Provisional counts of the number of total deaths and deaths not involving the coronavirus (COVID-19), between 28 December 2019 and 10 July 2020. This includes deaths disaggregated by age and sex; by region of England, and Wales, and place of death; and for underlying causes of death and deaths involving leading causes.

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.

These datasets include all deaths registered in England and Wales for the time periods specified.

Data are supplied to ONS by the Local Registration Service, in partnership with the General Register Office (GRO). Coding for cause of death is carried out according to the World Health Organization (WHO) International Classification of Diseases (ICD-10) and internationally agreed rules, allowing for international comparisons. Deaths registered in England and Wales to those usually resident outside of England and Wales are included. Deaths registered outside of England and Wales to those usually resident in England and Wales are excluded.

This data comprises the finalised annual Death Registration data which covers the period 1993-2019. For the latest Death Registration data (2020-2021), please see 'Death registration data - Provisional.'

The Public Health Research Database (PHRD) is a linked asset which currently includes Census 2011 data; Mortality Data; Hospital Episode Statistics (HES); GP Extraction Service (GPES) Data for Pandemic Planning and Research data. Researchers may apply for these datasets individually or any combination of the current 4 datasets.

The purpose of this dataset is to enable analysis of deaths involving COVID-19 by multiple factors such as ethnicity, religion, disability and known comorbidities as well as age, sex, socioeconomic and marital status at subnational levels. 2011 Census data for usual residents of England and Wales, who were not known to have died by 1 January 2020, linked to death registrations for deaths registered between 1 January 2020 and 8 March 2021 on NHS number. The data exclude individuals who entered the UK in the year before the Census took place (due to their high propensity to have left the UK prior to the study period), and those over 100 years of age at the time of the Census, even if their death was not linked. The dataset contains all individuals who died (any cause) during the study period, and a 5% simple random sample of those still alive at the end of the study period. For usual residents of England, the dataset also contains comorbidity flags derived from linked Hospital Episode Statistics data from April 2017 to December 2019 and GP Extraction Service Data from 2015-2019.

Deaths registered in England and Wales by week, from 28 December 2019 to 2 July 2021. Breakdowns include country, sex, age group, region, place of death, and leading cause. Includes analysis of excess deaths and relative cumulative age-standardised mortality rates.

Deaths registered in England and Wales in 2020 and how they compared with the five-year average (2015 to 2019), based on finalised 2020 mortality data. The figures are broken down by cause, place of death, age group, sex and deprivation.

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. The COVID-19 pandemic has wider impacts on individuals' health, and their use of healthcare services, than those that occur as the direct result of infection. Reasons for this may include: * Individuals being reluctant to use health services because they do not want to burden the NHS or are anxious about the risk of infection. * The health service delaying preventative and non-urgent care such as some screening services and planned surgery. * Other indirect effects of interventions to control COVID-19, such as mental or physical consequences of distancing measures. This dataset provides information on trend data regarding the wider impact of the pandemic on the number of deaths in Scotland, derived from the National Records of Scotland (NRS) weekly deaths registration data. Data show recent trends in deaths (2020), whether COVID or non-COVID related, and historic trends for comparison (five-year average, 2015-2019). The recent trend data are shown by age group and sex, and the national data are also shown by broad area deprivation category (Scottish Index of Multiple Deprivation, SIMD). This data is also available on the COVID-19 Wider Impact Dashboard. Additional data sources relating to this topic area are provided in the Links section of the Metadata below. Information on COVID-19, including stay at home advice for people who are self-isolating and their households, can be found on NHS Inform. All publications and supporting material to this topic area can be found in the weekly COVID-19 Statistical Report. The date of the next release can be found on our list of forthcoming publications.

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.

Notes:

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.

