently announced deaths in Hospitals

21 June 22 June 23 June 24 June 25 June 26 June 27 June London No positive test 0 0 1 4 0 0 0 London Positive test 3 7 2 10 0 0 2 Rest of England No positive test 2 6 4 4 0 0 6 Rest of England Positive test 47 49 41 58 6 0 81

16 May 23 May 30 May 06 June 13 June 20 June 27 June London No positive test 14 3 4 0 4 3 5 London Positive test 45 34 55 20 62 40 24 Rest of England No positive test 41 58 33 23 47 23 22 Rest of England Positive test 456 375 266 218 254 261 282 Deaths by date of occurrence

21 June 22 June 23 June 24 June 25 June 26 June 27 June London 20,683 20,686 20,690 20,691 20,692 20,692 20,692 Rest of England 106,604 106,635 106,679 106,697 106,713 106,733 106,742 Interpreting the data The data published by NHS England are incomplete due to:

delays in the occurrence and subsequent reporting of deaths deaths occurring outside of hospitals not being included

The total deaths reported up to a given point are therefore less than the actual number that have occurred by the same point. Delays in reporting NHS provide the following guidance regarding the delay between occurrence and reporting of deaths: Confirmation of COVID-19 diagnosis, death notification and reporting in central figures can take up to several days and the hospitals providing the data are under significant operational pressure. This means that the totals reported at 5pm on each day may not include all deaths that occurred on that day or on recent prior days. The data published by NHS England for reporting periods from April 1st onward includes both date of occurrence and date of reporting and so it is possible to illustrate the distribution of these reporting delays. This data shows that approximately 10% of COVID-19 deaths occurring in London hospitals are included in the reporting period ending on the same day, and that approximately two-thirds of deaths were reported by two days after the date of occurrence.

Deaths outside of hospitals The data published by NHS England does not include deaths that occur outside of hospitals, i.e. those in homes, hospices, and care homes. ONS have published data for deaths by place of occurrence. This shows that, up to 05 August, 79% of deaths in London recorded as involving COVID-19 occurred in hospitals (this compares with 44% for all causes of death). This would suggest that the NHS England data may underestimate overall deaths from COVID-19 by around 20%.

Comparison of data sources

Note on data sources

NHS England provides numbers of patients who have died in hos

Estimates of the risk of hospital admission for coronavirus (COVID-19) and death involving COVID-19 by vaccination status, overall and by age group, using anonymised linked data from Census 2021. Experimental Statistics.

Outcome definitions

For this analysis, we define a death as involving COVID-19 if either of the ICD-10 codes U07.1 (COVID-19, virus identified) or U07.2 (COVID-19, virus not identified) is mentioned on the death certificate. Information on cause of death coding is available in the User Guide to Mortality Statistics. We use date of occurrance rather than date of registration to give the date of the death.

We define COVID-109 hospitalisation as an inpatient episode in Hospital Episode Statistics where the primary diagnosis was COVID-19, identified by the ICD-19 codes (COVID-19, virus identified) or U07.2 (COVID-19, virus not identified). Where an individual had experienced more than one COVID-19 hospitalisation, the earliest that occurred within the study period was used. We define the date of COVID-19 hospitalisation as the start of the hospital episode.

ICD-10 code

U07.1 :

COVID-19, virus identified

U07.2:

COVID-19, virus not identified

Vaccination status is defined by the dose and the time since the last dose received

Unvaccinated:

no vaccination to less than 21 days post first dose

First dose 21 days to 3 months:

more than or equal to 21 days post second dose to earliest of less than 91 days post first dose or less than 21 days post second dose

First dose 3+ months:

more than or equal to 91 days post first dose to less than 21 days post second dose

Second dose 21 days to 3 months:

more than or equal to 21 days post second dose to earliest of less than 91 days post second dose or less than 21 days post third dose

Second dose 3-6 months:

more than or equal to 91 days post second dose to earliest of less than 182 days post second dose or less than 21 days post third dose

