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Preventable Deaths Tracker

A platform to explore concerns raised by coroners to prevent future deaths

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  • Preventable Deaths Database
    • Geographical variation
    • Responses to PFDs
    • Coroners
    • Death categories

Preventable Deaths Tracker

A platform to explore concerns raised by coroners to prevent future deaths

In August 2021, the WHO published the Global Patient Safety Action Plan (2021-2030) to eliminate avoidable harms in healthcare. In England and Wales, legislation is in place to capture information on preventable deaths. Yet little is being done to use this information to reduce premature deaths.

We have created the Preventable Deaths Tracker to collate this information and make it accessible for all. Our Tracker also shares systematic analyses of this information, to warn against repeat hazards and highlight important lessons, to improve public safety, reduce avoidable harms, and prevent premature deaths.


What’s in the Database?

As of 22 June 2022, the Courts and Tribunals Judiciary had uploaded 4001 Prevention of Future Deaths reports (PFDs). The graph below illustrates the number of PFDs published over time. You can see the latest individual data here.

Number of Prevention of Future Deaths reports (PFDs) published on the Courts and Tribunals Judiciary website from inception (July 2013) to 22nd June 2022.

What’s new?

Oxford physics student, Qingyang Zhang, reflects on her internship working on the Preventable Deaths programme of research.


Oxford medical student, Harrison France, wins several awards for his research on preventable deaths involving medicines, including 1st place for the national IUPHAR student poster competition published in the British Pharmacology Society & the 2022 Oxford Wronker Research Project Prize.




School for Primary Care Research
BMJ Journals

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How to cite this resource:

Richards, GC. Preventable Deaths Tracker. 2022. https://preventabledeathstracker.net/

Prevention of Future Deaths reports.

On average, 1% of inquests are written as PFD reports every year (2014-2021), the lowest ratio in the whole pipeline.

An inquest is opened by a coroner, and is a fact-finding investigation used to determine when, where and how a person died. On average, inquests are opened on 53.8% of postmortems conducted every year (2014-2021).

A caveat to the pipeline is that inquests can be opened without a postmortem examination. From 2014 to 2021, 18.5% of inquests are opened without postmortems. 

Inquests can be concluded (a cause of death is determined), adjourned (postponed), or left open (no conclusion is reached regarding the cause of death).

Postmortem examinations is an examination of the body to determine the cause of death.

On average, postmortem is conducted on 38.8% of all reported deaths every year (2014-2021).

In 2021, 33% of all deaths were reported to coroners.