Age-standardised rate of mortality from oral cancer (ICD-10 codes C00-C14) in persons of all ages and sexes per 100,000 population.RationaleOver the last decade in the UK (between 2003-2005 and 2012-2014), oral cancer mortality rates have increased by 20% for males and 19% for females1Five year survival rates are 56%. Most oral cancers are triggered by tobacco and alcohol, which together account for 75% of cases2. Cigarette smoking is associated with an increased risk of the more common forms of oral cancer. The risk among cigarette smokers is estimated to be 10 times that for non-smokers. More intense use of tobacco increases the risk, while ceasing to smoke for 10 years or more reduces it to almost the same as that of non-smokers3. Oral cancer mortality rates can be used in conjunction with registration data to inform service planning as well as comparing survival rates across areas of England to assess the impact of public health prevention policies such as smoking cessation.References:(1) Cancer Research Campaign. Cancer Statistics: Oral – UK. London: CRC, 2000.(2) Blot WJ, McLaughlin JK, Winn DM et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res 1988; 48: 3282-7. (3) La Vecchia C, Tavani A, Franceschi S et al. Epidemiology and prevention of oral cancer. Oral Oncology 1997; 33: 302-12.Definition of numeratorAll cancer mortality for lip, oral cavity and pharynx (ICD-10 C00-C14) in the respective calendar years aggregated into quinary age bands (0-4, 5-9,…, 85-89, 90+). This does not include secondary cancers or recurrences. Data are reported according to the calendar year in which the cancer was diagnosed.Counts of deaths for years up to and including 2019 have been adjusted where needed to take account of the MUSE ICD-10 coding change introduced in 2020. Detailed guidance on the MUSE implementation is available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/causeofdeathcodinginmortalitystatisticssoftwarechanges/january2020Counts of deaths for years up to and including 2013 have been double adjusted by applying comparability ratios from both the IRIS coding change and the MUSE coding change where needed to take account of both the MUSE ICD-10 coding change and the IRIS ICD-10 coding change introduced in 2014. The detailed guidance on the IRIS implementation is available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/impactoftheimplementationofirissoftwareforicd10causeofdeathcodingonmortalitystatisticsenglandandwales/2014-08-08Counts of deaths for years up to and including 2010 have been triple adjusted by applying comparability ratios from the 2011 coding change, the IRIS coding change and the MUSE coding change where needed to take account of the MUSE ICD-10 coding change, the IRIS ICD-10 coding change and the ICD-10 coding change introduced in 2011. The detailed guidance on the 2011 implementation is available at https://webarchive.nationalarchives.gov.uk/ukgwa/20160108084125/http://www.ons.gov.uk/ons/guide-method/classifications/international-standard-classifications/icd-10-for-mortality/comparability-ratios/index.htmlDefinition of denominatorPopulation-years (aggregated populations for the three years) for people of all ages, aggregated into quinary age bands (0-4, 5-9, …, 85-89, 90+)

Deaths from alcohol-related conditions, all ages, directly age-standardised rate per 100,000 population (standardised to the European standard population).

Rationale Alcohol consumption is a contributing factor to hospital admissions and deaths from a diverse range of conditions. Alcohol misuse is estimated to cost the NHS about £3.5 billion per year and society as a whole £21 billion annually.

The Government has said that everyone has a role to play in reducing the harmful use of alcohol - this indicator is one of the key contributions by the Government (and the Department of Health and Social Care) to promote measurable, evidence-based prevention activities at a local level, and supports the national ambitions to reduce harm set out in the Government's Alcohol Strategy. This ambition is part of the monitoring arrangements for the Responsibility Deal Alcohol Network. Alcohol-related deaths can be reduced through local interventions to reduce alcohol misuse and harm.

The proportion of disease attributable to alcohol (alcohol attributable fraction) is calculated using a relative risk (a fraction between 0 and 1) specific to each disease, age group, and sex combined with the prevalence of alcohol consumption in the population. All mortality records are extracted that contain an attributable disease and the age and sex-specific fraction applied. The results are summed into quinary age bands for the numerator and a directly standardised rate calculated using the European Standard Population. This revised indicator uses updated alcohol attributable fractions, based on new relative risks from ‘Alcohol-attributable fractions for England: an update’ (1) published by PHE in 2020. A detailed comparison between the 2013 and 2020 alcohol attributable fractions is available in Appendix 3 of the PHE report (2). A consultation was also undertaken with stakeholders where the impact of the new methodology on the LAPE indicators was quantified and explored (3).

The calculation that underlies all alcohol-related indicators has been updated to take account of the latest academic evidence and more recent alcohol-consumption figures. The result has been that the newly published mortality and admission rates are lower than those previously published. This is due to a change in methodology, mainly because alcohol consumption across the population has reduced since 2010. Therefore, the number of deaths and hospital admissions that we attribute to alcohol has reduced because in general people are drinking less today than they were when the original calculation was made.

Figures published previously did not misrepresent the burden of alcohol based on the previous evidence – the methodology used in this update is as close as sources and data allow to the original method. Though the number of deaths and admissions attributed to alcohol each year has reduced, the direction of trend and the key inequalities due to alcohol harm remain the same. Alcohol remains a significant burden on the health of the population and the harm alcohol causes to individuals remains unchanged.