Second dose 6+ months:

more than or equal to 182 days post second dose to less than 21 days post third dose

Third dose 21 days to 3 months:

more than or equal to 21 days post third dose to less than 91 days post third dose

Third dose 3+ months:

more than or equal to 91 days post third dose

Model adjustments

Three sets of model adjustments were used

Age adjusted:

age (as a natural spline)

Age, socio-demographics adjusted:

age (as a natural spline), plus socio-demographic characteristics (sex, region, ethnicity, religion, IMD decile, NSSEC category, highest qualification, English language proficiency, key worker status)

Fully adjusted:

age (as a natural spline), plus socio-demographic characteristics (sex, region, ethnicity, religion, IMD decile, NSSEC category, highest qualification, English language proficiency, key worker status), plus health-related characteristics (disability, self-reported health, care home residency, number of QCovid comorbidities (grouped), BMI category, frailty flag and hospitalisation within the last 21 days.

Age

Age in years is defined on the Census day 2021 (21 March 2021). Age is included in the model as a natural spline with boundary knots at the 10th and 90th centiles and internal knots at the 25th, 50th and 75th centiles. The positions of the knots are calculated separately for the overall model and for each age group for the stratified model.

United Kingdom recorded 225324 Coronavirus Deaths since the epidemic began, according to the World Health Organization (WHO). In addition, United Kingdom reported 24603076 Coronavirus Cases. This dataset includes a chart with historical data for the United Kingdom Coronavirus Deaths.

The percentage of extra deaths that occurred due to winter, including those that had COVID-19 mentioned on the death certificate. The Excess Winter Mortality (EWM) index is calculated as the number of excess winter deaths divided by the average non-winter deaths, expressed as a percentage. Calculated so that comparisons can be made between sexes, age groups, and regions.

An EWM index of 20 shows that there were 20 percent more deaths in winter compared with the non-winter period. Provisional figures at country and region level are produced for the most recent winter using estimation methods, and so are rounded to the nearest 100 deaths. Data post 2019/20 should be treated with caution due to high numbers of deaths from COVID-19 in the summer period.

For data years 2020/21 onwards, instances where the number of winter deaths compared to non-winter deaths were equal to zero or a negative value, an EWM index is presented. (For earlier years, the EWM index was removed). A zero value for winter deaths compared to non-winter deaths is often affected by rounding, so in these instances, the winter mortality index can either be a positive or negative value. A negative winter mortality index means there were a higher number of deaths in the non-winter periods than the winter period.

Alternatively, figures are available for deaths excluding COVID-19, calculated using all-cause deaths that did not have COVID-19 mentioned on the death certificate.

Data is Powered by LG Inform Plus and automatically checked for new data on the 3rd of each month.

These indicators are designed to accompany the SHMI publication. COVID-19 activity is included in the SHMI if the discharge date is on or after 1 September 2021. Contextual indicators on the number of provider spells which are related to COVID-19 and on the number of provider spells as a percentage of pre-pandemic activity (January 2019 – December 2019) are produced to support the interpretation of the SHMI. These indicators are being published as official statistics in development. Official statistics in development are published in order to involve users and stakeholders in their development and as a means to build in quality at an early stage. Notes: 1. There is a shortfall in the number of records for East Lancashire Hospitals NHS Trust (trust code RXR) and Harrogate and District NHS Foundation Trust (trust code RCD). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 2. Frimley Health NHS Foundation Trust (trust code RDU) stopped submitting data to the Secondary Uses Service (SUS) during June 2022 and did not start submitting data again until April 2023 due to an issue with their patient records system. This is causing a large shortfall in records and values for this trust should be viewed in the context of this issue. 3. Royal Surrey County Hospital NHS Foundation Trust (trust code RA2) has a high percentage of records with no data for secondary diagnoses. This is having a large impact on this trust’s data and values for this trust should therefore be interpreted with caution. 4. There is a high percentage of invalid diagnosis codes for Chesterfield Royal Hospital NHS Foundation Trust (trust code RFS), East Lancashire Hospitals NHS Trust (trust code RXR), Portsmouth Hospitals University NHS Trust (trust code RHU), and University Hospitals Plymouth NHS Trust (trust code RK9). Values for these trusts should therefore be interpreted with caution. 5. A number of trusts are now submitting Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS) rather than the Admitted Patient Care (APC) dataset. The SHMI is calculated using APC data. Removal of SDEC activity from the APC data may impact a trust’s SHMI value and may increase it. More information about this is available in the SHMI background quality report. 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of this page.

