NHS crisis causing continued higher-than-normal levels of death in England and Wales

The crisis in the NHS is leading to continued higher-than-usual death levels in England and Wales, experts have said.

Figures from the Office for National Statistics reveal that almost 170,000 more people than normal died in England and Wales between March 2020, when coronavirus was declared a pandemic, and the end of 2022 – 11% higher than the five-year average.

However, the new data also shows that the number of excess deaths has continued, even as the virus’ fatality rate has declined thanks to vaccinations and weaker strains, with 90% of the excess deaths in 2022 occurring in the second half of the year, coinciding with recent NHS pressures and the impact of a cold winter.

Prof David Spiegelhalter of Cambridge University said that “analyses have suggested that delays in ambulance arrivals and in A&E will have had a substantial impact, as well as the cold weather and the early flu season.”

Last year saw almost 34,000 more deaths than expected – an increase of 6% above the five-year average level. Only a quarter of these excess deaths were due to Covid, while there was a 41% increase in excess deaths due to accidental falls between June and October 2022, “where delays in treatment and admission may have played a role”, Spiegelhalter added.

December last year saw a particularly high number of excess deaths not related to Covid, with a 25% increase in the number of deaths due to influenza and pneumonia (598 additional deaths) when compared to normal, a 10% increase in ischaemic heart disease deaths (454) and a 39% rise in the number of deaths due to cardiac arrhythmias (244).

The figures show the devastating impact of Covid in 2020. A total of 57,641 more people than usual died during the first four months of the pandemic (March to July 2020). The second wave of the virus between September 2020 and March 2021 saw a further 52,679 excess deaths.

In 2021, the impact of the vaccination programme can be seen – with a declining number of excess deaths (32,922 more people than usual), and a higher proportion not directly attributable to the virus.

Two-thirds of the total excess deaths (105,000) registered since the start of the pandemic have occurred in private households. The number of people dying in their homes has been consistently above average since the beginning of the pandemic.

Spiegelhalter said that few of the people dying at home “are extra deaths, so this represents a huge shift away from dying in hospital, hospice or care homes. This may be a positive change, if their end-of-life care is good.”