You asked
Under the Freedom of Information Act I wish to obtain data in relation to the MCCD Part 1a (disease or condition leading directly to death, Part 1b (other disease or condition leading to 1a) and Part 1c (other diseasse or condition leading to 1b, if any): Death Certificate coding and underlying Cause of Death
1. Please provide the number of deaths from the earliest date recorded to the most recent date of deceased in England and Wales where COVID 19 has been recorded on the death certificates at the following parts of the MCCD broken down as follows:
I. Part 1 a only
ii. Part 1 b only
iii. Part 1 c only
iv. Parts 1a AND 1c only
v. Parts 1b AND 1c only
vi. Parts 1a AND 1b AND 1c only
2. Where more than one condition is given on the lowest used line of part 1, ONS will use the internationally agreed mortality coding rules in ICD-10 to select the underlying cause for routine mortality statistics, therefore please provide the following breakdown - the number of deaths from the earliest date recorded to the most recent date of deceased in England and Wales where ICD-10 has been recorded on the death certificate at the following parts of the MCCD broken down as follows:
I. Part 1 a only
ii. Part 1 b only
iii. Part 1 c only
iv. Parts 1a AND 1c only
v. Parts 1b AND 1c only
vi. Parts 1a AND 1b AND 1c only
3. Please confirm whether the "lowest used line of Part 1 is in fact 1c or whether it is 1a or 1b.
4. Please provide number of coroner inquiries emanating from the above figures.
We said
Thank you for your request.
Unfortunately, we are unable to provide the information exactly as you have requested.
ONS mortality data comes from the information collected at death registration. Each condition mentioned on the death certificate is coded using the International Classification of Diseases, Tenth Revision (ICD-10). From all the conditions mentioned, an underlying cause of death is selected using ICD-10 coding rules. The underlying cause of death is defined by WHO as:
a) the disease or injury that initiated the train of events directly leading to death, or
b) the circumstances of the accident or violence that produced the fatal injury
When cause of death information is gathered from the death certificate, it does not necessarily map directly from line to cause code. The coding team follow a specific set of rules when coding the underlying cause of death and the codes allocated to each condition depends on where they occur on the certificate. For example, underlying cause is not always taken from one specific line of the death certificate, the coding team read all of the causes listed on the certificate and choose the cause that led to the sequence of events that led to death. Further information about ONS coding rules is available in ICD-10 Volume 2 Instruction manual 2010.
Provisional numbers of death registrations involving COVID-19 for England and Wales, 2020, can be found in the latest provisional weekly deaths publication. This includes a breakdown of deaths 'due to' COVID-19 (where it was recorded as the underlying cause of death) and deaths 'involving' COVID-19 (where it was mentioned anywhere on the death certificate, either as the underlying cause or as a contributory factor). This breakdown is available in Figure 2 and data are available to download in excel format underneath the chart.
Special extracts of 2020 mortality data for England and Wales can be requested after it is finalised and published in July 2021 (subject to legal frameworks, disclosure control, resources and agreements of costs, where appropriate). Such enquiries would fall outside of the Freedom of Information regime and should be made to: Health.Data@ons.gov.uk.