Abstract copyright UK Data Service and data collection copyright owner.

The Death Registrations in England and Wales, 1993-2022: Secure Access study includes annual data files for all deaths registered in England and Wales from 1993 to 2022. Death registration is a legal requirement under the Births and Deaths Registration Act 1836. The registration of deaths occurring in England and Wales is a service carried out by the Local Registration Service in partnership with the General Register Office (GRO). Information collected at death registration is recorded on the Registration Online (RON) system by registrars. The information supplied at the time of registration is from 1 of 4 sources:

1. details supplied by the doctor when certifying a death
2. details supplied by the informant to the registrar
3. details supplied by a coroner to the registrar following an investigation
4. details derived from the information supplied above

Death registration data are passed to the Office for National Statistics electronically from GRO for statistical purposes. Each annual dataset is a static file of death registration records available at the time the annual subset was closed. Revisions to records can still be made after the subset has been finalised but these will not be reflected in the annual dataset or used to compile statistics. The annual datasets include deaths that have been registered in that calendar year, a small percentage of these deaths may have occurred in previous years (2.9% in 2001 and 4.8% in 2015). Deaths to those usually resident in England or Wales who die abroad are not included in the dataset. Deaths registered in England and Wales to those whose usual residence is outside England and Wales are included.

Further information about mortality statistics is available from the Office for National Statistics deaths web page.

Prospective users will need to apply for access to this controlled access data via the UK Data Service Secure Lab. Further information is available on the Apply to Access Controlled Data in SecureLab web pages.

Latest edition information:
For the ninth edition (May 2024), the 2022 data file has been added to the study, along with the latest Mortality statistics in England and Wales QMI documentation file.

Main Topics:

Full details of the variables included are in the 'Deaths Variable Catalogue' and in 'Deaths Metadata' available from the Documentation section. Not all variables are available every year but the main areas covered include:

• registration details (date of registration)
• characteristics of the death (age, date of birth and gender of deceased, date of death, death certificate information, date last seen alive, manner of death, post-mortem information)
• cause of death variables for aged 28 days and over and for aged under 28 days (cause of death coded using International Classification of Diseases (ICD) using ICD9 for deaths from 1993-2000 and ICD10 for deaths from 2001-2020)
• marital status / spouse details (spouse age and date of birth)
• occupation, employment status and socio-economic classification
• place of death (communal establishment information, ICD place of accident and workplace codes)
• geography variables (country of residence, country of birth, country and postcode of usual residence, postcode of place of death)

Annual data on deaths registered by age, sex and selected underlying cause of death. Tables also provide both mortality rates and numbers of deaths over time.

Annual UK and constituent country figures for births, deaths, marriages, divorces, civil partnerships and civil partnership dissolutions.

Annual number of deaths registered related to drug poisoning in England and Wales by sex, region and whether selected substances were mentioned anywhere on the death certificate, with or without other drugs or alcohol, and involvement in suicides.

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.

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 due to COVID-19 impacting on activity for England 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 County Durham and Darlington NHS Foundation Trust (trust code RXP), East Lancashire Hospitals NHS Trust (trust code RXR), Guy’s and St Thomas’ NHS Foundation Trust (trust code RJ1), King’s College Hospital NHS Foundation Trust (trust code RJZ) and The Princess Alexandra Hospital NHS Trust (trust code RQW). Values for these trusts 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.

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.

On very rare occasions a mother will die during pregnancy or childbirth in Belgium. We estimate about 12 women per year, based on current data of STATBEL and the Maternal Mortality Ratio (MMR) of our neighboring countries. At this point (december 2020) we know very little about these mothers. The information of their death is limited to the data on the death certificates, and in Flanders from what was communicated as the cause of death to the SPE (Vlaamse Studiecentrum voor Perinatale Epidemiologie). This unlike our neighboring countries (the United Kingdom, the Netherlands, France, Italy) who have an enhanced maternal mortality registration and analysis system since years. The most known being the MBRRACE-UK, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK. Thanks to these systems we know that an important number of the deceased mothers had an underlying disease, for example a heart disease, which aggravated during pregnancy. And importantly, the in-depth analyses of maternal deaths in our neighboring countries revealed 'substandard care' in more than half of cases, which (may have) contributed to the death of these mothers. Therefore, the Federal Public Service of Public Health strongly supports the Belgian Analysis system for Maternal Mortality that registers and analyses the cases of maternal death in Belgium, in a structured manner by a national multidisciplinary expert team.

Number of suicides and suicide rates, by sex and age, in England and Wales. Information on conclusion type is provided, along with the proportion of suicides by method and the median registration delay.

