Guidance

Measuring excess mortality: a guide to the main reports

A guide to the major publications related to excess deaths in the UK, who produces them and links to the methods and analysis.

Excess deaths can be defined as the difference between the actual number of deaths in a particular period and the estimated number of deaths expected in that period. Expected deaths can be derived in a variety of ways for different purposes, which means that there may be different estimates of excess deaths published by different organisations and used for those specific purposes.

This document explains the major publications related to excess deaths in the UK. Details of the methodologies are published by individual organisations.

Producers and publishers of the main reports

The 聽is responsible for collecting, analysing and disseminating statistics about the UK鈥檚 economy, society and population.聽As such,聽ONS聽produces statistics related to the registration of life events which includes publication of聽. National Records of Scotland (NRS) and Northern Ireland Statistics and Research Agency (NISRA) are responsible for mortality outputs for聽听补苍诲听, respectively.

The Office for Health Improvement and Disparities (OHID)聽forms part of the Department of Health and Social Care (DHSC) and is responsible for work to improve the nation鈥檚 health and reduce health disparities.聽OHID聽produces the monthly publication Excess mortality within England: post-pandemic method.

The UK Health Security Agency (UKHSA)聽is responsible for surveillance of infectious diseases and other health related threats to the security of the nation鈥檚 health. UKHSA聽currently produces 3 excess mortality related products:聽Weekly all-cause mortality surveillance in England, Annual heat mortality monitoring in England and Annual surveillance of influenza and other seasonal respiratory viruses in the UK.

ONS reports

Deaths registered weekly in England and Wales

罢丑别听聽publication includes estimates of excess all-cause mortality in England and Wales.

On 20 February 2024,聽ONS聽published a new method for measuring excess mortality that will allow national comparisons of excess deaths. In the future, the weekly publication will include numbers of death registrations and excess deaths for each of the 4 UK countries as well as the UK as a whole.聽Therefore, this publication will contain the headline figures for England and will be the most appropriate for making comparisons across each of the devolved administrations of the UK.

NRS听补苍诲听NISRA聽currently produce excess mortality figures for聽听补苍诲听, respectively, and have updated their methodology in line with that implemented by聽ONS. This means a consistent method is used by all 4 nations, which enables comparisons at national level.

ONS鈥檚 new methodology for estimating the expected number of deaths, which replaces the previous 5-year average approach, is closely aligned with聽OHID鈥檚 updated methodology described below. Both organisations publish estimates of excess deaths for England. Those produced by聽ONS聽are consistent with estimates for other UK countries, while those produced by聽OHID聽can be disaggregated by local authorities within England (at present,聽ONS鈥檚 new methodology permits only regional breakdowns in England).

OHID reports

Excess mortality within England: post-pandemic method

OHID听辫谤辞诲耻肠别蝉听monthly estimates of excess mortality聽within England.聽OHID聽published this revised version of its report聽on 20 February 2024. This new analysis and methodology will be aligned with聽ONS鈥檚 new method where possible.

Rather than measuring the impact of the COVID-19 pandemic on mortality, the new approach provides a method for ongoing monitoring which includes an updated baseline period. These estimates represent the number of deaths above the number expected, based on trends in mortality over the previous 5 years instead of comparing to the pre-pandemic period. Further details are captured in聽鈥機hanges to聽OHID鈥檚 reporting of excess mortality in England鈥� (published alongside the report).

This publication is the most appropriate to use when comparing excess mortality within England.聽OHID聽produces breakdowns which show inequalities in levels of excess mortality, including by sex, age group and level of deprivation for the English regions and local authorities.聽OHID鈥檚 analysis by cause of death describes which causes are particularly contributing to excess deaths in specific time periods.

OHID鈥檚 monthly publication provides estimated numbers of excess deaths and the ratio of registered to expected deaths. Users can adjust the time periods presented, allowing cumulative estimates to be shown for specific periods.

UKHSA reports

Weekly all-cause mortality surveillance in England

All-cause mortality surveillance shows time periods when mortality levels were higher than expected, rather than providing an estimate of the number of actual or expected deaths. 罢丑别听weekly all-cause mortality surveillance reports聽are published every Thursday.

This publication includes details of the weeks in which observed deaths are higher than an expected threshold, which is calculated using a European-wide algorithm called聽. It includes a chart of observed and expected deaths by the date the death occurred across all ages in England. The chart also shows the upper limit for when the number of deaths is considered to be significantly higher than expected.

This publication can be used for making international comparisons and for other surveillance purposes, prompting further investigation to determining the cause, and assessing the impact of known health events. Health events could include high levels of influenza, extreme heat or extreme cold, for example.

Annual heat mortality monitoring in England

The heat mortality monitoring reports are published yearly during the summer season in the following year.

During episodes of heat in the summer months, UKHSA estimates the number of deaths caused by the heat using the baseline death registration data from the General Register Office (GRO). Heat episodes are defined as any day on which an amber Heat-Health Alert (HHA) is issued in at least one region, or the mean central England temperature is at least 20掳C. One day either side of the alert or mean temperature is also included to allow for the time-lagged effects of temperature on mortality. Where episodes overlap, they are counted as one episode. The data is stratified by NHS England region, age group, sex and heat period. Figures are reported for heat-associated deaths and years of life lost.

The publication includes a plotted graph for those aged 65 years and over of daily all-cause excess mortality and heat-attributable mortality in England. An additional plot compares the total all-cause excess mortality estimates using observed deaths and modelled excess all-cause mortality by heat episode and total estimate across all episodes in England.

UKHSA鈥檚 heat mortality monitoring provides information on heat-associated deaths observed during episodes of heat each year to inform public health actions. It also provides information to the public on the observed impacts from heat on health. The publication also serves as a basis to update the Weather-Health Alerts (WHA) temperature thresholds.

Annual surveillance of influenza and other seasonal respiratory viruses in the UK

罢丑别听surveillance of influenza and other seasonal respiratory viruses in the UK聽statistics are published every year after the winter period.

This publication includes estimates of the number of deaths attributable to influenza, COVID-19 and extreme cold using all-cause mortality data.

This publication can be used to indicate the potential mortality burden from COVID-19, other respiratory diseases and extreme cold.

Updates to this page

Published 20 February 2024
Last updated 30 October 2024 show all updates
  1. Change of wording to 'Annual heat mortality monitoring in England' section.

  2. First published.

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