Health chiefs are failing to investigate a clear pattern of rising death rates and worsening health outcomes in England and Wales, argue experts in The BMJ, as the latest figures show more than 10,000 extra deaths in first weeks of 2018 compared with previous years.
Lucinda Hiam at the London School of Hygiene & Tropical Medicine and Danny Dorling at the University of Oxford say weekly mortality figures show 10,375 additional deaths (a rise of 12.4%) in England and Wales in the first seven weeks of 2018 compared with the previous five years.
This rise 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, they write.
However, they note that the first seven weeks of 2018 were unusual in terms of the operation of the NHS.
On 2 January, after '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 of National Statistics 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.
Mortality in infants born into the poorest families in the UK has also risen significantly since 2011.
Hiam and Dorling 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.
'Editorial: Rise in mortality in England and Wales in the first seven weeks of 2018' can be read in The BMJ.