Deaths registered weekly in England and Wales, provisional: week ending 25 October 2024

• In the week ending 25 October 2024 (Week 43), 11,012 deaths were registered in England and Wales (including non-residents), an increase from 10,784 in the previous week (Week 42).
• The number of deaths registered in Week 43 was 7.2% lower than the expected number (857 fewer deaths).
• In the week ending 25 October 2024, 13.8% of registered deaths involved influenza or pneumonia (1,525 deaths), while 2.6% involved coronavirus (COVID-19) (282 deaths).
• In the same week, influenza or pneumonia were the underlying cause of 3.7% of deaths (409 deaths), while COVID-19 was the underlying cause of 1.7% of deaths (187 deaths).
• Of deaths registered in the week ending 25 October 2024, 35.2% occurred within the previous seven days; the median time from death to registration was eight days.
• In Week 43 of 2024, 12,522 deaths were registered in the UK.

In the week ending 25 October 2024 (Week 43), 11,012 deaths were registered in England and Wales. Of these, 10,325 were registered in England and 657 were registered in Wales (Table 1).

Figure 1: Number of deaths from all causes was lower than expected in week 43

Number of deaths registered by week, England and Wales, 31 December 2022 to 25 October 2024

Notes:

1. Figures include deaths of non-residents.
2. Based on date a death was registered rather than occurred. All figures are provisional. The number of deaths registered in a week is affected when bank holidays occur.
3. A statistical model is used to estimate the expected number of deaths. The model accounts for changes in population size, age structure, and trends in mortality over time.
4. Changes to the process by which causes of deaths are scrutinised and certified (Death certification reform), including a statutory medical examiner system, came into force in England and Wales on 9 September 2024.

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• Deaths registered weekly in England and Wales by age and sex
• Deaths registered weekly in England and Wales by region

We publish timely, provisional counts of death registrations in our Deaths registered weekly in England and Wales, provisional dataset. These are presented:

• by sex
• by age group
• by place of death
• by selected causes of death
• for regions (within England)
• for Wales as a whole

To allow time for registration and processing, figures are published 12 days after the end of the week. We provide provisional updated totals for death occurrences based on the latest available death registrations. With each week's publication, we also update the data for previous weeks within our dataset, for both death registrations and occurrences.

Death registrations and occurrences

Weekly death registrations are revised over time to provide users with the most accurate data. Changes in numbers of death registrations in each period will usually be minor, but numbers for a given week can either increase or decrease. This can be because of:

• additional deaths having been registered, but not being available in the Registration Online (RON) system by the time data are extracted, either because of manual registrations that have not been entered into RON or technical issues
• change of date of registration (because of an error at the registration office)
• deduplication of death records (removal of an accidental double entry)
• cancellation of a registration (for instance, because of an error at the registration office)

Revisions to numbers of deaths by cause will likely be more pronounced, because cause of death is not always available at the time of the weekly publication. This is because text from the death registration must be converted to the International Classification of Diseases 10th Revision (ICD-10) codes for cause of death. Most deaths records (over 80%) have cause information available at the time of publication, and the remaining records are updated over time.

As we receive more death registrations from RON over time, the number of deaths that are known to have occurred in a period will increase. We are only informed about a death when it is registered, so numbers of death occurrences are never final; it is impossible to know definitively whether all deaths have been registered. The reported number of death occurrences depends on when data were extracted and increases as time between date of occurrence and data extraction increases.

The proportion of deaths occurring in a week that are registered in the same week is affected by the workloads of doctors certifying deaths, bank holidays and other closures of local registration offices, and other circumstances. Because of all these factors, the provisional death occurrence numbers for different weeks are not easily comparable, and numbers of death occurrences for previous weeks will change with each publication.

Death certification reform

Changes to the process by which causes of deaths are scrutinised and certified (Death certification reform), including a statutory medical examiner system, came into force in England and Wales on 9 September 2024.

From 9 September 2024, a statutory medical examiner system was introduced, meaning that a medical examiner provides independent scrutiny of the cause of death identified by the attending practitioner, before death registration, for all non-coronial deaths.

Once the attending practitioner and the medical examiner have completed their certification and scrutiny, the medical certificate of cause of death (MCCD) is sent to the Register Office. The medical examiner then notifies the informant that they can register the death with the Register Office.

Death certification reform also introduces a new MCCD with new data fields, including:

• Line 1d in the cause of death section of the MCCD, which brings the MCCD in line with international standards
• ethnicity of deceased, as self-declared by the patient on the medical record
• questions about whether the deceased was pregnant, and whether the pregnancy contributed to the death, which brings the MCCD in line with international standards

We will conduct analysis of these new data fields to assess their quality and use in future mortality statistics.

A medical examiner medical certificate of cause of death (ME MCCD) has also been introduced, whereby medical examiners can certify a death. This certificate is for exceptional circumstances where no medical practitioner can fulfil the attending criteria, but the cause of death is known and natural and therefore considered non-coronial by a senior coroner.

The ME MCCD allows the death to be registered as certified and avoids potentially avoidable post-mortems and uncertified deaths where the cause of death is known.

