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Analysis that sparked deaths controversy is axed

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The national public health oversight body has stopped its regular analysis reports which drew attention to the fact that mortality among older people has been higher than expected since the beginning of 2012.

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Public Health England stopped the production of the reports on deaths, which had been produced weekly by one of its regional public health intelligence teams, shortly after their findings were shared with LGC’s sister title Health Service Journal and made public. It resulted in widespread media coverage and shadow health secretary Andy Burnham called for an “urgent investigation” of the issue.

The cause of the increase in deaths is not known. Experts have said they could be related to particular viruses, or to cuts to support services.

PHE confirmed to HSJ it had stopped the production of the reports in the wake of the publicity. A spokesman said the publicity had drawn the organisation’s attention the fact the reports were “duplicating” work done in other parts of the organisation. He said a PHE regional analyst had produced the report “in his previous role” with the Department of Health, before transferring to PHE in April.

The spokesman said: “Having reviewed similar activity across PHE it was decided that this work didn’t add to the analysis conducted by the respiratory diseases team at [PHE’s analysis unit in] Colindale.”

The spokesman pointed to the Colindale team’s weekly flu surveillance reports. They include a short section monitoring deaths, using a slightly different methodology to that of the regional team’s deaths reports, and in much less detail.

The PHE spokesman told HSJ it was a “purely internal decision to cut one of the workstreams”. PHE is currently working on a report looking in more detail at the heightened death rate during 2013. It is not expected to look at deaths during 2012, however.

The report previously published by HSJ, dated 16 July, said: “When we focus on mortality over 75, we observe rapidly increasing mortality for both males and females, presenting throughout 2012, and continuing into 2013.”

An email sent by a PHE regional analyst, sent later in July and subsequently seen by HSJ, says, “possible links to current [accident and emergency] pressures and reductions in access to adult social care… are undoubtedly worth further investigation and cannot be ruled out; but equally it is premature to suggest that they are supported in the data”.

Meanwhile, NHS England deputy medical director and lead for health inequalities Steve Field, asked by HSJ to comment on the increased deaths, said he did now know and would not suggest a reason for them.

He said: “I really don’t know what the causes are but… patients are getting increasingly elderly and more and more complex. Vulnerable people including the vulnerable elderly need seamless services.”

Professor Field called for “collaboration at a local level that involves health and social care” and said the “mental health needs of the elderly haven’t always been supported adequately”.

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