According to a survey conducted in the United Kingdom (UK) in April 2022, **** percent of all people aged between 35 and 49 years reported to be suffering from long COVID symptoms, the highest share across all age groups. Furthermore, around *** percent of the population aged 50 to 69 years were estimated to suffer from long COVID. Overall, around *** thousand people in the UK reported their ability to undertake daily activities and routines was affected a little by long COVID symptoms.

Present state of COVID-19 As of May 2022, over ** million COVID-19 cases had been reported in the UK. The largest surge of cases was noted over the winter period 2021/22. The incidence of cases in the county since the pandemic began stood at around ****** per 100,000 population. Cyprus had the highest incidence of COVID-19 cases among its population in Europe at ****** per 100,000 people, followed by a rate of ****** in Iceland. Over *** thousand COVID-19 deaths have been reported in the UK. The deadliest day on record was January 20, 2021, when ***** deaths were recorded. In the UK, a COVID-19 death is defined as a person who died within ** days of a positive test.

Preventing long COVID through vaccination According to the WHO, being fully vaccinated alongside a significant proportion of the population also vaccinated is the best way to avoid the spread of COVID-19 or serious symptoms associated with the virus. It is therefore regarded that receiving a vaccine course as well as subsequent booster vaccines limits the chance of developing long COVID symptoms. As of April 27, 2022, around **** million first doses, **** million second doses, and **** booster doses had been administered in the UK.

Provisional counts of the number of deaths registered in England and Wales, by age, sex, region and Index of Multiple Deprivation (IMD), in the latest weeks for which data are available.

Concentrations of SARS-CoV-2 RNA and physichochemical data on wastewater samples collected from six sites across England and Wales between March and July 2020. Also included are the number of COVID-19 positive tests and COVID-19 related deaths for the same period collated from publicly available records. COVID-19 data relate to the lower tier local authority that the wastewater treatment plant was located within. Full details about this dataset can be found at https://doi.org/10.5285/ce40e62a-21ae-45b9-ba5b-031639a504f7