Death certification reform is applicable from 9 September 2024. Transitional arrangements in place in the days leading up to this date means that there will be a small number of deaths registered from 9 September 2024 that still use the existing MCCD.

More detailed information about Death certification reform will be provided in updates to our User guide to mortality statistics and Mortality statistics in England and Wales quality and methodology information (QMI) report, alongside the 2024 edition of our Death registration summary statistics, England and Wales bulletin, publishing in the near future.

Registration delays

This bulletin is based mainly on the date that deaths are registered, not the date of death (date of occurrence). The number of days between death occurrence and registration depends on many factors and there might be longer delays sometimes (for example, deaths referred to the coroner). Read more in our Impact of registration delays on mortality statistics in England and Wales: 2022 article.

Producing statistics based on date of death that are both timely and sufficiently complete is not possible. On the other hand, statistics based on date of registration are both timely and complete. It is important, however, to consider the limitations of using registration data over occurrence data. Measures of the average gap (or delay) between the date of occurrence and date of registration become important statistical quality metrics to help users understand this.

These quality metrics are provided in Table 4 of our accompanying Deaths registered weekly in England and Wales, provisional dataset, and include:

• the number of deaths registered in the reference week (and therefore included in the figures), which also occurred within the previous seven days; for example, if a death was registered on 7 January, it occurred between 1 January and 7 January
• the percentage of deaths registered in the reference week, which occurred within the seven days before the day of registration
• the median delay for all deaths registered that week
• the number of days taken to register the 25th and 75th percentile that week, meaning that if 10,000 deaths were registered that week, and all deaths were ordered according to length of delay from shortest to longest, the delay up to the 2,500th death would be the 25th percentile and the delay up to the 7,500th death would be the 75th percentile

Before 9 September 2024, deaths should legally have been registered within five days of the death occurring or the date which a body was found (including weekends and bank holidays), unless a coroner was involved.

However, since 9 September 2024, reforms mean that the five-day period starts from the date the registrar receives a signed MCCD from the medical examiner, or relevant notification from the coroner. For MCCDs, it is expected this will usually be the same date as the medical examiner signed the MCCD.

We will continue to monitor registration delays as part of our ongoing assessments of the quality and timeliness of mortality data, including whether death certification reforms have affected registration delays. This is important because any change in registration delays in the weeks following 9 September could affect the interpretation of our statistics; for example, our excess deaths measure, where the observed number of registrations is compared with a statistically calculated expected number of deaths each week.

We have added additional breakdowns by certification type into Table 4 of our accompanying dataset to help monitor any impact of death certification reform on registration delays.

Excess mortality

Excess mortality is the difference between the observed number of deaths in a particular period and the number of deaths that would have been expected in that period, based on historical data.

To estimate the expected number of deaths, we fit a quasi-Poisson regression model to aggregated death registration data. The statistical model provides the expected number of deaths registered in the current period, had trends in mortality rates remained in keeping with those from recent periods and in the absence of extraordinary events affecting mortality, such as the peak of the coronavirus (COVID-19) pandemic.

Our approach moves away from using averages drawn from raw numbers and instead uses age-specific mortality rates, accounting for how the population has grown and aged over time. The models also account for trends and seasonality in population mortality rates and allow for estimates of excess deaths to be broken down by age group, sex, constituent countries of the UK, and English region.

For further information on our methods to estimate excess deaths, see our Estimating excess deaths in the UK, methodology changes: February 2024 article.

Underlying cause of death versus contributory causes

In this release, we discuss both deaths "involving" a particular cause, and deaths "due to" a particular cause. Those "involving" a cause include all deaths that had the cause mentioned on the death certificate, whether as the underlying or a contributory cause. Deaths "due to" a particular cause refer to the underlying cause of death.

Data coverage

The number of weeks in the year will affect how many days the data cover in the year. Leap years require a 53rd week to be added to the end of the calendar year. The last leap year was in 2020. It is more appropriate to compare 2020 figures with the average for Week 52 than with a single year from five years previously. Read more on the data coverage in this bulletin in Section 1 of our Coronavirus and mortality in England and Wales methodology.

Classification codes

From the week ending 26 February 2021 (Week 9), new International Classification of Diseases codes for COVID-19 issued by the World Health Organization (WHO) were used for deaths involving COVID-19. Read more in our Coronavirus and mortality in England and Wales methodology. Further information on data quality, legislation and procedures relating to mortality, and a glossary of terms, is available in our User guide to mortality statistics methodology.

Data sources

The weekly figures that the Office for National Statistics (ONS) produces are for England and Wales only and are from the formal death registration process. They are published each week to provide users with timely data and capture seasonal trends. Data for Scotland and Northern Ireland are provided to us by the National Records of Scotland and the Northern Ireland Statistics and Research Agency, respectively, to produce numbers and rates for the UK overall.

Accredited official statistics

These accredited official statistics were independently reviewed by the Office for Statistics Regulation in February 2013. They comply with the standards of trustworthiness, quality and value in the Code of Practice for Statistics and should be labelled "accredited official statistics".

Quality

More quality and methodology information (QMI) on strengths, limitations, appropriate uses and how the data were created is available in our Mortality statistics in England and Wales QMI.