References:

PHE (2020) Alcohol-attributable fractions for England: an update PHE (2020) Alcohol-attributable fractions for England: an update: Appendix 3 PHE (2021) Proposed changes for calculating alcohol-related mortality

Definition of numerator Deaths from alcohol-related conditions based on underlying cause of death, registered in the calendar year for all ages. Each alcohol-related death is assigned an alcohol attributable fraction based on underlying cause of death (and all cause of deaths fields for the conditions: ethanol poisoning, methanol poisoning, toxic effect of alcohol). Alcohol-attributable fractions were not available for children.

Mortality data includes all deaths registered in the calendar year where the local authority of usual residence of the deceased is one of the English geographies and an alcohol attributable diagnosis is given as the underlying cause of death. Counts of deaths for years up to and including 2019 have been adjusted where needed to take account of the MUSE ICD-10 coding change introduced in 2020. Detailed guidance on the MUSE implementation is available at: MUSE implementation guidance.

Counts of deaths for years up to and including 2013 have been double adjusted by applying comparability ratios from both the IRIS coding change and the MUSE coding change where needed to take account of both the MUSE ICD-10 coding change and the IRIS ICD-10 coding change introduced in 2014. The detailed guidance on the IRIS implementation is available at: IRIS implementation guidance.

Counts of deaths for years up to and including 2010 have been triple adjusted by applying comparability ratios from the 2011 coding change, the IRIS coding change, and the MUSE coding change where needed to take account of the MUSE ICD-10 coding change, the IRIS ICD-10 coding change, and the ICD-10 coding change introduced in 2011. The detailed guidance on the 2011 implementation is available at: 2011 implementation guidance.

Definition of denominator ONS mid-year population estimates aggregated into quinary age bands.

Caveats There is the potential for the underlying cause of death to be incorrectly attributed on the death certificate and the cause of death misclassified. Alcohol-attributable fractions were not available for children. Conditions where low levels of alcohol consumption are protective (have a negative alcohol-attributable fraction) are not included in the calculation of the indicator.

The confidence intervals do not take into account the uncertainty involved in the calculation of the AAFs – that is, the proportion of deaths that are caused by alcohol and the alcohol consumption prevalence that are included in the AAF formula are only an estimate and so include uncertainty. The confidence intervals published here are based only on the observed number of deaths and do not account for this uncertainty in the calculation of attributable fraction - as such the intervals may be too narrow.

Background and aimWith the Coronavirus Disease 2019 (COVID-19) pandemic continuing to impact healthcare systems around the world, healthcare providers are attempting to balance resources devoted to COVID-19 patients while minimizing excess mortality overall (both COVID-19 and non-COVID-19 patients). To this end, we conducted a systematic review (SR) to describe the effect of the COVID-19 pandemic on all-cause excess mortality (COVID-19 and non-COVID-19) during the pandemic timeframe compared to non-pandemic times.MethodsWe searched EMBASE, Cochrane Database of SRs, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Controlled Trials Register (CENTRAL), from inception (1948) to December 31, 2020. We used a two-stage review process to screen/extract data. We assessed risk of bias using Newcastle-Ottawa Scale (NOS). We used Critical Appraisal and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.ResultsOf 11,581 citations, 194 studies met eligibility. Of these studies, 31 had mortality comparisons (n = 433,196,345 participants). Compared to pre-pandemic times, during the COVID-19 pandemic, our meta-analysis demonstrated that COVID-19 mortality had an increased risk difference (RD) of 0.06% (95% CI: 0.06–0.06% p < 0.00001). All-cause mortality also increased [relative risk (RR): 1.53, 95% confidence interval (CI): 1.38–1.70, p < 0.00001] alongside non-COVID-19 mortality (RR: 1.18, 1.07–1.30, p < 0.00001). There was “very low” certainty of evidence through GRADE assessment for all outcomes studied, demonstrating the evidence as uncertain.InterpretationThe COVID-19 pandemic may have caused significant increases in all-cause excess mortality, greater than those accounted for by increases due to COVID-19 mortality alone, although the evidence is uncertain.Systematic review registration[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42020201256].

Commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, this report includes analysis of 3,347 children who died in England between 1 April 2019 and 31 March 2020 and investigates the characteristics of their deaths to identify if socio-economic deprivation is associated with childhood mortality.

Annual data on death registrations by area of usual residence in the UK. Summary tables including age-standardised mortality rates.

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. 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. 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. There is a high percentage of invalid diagnosis codes for Barking, Havering and Redbridge University Hospitals NHS Trust (trust code RF4), Chesterfield Royal Hospital NHS Foundation Trust (trust code RFS), Milton Keynes University Hospital NHS Foundation Trust (trust code RD8) and Portsmouth Hospitals University NHS Trust (trust code RHU). Values for these trusts should therefore be interpreted with caution. 4. 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. 5. 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.