This publication was archived on 12 October 2023. Please see the Viral Respiratory Diseases (Including Influenza and COVID-19) in Scotland publication for the latest data. This dataset provides information on number of new daily confirmed cases, negative cases, deaths, testing by NHS Labs (Pillar 1) and UK Government (Pillar 2), new hospital admissions, new ICU admissions, hospital and ICU bed occupancy from novel coronavirus (COVID-19) in Scotland, including cumulative totals and population rates at Scotland, NHS Board and Council Area levels (where possible). Seven day positive cases and population rates are also presented by Neighbourhood Area (Intermediate Zone 2011). Information on how PHS publish small are COVID figures is available on the PHS website. Information on demographic characteristics (age, sex, deprivation) of confirmed novel coronavirus (COVID-19) cases, as well as trend data regarding the wider impact of the virus on the healthcare system is provided in this publication. Data includes information on primary care out of hours consultations, respiratory calls made to NHS24, contact with COVID-19 Hubs and Assessment Centres, incidents received by Scottish Ambulance Services (SAS), as well as COVID-19 related hospital admissions and admissions to ICU (Intensive Care Unit). Further data on the wider impact of the COVID-19 response, focusing on hospital admissions, unscheduled care and volume of calls to NHS24, is available on the COVID-19 Wider Impact Dashboard. Novel coronavirus (COVID-19) is a new strain of coronavirus first identified in Wuhan, China. Clinical presentation may range from mild-to-moderate illness to pneumonia or severe acute respiratory infection. COVID-19 was declared a pandemic by the World Health Organisation on 12 March 2020. We now have spread of COVID-19 within communities in the UK. Public Health Scotland no longer reports the number of COVID-19 deaths within 28 days of a first positive test from 2nd June 2022. Please refer to NRS death certificate data as the single source for COVID-19 deaths data in Scotland. In the process of updating the hospital admissions reporting to include reinfections, we have had to review existing methodology. In order to provide the best possible linkage of COVID-19 cases to hospital admissions, each admission record is required to have a discharge date, to allow us to better match the most appropriate COVID positive episode details to an admission. This means that in cases where the discharge date is missing (either due to the patient still being treated, delays in discharge information being submitted or data quality issues), it has to be estimated. Estimating a discharge date for historic records means that the average stay for those with missing dates is reduced, and fewer stays overlap with records of positive tests. The result of these changes has meant that approximately 1,200 historic COVID admissions have been removed due to improvements in methodology to handle missing discharge dates, while approximately 820 have been added to the cumulative total with the inclusion of reinfections. COVID-19 hospital admissions are now identified as the following: A patient's first positive PCR or LFD test of the episode of infection (including reinfections at 90 days or more) for COVID-19 up to 14 days prior to admission to hospital, on the day of their admission or during their stay in hospital. If a patient's first positive PCR or LFD test of the episode of infection is after their date of discharge from hospital, they are not included in the analysis. Information on COVID-19, including stay at home advice for people who are self-isolating and their households, can be found on NHS Inform. Data visualisation of Scottish COVID-19 cases is available on the Public Health Scotland - Covid 19 Scotland dashboard. Further information on coronavirus in Scotland is available on the Scottish Government - Coronavirus in Scotland page, where further breakdown of past coronavirus data has also been published.

India marks one COVID-19 death every 5 minutes

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Content

People across India scrambled for life-saving oxygen supplies on Friday and patients lay dying outside hospitals as the capital recorded the equivalent of one death from COVID-19 every five minutes.

For the second day running, the country’s overnight infection total was higher than ever recorded anywhere in the world since the pandemic began last year, at 332,730.

India’s second wave has hit with such ferocity that hospitals are running out of oxygen, beds, and anti-viral drugs. Many patients have been turned away because there was no space for them, doctors in Delhi said.

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Mass cremations have been taking place as the crematoriums have run out of space. Ambulance sirens sounded throughout the day in the deserted streets of the capital, one of India’s worst-hit cities, where a lockdown is in place to try and stem the transmission of the virus. source

Dataset

The dataset consists of the tweets made with the #IndiaWantsOxygen hashtag covering the tweets from the past week. The dataset totally consists of 25,440 tweets and will be updated on a daily basis.

The description of the features is given below | No |Columns | Descriptions | | -- | -- | -- | | 1 | user_name | The name of the user, as they’ve defined it. | | 2 | user_location | The user-defined location for this account’s profile. | | 3 | user_description | The user-defined UTF-8 string describing their account. | | 4 | user_created | Time and date, when the account was created. | | 5 | user_followers | The number of followers an account currently has. | | 6 | user_friends | The number of friends an account currently has. | | 7 | user_favourites | The number of favorites an account currently has | | 8 | user_verified | When true, indicates that the user has a verified account | | 9 | date | UTC time and date when the Tweet was created | | 10 | text | The actual UTF-8 text of the Tweet | | 11 | hashtags | All the other hashtags posted in the tweet along with #IndiaWantsOxygen | | 12 | source | Utility used to post the Tweet, Tweets from the Twitter website have a source value - web | | 13 | is_retweet | Indicates whether this Tweet has been Retweeted by the authenticating user. |

Acknowledgements

https://globalnews.ca/news/7785122/india-covid-19-hospitals-record/ Image courtesy: BBC and Reuters

Inspiration

The past few days have been really depressing after seeing these incidents. These tweets are the voice of the indians requesting help and people all over the globe asking their own countries to support India by providing oxygen tanks.

