Abstract
Changes in the absolute number of deaths (all-cause mortality) act via their impact on end-of-life care to affect marginal changes in NHS medical admissions, bed occupancy and costs. These effects are poorly understood. A very large and unexpected increase in deaths in 2015 offers the opportunity to explore the reasons for this and previous examples of periods of increased deaths. While the event in 2015 was large it is simply a further example of a long-term series of similar events. An influenza outbreak in early 2015 did make an additional contribution, however deaths had already begun to increase around mid-2014. Interaction between the agent causing the earlier increase in deaths and influenza appear highly likely. The resulting complex short-term trends in death imply that health and social care costs will show far higher volatility than that implied by simple demographic change.
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