Coherence of weekly deaths statistics in the UK

Weekly deaths statistics are an important tool for monitoring public health and informing public policy. They serve as an early warning system during crises such as flu outbreaks, heatwaves, and pandemics.

In the United Kingdom the weekly deaths statistics are produced by:

• the Office for National Statistics (ONS) for England and Wales
• National Records of Scotland (NRS) for Scotland
• the Northern Ireland Statistics and Research Agency (NISRA) for Northern Ireland

Because health is a devolved policy area in the UK, each UK nation makes its own decisions about how healthcare is legislated, funded, and provided. This means there can be differences that affect the comparability of these weekly deaths data. Comparability can also be affected by differences in reporting practices used by each statistical producer.

This review covers:

1. How its deaths are processed by each UK nation
2. How weekly deaths statistics are produced for each UK nation

Commentary is provided on the similarities and differences between nations in relation to death registration deadlines, bank holidays, death certification processes, and statistical reporting.

These differences limit the comparability and aggregation of weekly deaths statistics to the UK level, although UK-level figures are still included in the ONS weekly deaths statistics release.

Similarities

In all four nations of the UK, headline weekly deaths statistics are based on a death’s registration date, rather than the date the death occurred.

Because of legally-required protocols and practical factors, there will always be a time lag between a death’s occurrence and its registration date.

Before a death can be registered, and unless a coroner (or, in Scotland, a Procurator Fiscal) is involved, an eligible doctor must certify the cause of death. If an eligible certifying doctor is unavailable, or if the cause of death is unclear, this can prolong the certification process.

If the death is referred to a coroner or Procurator Fiscal (for example, because the death was unexpected, violent, or otherwise suspicious or non-routine), this can require post-mortems, inquests, and further scrutiny, creating considerable delays.

A death can only be registered by certain people (most commonly, a relative of the deceased) who may be emotionally affected by the bereavement and preoccupied with their grief.

Registration offices are typically closed on bank holidays, meaning that no deaths will be registered during these times.

IT systems and backlogs can cause further administrative delays.

Despite these challenges, there is a statutory deadline for registering deaths, except for when a coroner or Procurator Fiscal becomes involved (at which point the deadline is suspended until their investigation concludes). In extenuating circumstances, short-term extensions may be granted by the registrar.

The ONS, NRS, and NISRA collect data from local death registrars (either directly or through a General Register Office) in a regular and reliable fashion.

All registered deaths (excluding stillbirths) are included in the weekly reporting, regardless of demographics or cause or place of death. Breakdowns by age, sex, and local area are provided.

Weekly deaths statistics based on occurrence date, rather than registration date, are still published by all four nations. However, these are shown as secondary, non-headline statistics in the data tables.

Differences

Statutory deadlines for death registration

The statutory deadlines for death registration vary between UK nations.

In England, Wales, and Northern Ireland, deaths must be registered within 5 days of the death occurring. In Scotland, this requirement is 8 days.

Bank holidays

The number of bank holidays, and where they fall in the calendar year, varies across UK nations.

Because registrar offices are closed on bank holidays, there is typically a dip in registrations during an affected week, followed by a catch-up spike the week after. For example, in Deaths registered weekly in England and Wales, provisional: week ending 18 April 2025, the ONS reported a 22% drop in registered deaths due to the Good Friday bank holiday. This is not because fewer people died, but because fewer deaths were registered.

Where bank holidays differ across the UK, these induced dips and spikes in weekly deaths statistics will be different or misaligned. This makes direct comparisons of those periods challenging.

Certification processes

The rules around which doctors can certify a death are different across the UK.

Previously in England and Wales, and currently in Northern Ireland, the certifying doctor must have attended the patient during their last illness, with deaths referred to the coroner if the doctor had not seen the patient within 28 days before the death.

Following reforms in September 2024, any doctor in England and Wales who attended the deceased during their lifetime can now sign the death certificate. Certificates are then independently reviewed by either a Medical Examiner or a coroner, who scrutinises the certifying doctor’s assertions (especially any comments about the cause of death). This extra layer of assurance is designed partly to guard against doctor malpractice, but it can introduce further delays to death registration.

