Released 21 April 2021
Request:
- Total number of recorded Influenza deaths for the period 01/01/2018 – 31/12/2018.
- Total number of recorded Influenza deaths for the period 01/01/2019 – 31/12/2019.
- Total number of recorded Influenza deaths for the period 01/01/2020 – 31/12/2020.
- Total number of deaths from Covid-19 (where Covid-19 is the only cause of death reported) for the period 01/01/2020 – 31/12/2020.
- Total number of deaths with Covid-19 (where Covid-19 is not the only cause of death reported but where other co-morbidities are mentioned) for the period 01/01/2020 – 31/12/2020.
Please provide this information in relation to every health facility that falls within your Trust.
Information disclosed:
Assistance provided under Section 16 of the FOI Act:
The Trust has a responsibility under section 16 of the Act to provide assistance with FOI requests where possible and reasonable to do so.
Questions 1-3.
We don’t have an easy way of identifying patients that may have died from influenza. Medical Certificate of Cause of Death (MCCD) information is not held on a central reporting system and is currently held as paper-based records.
Any attempt to confirm whether influenza was a factor in a patient’s death, would require the manual audit of all relevant patient MCCDs by a medical examiner. Due to the significant time this research would require, such information cannot be provided within the ‘appropriate limit’ as outlined in the Fees Regulations and the engagement of section 12 exemption [cost limit] under the Act is appropriate at this time.
The closest data we can provide would be the number of inpatients whose diagnosis code was influenza and they died while in hospital, although we would not be able to confirm that influenza was necessarily the direct cause of death. We can only provide Trust-wide data in this context and would not be able to provide a breakdown of this data by specific hospital. Please let us know if you would like to receive this information.
Questions 4-5.
The Trust is currently collecting and reporting data relevant to Covid-related deaths according to the national definitions issued by Public Health England (PHE). Although we appreciate that there is a level of public interest in alternative information relevant to Covid-related deaths, we are currently unable to provide this additional data within the ‘appropriate limit’ as outlined in the Fees Regulations and the engagement of section 12 exemption [cost limit] under the Act is appropriate at this time.
Any attempt to compile data where Covid-19 was the ‘direct’ cause of death or if there were other ‘contributing’ factors or ‘underlying’ diseases or conditions that may have been involved in these patient deaths, would require investigation into each patient’s medical history and the manual audit of every relevant Medical Certificate of Cause of Death (MCCD) by a medical examiner. The reason this would be necessary is that the distinction between those patients that died as a ‘direct result of becoming infected with coronavirus’ and those patients that died ‘with coronavirus’ is difficult to establish.
As an example, a patient who tested positive for Covid-19 could have a heart attack two weeks later; a number of factors would require careful consideration to determine whether it was Covid-19 that caused the heart attack or if it was the result of an underlying heart condition. Unfortunately, such complex investigation into each patient death in this context would require an unreasonable level of staff resources to carry out. We regret this decision, but we simply do not have the spare capacity to carry out the work involved in providing information in the format you have requested.
We are, however, currently able to offer 2 different sets of data relevant to your request. The first is the total number of patients that died in all Trust hospitals with COVID-19 indicated on their Medical Certificate of Cause of Death (part 1 or 2) by month. Please let us know if you would like to receive this information. The reason that we are able to provide this data for COVID-19, and not similar data relevant to influenza (see above), is because we have been auditing MCCDs and compiling this information since the start of the pandemic.
The Trust is also reporting Covid-related deaths in line with national guidance issued by NHS England and Public Health England. This Trust-level data is reported daily and is accessible to the public. Information about the definitions used for this data is also available from this website. Since this information is reasonably accessible via other means, section 21 exemption under the FOIA is engaged. Additional information about Covid-related deaths across the UK, including a daily dashboard of this activity, can be found on the government’s website.
With the above in mind, we are writing to you under section 16 of the Act [duty to assist] to offer you the opportunity to revise your request. If you would like to receive the alternative data we can provide as outlined above, please let us know and we will make every effort to get this information to you as soon as possible.