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Release: Death Certification Reform: A Case Study on the Potential Impact on Mortality Statistics, England and Wales

Released: 26 November 2012


Claudia Wells

Life Events and Population Sources

Telephone: +44 (0)1633 455867

Categories: Population, Mortality Rates, Deaths, Death Registrations

Frequency of release: Ad-hoc

Language: English

Geographical coverage: England and Wales

Geographical breakdown: Country

  • A case study on medical examiner scrutiny of death certificates found that in 78 per cent cases the underlying cause of death remained unchanged.

  • The broad underlying cause of death (as defined by International Classification of Diseases chapter) changed after medical examiner scrutiny in 12 per cent of cases.

  • In the remaining 10 per cent of cases the underlying cause changed but remained in the same International Classification of Disease chapter.

  • Following scrutiny by the medical examiner, there were 1 per cent more death certificates with an underlying cause of cancer (neoplasm), and an increase of 6 per cent in the proportion that were attributed to diseases of the circulatory system.

  • The percentage of deaths attributed to a respiratory disease underlying cause decreased by 7 per cent after medical examiner scrutiny.

  • In general, more conditions were mentioned on the death certificate as a result of scrutiny by medical examiners.

About this bulletin

This statistical bulletin presents results from a case study of areas piloting death certification reform showing the potential impact on mortality statistics by cause of death.

Additional information

Information about the underlying mortality data, including details on how the data is collected and coded, data quality and legislation are available in the Mortality metadata (2.46 Mb Pdf) and Quality and Methodology Information for Mortality Statistics in England and Wales (222.3 Kb Pdf) .

Further ONS releases based on death registrations

Mortality Statistics: Deaths registered in England and Wales (Series DR) is an annual publication containing a range of detailed reference tables, including the number of deaths broken down by cause of death, sex and five-year age group.

The 20th Century Mortality Files are a record of mortality in England and Wales from 1901 to 2000 while the 21st Century Mortality Files are a record of mortality in England and Wales from 2001 onwards.

UK data

For mortality data for other UK countries please see statistics on deaths in Scotland and statistics on deaths in Northern Ireland.


We welcome feedback on the content, format and relevance of this release. User Engagement in the Health and Life Events Division outlines the divisional approach to user engagement.

Content from the Office for National Statistics.
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