Recording Healthcare Worker Deaths

8.1 The Welsh Government agrees with the Inquiry’s recommendation that, in the event of a future pandemic, there should be a clear way to record, analyse and publish information about the deaths of healthcare workers. This would help us understand how a pandemic has affected the workforce. It would also help public services take action to protect staff and be open with the public. 8.2 During the Covid‑19 pandemic, information about healthcare worker deaths came from several sources, including Public Health Wales, and other NHS organisations in Wales, and Office for National Statistics. These sources provided important intelligence, but they were designed for different purposes and each had limitations. Some information was available quickly but was not complete. Other information was more reliable for later analysis but was not available quickly enough to support urgent decisions. 8.3 The Welsh Government’s view is that no single existing data source is likely to meet all the needs of this recommendation. During a pandemic, data may be needed quickly to help protect staff, operational planning and urgent decision making. Over time, more detailed analysis may be needed to understand patterns by role, setting, areas and population groups. This means Wales may need to use more than one source of information. 8.4 There are significant practical and ethical issues to resolve. Any approach would need to be accurate, timely, and clear about who it includes. It should consider healthcare workers outside directly employed NHS roles, including primary care, community services and independent providers where relevant. It would also need to avoid implying that a death was caused by occupational exposure where that cannot be established. Any published information would need to be handled sensitively, with appropriate context, recognising the impact on families, colleagues and the wider workforce. 8.5 The Welsh Government will therefore take a proportionate, staged approach to implementation. It will work with the UK Government, the other devolved governments, the UK Statistics Authority, the Office for National Statistics, Public Health Wales, the NHS in Wales and relevant employers to identify the most appropriate approach for Wales and to support comparability across the UK as far as is possible. 8.6 The Welsh Government will ask the Office for National Statistics to include occupation routinely in mortality analysis for Wales during a future pandemic, where data quality allows. This will support better understanding of impacts on healthcare workers and other occupational groups.

8.7 Preparatory work will also need to consider the legal, information governance and operational arrangements that would allow any mechanism to be activated quickly in a future pandemic. This includes considering whether data sharing powers or notices would be required, how data quality would be assured, and how outputs would be communicated clearly and responsibly. The aim is not simply to create a publication, but to ensure that information is available in a form that can support decisions, protect the workforce and maintain public trust.

This recommendation is accepted in principle. The recommendation is not accepted in full as whilst all four nations will endeavour that the data is comparable across the UK, different data sources may not make this completely possible.

Two workshops have been held with four nations colleagues and there was strong support for collecting healthcare worker (HCW) death data, with clear value across surveillance, protection, transparency, and recognition.

There are significant practical and ethical issues to resolve in delivery of this recommendation. Any approach would need to be accurate enough to command confidence, timely enough to be useful, and clear about coverage. There will also need to be consideration of the significant burdens reporting may have on employers especially during a pandemic.

No single data source meets all use cases; a mixed approach is likely required.

A phased approach is proposed. The first phase focuses on improving existing data collections and ensuring greater consistency through clearer definitions, enhanced reporting, and alignment across the UK. This will include developing minimum definitions and standards (e.g. “healthcare worker”) to improve consistency across the UK and exploring how current data sources and systems of reporting could be improved. However, their distinct purposes suggest different data sources, or a combined approach, will be needed, rather than a single measure.

The second phase, tests the feasibility of linking workforce and mortality datasets, alongside establishing the necessary legal, data-sharing, and governance frameworks, and embedding these processes into pandemic preparedness structures. Initial discussions for this phase propose data linkage of the Electronic Staff Record (ESR) on health worker employment status and Office for National Statistics (ONS) data on death as a promising, but currently underdeveloped, solution. Note that in Scotland this will be between eESS (Electronic Employee Support System) and National Records of Scotland (NRS). There are significant challenges in reporting data especially for those employed outside of NHS providers such as primary care, community services and independent providers and comparing with other professions and industries including social care.

The third phase is to move towards a more integrated analytical approach, combining early operational indicators with validated statistical outputs.

The government agrees that, in the event of a future pandemic, data on healthcare worker deaths plays a vital role in supporting and protecting the workforce as well as improving epidemic surveillance. The government will take a proportionate, staged approach to implement the recommendation.

No statement on delivery from Department of Health and Social Care has been found in the sources searched. This is separate from the response above.