In all the cases we examined Harold Shipman was likely to have been present at the time of death or have visited the patient recently Professor Richard Baker

Jayne Gaskell, whose 68-year-old mother Bertha Moss almost certainly died at the hands of Harold Shipman, said: "We were prepared for this. We knew before the trial ended that there would be around about this total, maybe more."

Shipman, who was arrested in August 1998, was not actually charged with Mrs Moss's murder which makes her death even more difficult for the family to come to terms with.

Professor Richard Baker, of the University of Leicester, who carried out the analysis on behalf of the Department of Health, said a clear pattern had emerged from Shipman's records.

He said: "In all the cases we examined Harold Shipman was likely to have been present at the time of death or have visited the patient recently.

"The patient was more likely to have died suddenly, more likely to have died at home, more likely to have been older and certainly more likely to have been female."

Andrea Robinson, from the Families Support Group, said: "I am shocked but not surprised.

"It's like a dog with a bone, the more you dig the more you are going to find."

The report has been handed to Greater Manchester Police.

But Director of Public Prosecutions, David Calvert-Smith QC, has said further trials could not take place fairly because of the huge amount of media publicity the case has already generated.

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