And I strongly believe that this is not just some data, but the pure emotions of people and their call for help. And I hope we as data scientists could contribute on this front by providing valuable information and insights.

Demographic and clinical characteristics for the total cohort and those who died or were admitted to hospital with COVID-19.

PIONEER: Deeply-phenotyped hospital COVID patients: severity, acuity, therapies, outcomes Dataset number 4.0

Coronavirus disease 2019 (COVID-19) was identified in January 2020. Currently, there have been more than 6 million cases& more than 1.5 million deaths worldwide. Some individuals experience severe manifestations of infection, including viral pneumonia, adult respiratory distress syndrome (ARDS)& death. There is a pressing need for tools to stratify patients, to identify those at greatest risk. Acuity scores are composite scores which help identify patients who are more unwell to support & prioritise clinical care. There are no validated acuity scores for COVID-19 & it is unclear whether standard tools are accurate enough to provide this support. This secondary care COVID dataset contains granular demographic, morbidity, serial acuity and outcome data to inform risk prediction tools in COVID-19.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. There is a higher than average percentage of minority ethnic groups. WM has a large number of elderly residents but is the youngest population in the UK. Each day >100,000 people are treated in hospital, see their GP or are cared for by the NHS. The West Midlands was one of the hardest hit regions for COVID admissions in both wave 1 & 2.

EHR. University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. UHB has cared for >5000 COVID admissions to date.

Scope: All COVID swab confirmed hospitalised patients to UHB from January – May 2020. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes but also primary care records& clinic letters. Serial, structured data pertaining to care process (timings, staff grades, specialty review, wards), presenting complaint, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, microbiology, all prescribed & administered treatments (fluids, antibiotics, inotropes, vasopressors, organ support), all outcomes. Linked images available (radiographs, CT, MRI, ultrasound).

Available supplementary data: Health data preceding & following admission event. Matched “non-COVID” controls; ambulance, 111, 999 data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

This is an indicator designed to accompany the Summary Hospital-level Mortality Indicator (SHMI). As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. This indicator shows the number of provider spells which are coded as COVID-19, and therefore excluded from the SHMI, as a percentage of all provider spells in the SHMI (prior to the exclusion). This new indicator is being published as an experimental statistic. Experimental statistics are official statistics which are published in order to involve users and stakeholders in their development and as a means to build in quality at an early stage. Notes: 1. Please note that there has been a fall in the number of spells for most trusts between this publication and the previous SHMI publication, ranging from 0 per cent to 4 per cent. This is due to COVID-19 impacting on activity from March 2020 onwards and appears to be an accurate reflection of hospital activity rather than a case of missing data. 2. Day cases and regular day attenders are excluded from the SHMI. However, some day cases for University College London Hospitals NHS Foundation Trust (trust code RRV) have been incorrectly classified as ordinary admissions meaning that they have been included in the SHMI. Maidstone and Tunbridge Wells NHS Trust (trust code RWF) has submitted a number of records with a patient classification of ‘day case’ or ‘regular day attender’ and an intended management value of ‘patient to stay in hospital for at least one night’. This mismatch has resulted in the patient classification being updated to ‘ordinary admission’ by the HES data cleaning rules. This may have resulted in the number of ordinary admissions being overstated. The trust has been contacted to clarify what the correct patient classification is for these records. Values for these trusts should therefore be interpreted with caution. 3. There is a shortfall in the number of records for Bedfordshire Hospitals NHS Foundation Trust (trust code RC9) meaning that values for this trust are based on incomplete data and should therefore be interpreted with caution. 4. Airedale NHS Foundation Trust (trust code RCF) has submitted an increased number of delivery episode records. HES data cleaning rules have amended some of the records to birth episodes however, most records have not been changed. It is therefore considered likely that the increased number of delivery episodes (and corresponding reduction in ordinary episodes) is incorrect. Values for this trust should therefore be interpreted with caution. 5. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page. 6. The tool below is in Microsoft PowerBI which does not fully support all accessibility needs. If you need further assistance, please contact us for help.

