Intended for healthcare professionals

Letters Rise in mortality in England and Wales

Rise in mortality—when will the government take note?

BMJ 2018; 361 doi: (Published 25 June 2018) Cite this as: BMJ 2018;361:k2747
  1. Lucinda Hiam, general practitioner and honorary research fellow1,
  2. Danny Dorling, Halford Mackinder professor of geography2,
  3. Martin McKee, professor of European public health1
  1. 1London School of Hygiene and Tropical Medicine, London, UK
  2. 2University of Oxford, Oxford, UK
  1. lucinda.hiam1{at}

In March, we raised concerns in The BMJ that more than 10 000 extra deaths had occurred in the first seven weeks of 2018, compared with the average of the past five years.1 As mentioned in our previous rapid response,2 Jeremy Hunt was asked on 20 March 2018 in the House of Commons: “During the first seven weeks of 2018, 10 375 more people died in hospital than in the same weeks in the previous five years. Why did all these extra deaths occur?”

He replied: “As the honourable gentleman will know, these figures cover England and Wales. He will also know that they do not take account of changes in population or changes in demography, so we use the age standardised mortality rate, which, according to Public Health England, has remained broadly stable over recent years.”3

The response from a spokesperson for the Department of Health and Social Care to our concerns when the excess deaths had reached 20 0004 on 8 May 2018 was similar:

“We keep all research in this area under review, but the age standardised mortality rate—which has been broadly stable in recent years—is considered a much more reliable measure, as this type of research doesn’t take into account fluctuations in population numbers and the ageing population.”5

The quarterly mortality report from the Office for National Statistics published on 18 June 2018 confirms our fears.6 It states: “The age standardised mortality rate for deaths registered in [the first quarter of] 2018 was 1187 deaths per 100 000 population—a statistically significant increase of 5% from quarter 1 2017 and the highest rate since 2009.” Figure 1 in the report shows how remarkable this is.6

The age standardised mortality rate has risen by 5%. So, once again, we ask: how many deaths will it take for the government to take note?


  • Competing interests: None declared.