London School of Hygiene & Tropical Medicine

In the first seven weeks of 2018, there were an additional 10,375 deaths (a rise of 12.4%) in England and Wales compared with the previous five years.

Writing in the BMJ, Lucinda Hiam, GP and Honorary Researcher at the London School of Hygiene & Tropical Medicine, and Professor Danny Dorling, Halford Mackinder Professor of Geography, from the University of Oxford, say that the government is failing to investigate a clear pattern of rising death rates and worsening health outcomes in England and Wales.

The rise in deaths cannot be explained by ageing of the population, a flu epidemic, or cold weather - and no official explanation has been forthcoming as to why death rates have continued to be so high relative to previous trends, the authors write.

However, they note that the first seven weeks of 2018 were unusual in terms of the operation of the NHS.

On 2 January, in “an unprecedented step by NHS officials,” thousands of non-urgent operations were cancelled—a clear sign of a system struggling to cope. Many hospitals were already at or beyond their safe working levels, “with high numbers of frail patients stuck on wards for want of social care,” and a rise in influenza cases had begun.

However, they then show that influenza can have only accounted for a very small part of the overall rise in mortality in early 2018.

The past five years have been challenging in terms of health outcomes in the UK, they add. For example, spending on health and social care year on year has increased at a much slower rate than in previous years, while outcomes in a large number of indicators have deteriorated, including a very rapid recent increase in the numbers of deaths among mental health patients in care in England and Wales.

They point out that the Office for National Statistics (ONS) has in the past 12 months reduced its projections of future life expectancy for both men and women in the UK by almost a year each, and, in doing so, has estimated that more than a million lives will now end earlier than expected.

Dr Lucinda Hiam said: “Health outcomes in the UK have been worsening over recent years, and mortality figures from the ONS for the first seven weeks of the year are cause for further alarm.

“Although the number of deaths is not a reliable measure, as it does not take into account age variation, these figures are extremely worrying combined with the background of worsening mortality trends.

“Health experts have repeatedly raised concerns about the impact that the lack of sufficient funding for health and social care is having on the health of the population, and these concerns have been repeatedly disregarded by the Department of Health and Social Care.

“It is time for an urgent investigation to explore why for some in the UK, unlike Europe, life expectancy is not only stalling, but reversing.”

Mortality in infants born into the poorest families in the UK has also risen significantly since 2011.

The authors both argue that there remains “a clear lack of consensus” over the reasons for the rise in deaths - and say they and others have already called for an urgent investigation by the Health Select Committee of the House of Commons.

“The latest figures for this year make the case for an investigation stronger and more urgent with each passing day,” they conclude.