These indicators are designed to accompany the SHMI publication. The SHMI methodology does not make any adjustment for deprivation. This is because adjusting for deprivation might create the impression that a higher death rate for those who are more deprived is acceptable. Patient records are assigned to 1 of 5 deprivation groups (called quintiles) using the Index of Multiple Deprivation (IMD). The deprivation quintile cannot be calculated for some records e.g. because the patient's postcode is unknown or they are not resident in England. Contextual indicators on the percentage of provider spells and deaths reported in the SHMI belonging to each deprivation quintile are produced to support the interpretation of the SHMI. Notes: 1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in the contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication. 2. Please note that there was a fall in the overall number of spells from March 2020 for England due to COVID-19 impacting on activity and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. There is a shortfall in the number of records for The Princess Alexandra Hospital NHS Trust (trust code RQW). Values for this trust are based on incomplete data and should therefore be interpreted with caution. 4. Frimley Health NHS Foundation Trust (trust code RDU) has not submitted data to the Secondary Uses Service (SUS) since June 2022 due to an issue with their patient records system. This is causing a large shortfall in records with data only submitted for 4 months out of the 12 months in the current time period. Values for this trust should be viewed in the context of this issue. 5. A number of trusts are currently engaging in a pilot to submit Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS), rather than the Admitted Patient Care (APC) dataset. As the SHMI is calculated using APC data, this does have the potential to impact on the SHMI value for these trusts. Trusts with SDEC activity removed from the APC data have generally seen an increase in the SHMI value. This is because the observed number of deaths remains approximately the same as the mortality rate for this cohort is very low; secondly, the expected number of deaths decreases because a large number of spells are removed, all of which would have had a small, non-zero risk of mortality contributing to the expected number of deaths. We are working to better understand the planned changes to the recording of SDEC activity and the potential impact on the SHMI. The trusts affected in this publication are: Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), Epsom and St Helier University Hospitals NHS Trust (trust code RVR), Frimley Health NHS Foundation Trust (trust code RDU), Imperial College Healthcare NHS Trust (trust code RYJ), Manchester University NHS Foundation Trust (trust code R0A), Norfolk and Norwich University Hospitals NHS Foundation Trust (trust code RM1), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG). 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page.

These indicators are designed to accompany the SHMI publication. Information on the main condition the patient is in hospital for (the primary diagnosis) is used to calculate the expected number of deaths used in the calculation of the SHMI. A high percentage of records with an invalid primary diagnosis may indicate a data quality problem. A high percentage of records with a primary diagnosis which is a symptom or sign may indicate problems with data quality or timely diagnosis of patients, but may also reflect the case-mix of patients or the service model of the trust (e.g. a high level of admissions to acute admissions wards for assessment and stabilisation). Contextual indicators on the percentage of provider spells with an invalid primary diagnosis and the percentage of provider spells with a primary diagnosis which is a symptom or sign are produced to support the interpretation of the SHMI. Notes: 1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in the contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication. 2. Please note that there was a fall in the overall number of spells for England from March 2020 due to COVID-19 impacting on activity and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. There is a shortfall in the number of records for The Princess Alexandra Hospital NHS Trust (trust code RQW). Values for this trust are based on incomplete data and should therefore be interpreted with caution. 4. Frimley Health NHS Foundation Trust (trust code RDU) stopped submitting data to the Secondary Uses Service (SUS) during June 2022 and did not start submitting data again until April 2023 due to an issue with their patient records system. This is causing a large shortfall in records and values for this trust should be viewed in the context of this issue. 5. A number of trusts are now submitting Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS) rather than the Admitted Patient Care (APC) dataset. The SHMI is calculated using APC data. Removal of SDEC activity from the APC data may impact a trust’s SHMI value and may increase it. More information about this is available in the Background Quality Report. 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of this page.