The study assessed completeness and concordance of death recording in primary care records against ONS death registrations. It used records linked in OpenSAFELY-TPP, covering only practices using TPP software, for deaths from 2020 to 2025. Among 1,409,275 ONS-registered deaths, 88% had an identical primary care date and 8% had none. Of 1,324,995 primary-care-recorded deaths, under 2% lacked an ONS record. Single-source deaths were more common under age 45 and in Mixed, Asian, Black, and Chinese or Other ethnic groups. Primary-care-only deaths increased close to the data extraction date, reaching 7% in February 2026.
Why it is interesting: Quantifies how far a widely used primary care resource can stand in for national death registration. It also shows where completeness falls short, by age, ethnicity and recency.
Abstract — the authors' own words, CC BY
Introduction:
Primary care electronic health records (EHRs) are an important resource for health research, but death recording in primary care EHRs may be incomplete or differ from Office for National Statistics (ONS) death registrations. We used OpenSAFELY-TPP to assess the completeness and concordance of death recording and provide recommendations for using date-of-death information. Methods:
Using linked primary care EHRs and ONS death registrations, we assessed whether ONS-registered deaths from 2020-2025 had a primary care date of death and, where present, calculated the difference between dates. Where a primary care date was absent, we assessed death-related SNOMED CT codes. Analyses were conducted overall and by year, population subgroup, and general practice. We also examined GP registration end dates and primary-care-recorded deaths without a corresponding ONS record, including monthly patterns near the data extraction date. Results:
Among 1,409,275 ONS-registered deaths, 88% had the same date recorded in primary care and 8% had no corresponding primary care date. Among 1,324,995 deaths recorded in primary care, Conclusions:
Death recording in primary care EHRs showed high completeness and concordance with ONS registrations, but discrepancies remained for recent deaths and some population groups. Data recency and population-specific completeness should therefore be considered when using linked mortality data for research.
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