These indicators are designed to accompany the SHMI publication. As well as information on the main condition the patient is in hospital for (the primary diagnosis), the SHMI data contain up to 19 secondary diagnosis codes for other conditions the patient is suffering from. This information is used to calculate the expected number of deaths. 'Depth of coding' is defined as the number of secondary diagnosis codes for each record in the data. A higher mean depth of coding may indicate a higher proportion of patients with multiple conditions and/or comorbidities, but may also be due to differences in coding practices between trusts. Contextual indicators on the mean depth of coding for elective and non-elective admissions 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 Chelsea and Westminster Hospital NHS Foundation Trust (trust code RQM). 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. There is a high percentage of invalid diagnosis codes for Chesterfield Royal Hospital NHS Foundation Trust (trust code RFS), Milton Keynes University Hospital NHS Foundation Trust (trust code RD8), and West Suffolk NHS Foundation Trust (trust code RGR). Values for these trusts should therefore be interpreted with caution. 6. Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), East and North Hertfordshire NHS Trust (trust code RWH), 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), Sandwell and West Birmingham Hospitals NHS Trust (trust code RXK), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG) 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 is available in the Background Quality Report. 7. On 1 July 2023 Southport and Ormskirk Hospital NHS Trust (trust code RVY) was acquired by St Helens and Knowsley Teaching Hospitals NHS Trust (trust code RBN). The new organisation is known as Mersey and West Lancashire Teaching Hospitals NHS Trust (trust code RBN). This new organisation structure is reflected from this publication onwards. 8. 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. The SHMI methodology does not make any adjustment for patients who are recorded as receiving palliative care. This is because there is considerable variation between trusts in the way that palliative care is recorded. Contextual indicators on the percentage of provider spells and deaths reported in the SHMI where palliative care was recorded at either treatment or specialty level 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 has been a fall in the overall number of spells due to COVID-19 impacting on activity from March 2020 onwards and this appears to be an accurate reflection of hospital activity rather than a case of missing data. Further information is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. 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 Hospital Episode Statistics (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. 4. There is a shortfall in the number of records for Royal Free London NHS Foundation Trust (trust code RAL). Values for this trust are based on incomplete data and should therefore be interpreted with caution. 5. On 1st April 2022 Northern Devon Healthcare NHS Trust (trust code RBZ) merged with Royal Devon and Exeter NHS Foundation Trust (trust code RH8). The new trust is called Royal Devon University Healthcare NHS Foundation Trust (trust code RH8). This new organisation structure is reflected from this publication onwards. 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.

This indicator is designed to accompany the SHMI publication. The SHMI includes all deaths reported of patients who were admitted to non-specialist acute trusts in England and either died while in hospital or within 30 days of discharge. Deaths related to COVID-19 are excluded from the SHMI. A contextual indicator on the percentage of deaths reported in the SHMI which occurred in hospital and the percentage which occurred outside of hospital is 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 has been a fall in the overall number of spells due to COVID-19 impacting on activity from March 2020 onwards and this appears to be an accurate reflection of hospital activity rather than a case of missing data. Further information is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. 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 Hospital Episode Statistics (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. 4. There is a shortfall in the number of records for Royal Free London NHS Foundation Trust (trust code RAL). Values for this trust are based on incomplete data and should therefore be interpreted with caution. 5. On 1st April 2022 Northern Devon Healthcare NHS Trust (trust code RBZ) merged with Royal Devon and Exeter NHS Foundation Trust (trust code RH8). The new trust is called Royal Devon University Healthcare NHS Foundation Trust (trust code RH8). This new organisation structure is reflected from this publication onwards. 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. 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. There has been a fall in the number of spells for some trusts due to COVID-19 impacting on activity from March 2020 onwards and this appears to be an accurate reflection of hospital activity rather than a case of missing data. Contextual indicators on the number of provider spells which are excluded from the SHMI due to them being 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 experimental statistics. 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. 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 Hospital Episode Statistics (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. 2. There is a shortfall in the number of records for Royal Free London NHS Foundation Trust (trust code RAL) and Northern Care Alliance NHS Foundation Trust (trust code RM3). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 3. A proposed merger between Northern Devon Healthcare NHS Trust (trust code RBZ) and Royal Devon and Exeter NHS Foundation Trust (trust code RH8) was due to take place on 1 April 2022. The new trust name and code is yet to be confirmed. Please note that separate indicator values have been produced for these organisations for this publication. When we receive confirmation of the new trust name and code we will reflect the new organisation structure within future publications. 4. 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.