Scotland

In Scotland, the certifying doctor must have attended the patient during their last illness, though there is no statutory stipulation in terms of the number of days that can have passed since they last saw them. Scrutiny may be applied by a Medical Reviewer, but their process differs from that of the Medical Examiners in England and Wales.

Medical Examiners review every death certificate, whereas Medical Reviewers check only a random sample, which typically accounts for around 12% of all deaths. This means that 7 out of 8 death registrations in Scotland are not subject to these scrutiny-related delays that apply uniformly across England and Wales.

Medical Examiners are legally required to provide an opportunity for bereaved families to raise questions or concerns about their loved one’s cause of death or the care that they received before dying. This can take time, especially if a family member is temporarily unavailable. For Medical Reviewers, there is no requirement to contact family members during their review.

Northern Ireland

In Northern Ireland, cause related totals in weekly deaths (for example, COVID-19 related and flu or pneumonia related deaths) are based on a keyword search of the cause of death fields in death registration records. This is because the International Classification of Diseases, Tenth Revision (ICD-10) codes are not available as frequently as they are for the rest of the UK. NISRA revise weekly death tables on a quarterly basis and part of this revision involves replacing the word search-based cause of death totals with ICD-10 code-based totals. Minimal difference has been found between the figures, so there is high confidence that the keyword searches return a total with a high level of accuracy.

The Department of Health (Northern Ireland) is currently piloting an Independent Medical Examiner Role, where a random sample of Northern Ireland Medical Certificates of Cause of Death (MCCDs) is reviewed. This additional quality assurance (QA) process further enhances the quality of death data, and in particular the cause of death information flowing into the Northern Ireland registration system and Northern Ireland death statistics. Initial findings have indicated that this review process can be completed in a timely manner.

Statistical releases: Schedules

The weekly deaths statistics of England, Wales, and Northern Ireland consider Saturday to Friday as their statistical week. Scotland’s statistics cover the period from Monday to Sunday.

For example:

England, Wales, and Northern Ireland would consider the period 6 September to 12 September 2025 in a release, while Scotland would cover 8 September to 14 September.

Although all days are eventually captured in these rolling data series, this misalignment complicates direct comparisons and aggregation. A death occurring on 13 September would occur in the week-ending 19 September release for England, Wales, and Northern Ireland, but it would appear in the release for the week-ending 14 September for Scotland. However, the ONS does still sum country-level figures to create UK totals.

Publication dates are also different across the nations. In Scotland, data are reported four days after the week-ending day. In Northern Ireland, this lag is seven days. In England and Wales, the lag is twelve days.

Statistical releases: Characteristic breakdowns

Although certain characteristic breakdowns (such as age, sex, and local area) are reported for all nations, breakdowns by other variables (such as cause of death, place or death, and index of multiple deprivation) are reported weekly by only some nations.

Where a breakdown does exist for multiple nations, there are often differences in the definitions involved or sub-categories featured. For example, England uses an Index of Multiple Deprivation with decile range from 1 to 10, while the Welsh Index of Multiple Deprivation uses quintiles ranging from 1 to 5.

Further considerations

The alignment of statistical weeks across the four nations of the UK would improve the coherence of these statistics and simplify aggregations at the UK level. However, the number of public holidays and where they fall would continue to affect these statistics.

In a blog published April 2025, Excess deaths – our continued work towards a better understanding, the ONS set out its plans to explore various approaches to account for the effect of public holidays. If these methodological developments prove robust and viable, it could improve the potential for cross-UK comparisons.

As they are, weekly deaths statistics would likely fall in tier 4 or 5 of the UK-wide comparability framework tool, as developed by the Office for Statistics Regulation. There is the potential for weekly deaths statistics to move into tier 3 with the changes proposed by the ONS.

Further improvements to coherence, in terms of statutory registration deadlines and death certification processes, would likely be harder to achieve as they would require changes in legislation.

The UK Health Statistics Steering Group (HSSG) theme group on mortality continues to meet regularly to ensure there are relevant, coherent and accessible mortality statistics that meet user needs.