§ Mr. BurstowTo ask the Chancellor of the Exchequer what progress the Department has made on implementing a system of enabling MRSA to be recorded on death certificates. [133849]
§ Ruth KellyThe information requested falls within the responsibility of the National Statistician. I have asked him to reply.
Letter from Len Cook to Mr. Paul Burstow, dated 27 October 2003:
As National Statistician, I have been asked to reply to your recent question asking what progress the department has made on implementing a system of enabling MRSA to be recorded on death certificates. (133849)MRSA an already be recorded on death certificates. Doctors are required to certify all deaths to the best of their knowledge and belief. They should start with the immediate cause of death, and then go back through the diseases or injuries which caused it, to the condition which began the sequence leading to death. The death certificate is designed to obtain this first 'underlying cause of death'. It is up to the doctor how many conditions in the sequence, other than the underlying cause, he thinks should be recorded. MR SA may contribute to death, but it is unlikely to be the first event in the sequence.It is difficult to produce statistics on MRSA because there are no codes for antibiotic resistance in the International Classification of Diseases. ONS worked with the World Health Organisation to develop new codes in ICD-10 to identify antibiotic resistance. WHO has recommended that these codes may be used from 2006. ONS is working with the US National Centre for Health Statistics (NCHS) to ensure that these codes are implemented in NCHS systems used to code cause of death in the UK and many other countries.Currently, to obtain figures on the number of deaths where MRSA contributed, it is necessary to identify all deaths with codes relating to staphylococcal infections and study the text of the death certificates. A special study was conducted by ONS and the Communicable Disease Surveillance Centre to do this, using data from 1993–1998. The results were published in the British Medical Journal in December 2002. The table below gives figures from this study for 1993 to 1998.
Number of deaths where MRSA was mentioned anywhere on the death certificate, England and Wales, 1993–1998 Number 1993 47 1994 88 1995 187 1996 290 1997 377 1998 398
ONS is currently carrying out work to update these figures to 2002, including identifying all possible codes for staphylococcal infections in ICD-10. The results of this analysis are not yet available.