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Death certification reforms update – newsletter issue 1

The first edition of the death certification reforms newsletter, published September 2012.

Introduction

Welcome to our brand new two monthly newsletter.   It is designed to keep you up to date with the death certification reforms as they progress.

We do hope that you find this newsletter useful.  If you have any comments or suggestions for making it better, or any contributions you may have to support the reforms in general, please let us know by emailing us at deathcertification@dh.gsi.gov.uk

What are we doing?

The reforms to the death certification process will introduce a unified system of scrutiny of all deaths in England and Wales that do not need investigation by a coroner.  This will replace the current system of checks and form for cremations, and will extend proper scrutiny to burials. The new medical examiner service, which will carry out this work, will be run by local authorities.

Why you need to know

Reforming the current system will have an impact on a wide range of individuals and organisations. Key partners include local authorities, doctors and NHS staff, coroners and coroners’ officers, the funeral industry, registration services, burial and cremation authorities, bereavement services, the public, local government and other representative bodies.  The Department of Health is working with a wide range of organisations and groups to design, test and pilot the proposed new system for death certification in England and Wales.

Why do we need the reforms?

The process of death certification is being reformed to address weaknesses with the current system and the recommendations of the Shipman Inquiry’s third report.

The main aims of the reforms are to strengthen safeguards for the public, make the process simpler and more open for the bereaved, and increase the quality of certification and data about causes of death.

Currently, setting aside coroners’ cases, only deaths followed by cremation are subject to formal checks for any untoward signs.  The new system will provide safeguards for all deaths, which do not need to go to a coroner.

We know that, at present, death certificates are not all completed accurately.  The Office for National Statistics (ONS) has completed a study of the potential impact of medical examiners’ scrutiny of cause of death on mortality statistics using data from the death certification pilots.  ONS plan to report on the results of their analysis to the Department of Health in the near future.

Progress

The Department of Health and its partners have made significant progress to prepare for implementation of the reforms since the first public consultation on the proposals in July 2007.  Since then:

  • nominated by the Academy of Medical Royal Colleges, the Royal College of Pathologists will act as ‘lead college’ for medical examiners
  • training for medical examiners has been developed and will be delivered through a ‘blended approach’ of e-learning supported by face to face training
  • all doctors with a NHS email address with an interest in the medical examiner role can log on to the e-learning for Healthcare Website and register their details for access to the medical examiner e-learning training modules: http://www.e-lfh.org.uk/projects/medical_examiner/index.html
  • extensive piloting of the local medical examiner process has been completed successfully in a range of localities across England and Wales
  • pilots have demonstrated that the local medical examiner service can work well in both urban and rural settings without causing delays to funeral arrangements
  • currently testing the service citywide and countywide in our remaining pilot areas, Sheffield and Gloucester, to test it at a scale that will be required for implementation by local authorities
  • pilots will test whether the service works effectively and that they can accommodate the particular complexities and sensitivities of child deaths, community hospitals and hospices.

When will this happen?

The Coroners and Justice Act 2009 sets out the legal basis for the new system.

The Health and Social Care Act 2012 includes provision for responsibility for the new medical examiner service to sit with local authorities, following the changes to the NHS architecture, which will remove primary care trusts from April 2013.

National implementation of the new local medical examiner service will take place in April 2014.

What’s next

Updated 7 January 2013 - the publication date of the consultation on the death certification reforms, including draft regulations, which was planned for autumn 2012 has been put back to early in the new year to complete work on the impact assessment.

The Department of Health is due to launch a second public consultation on the death certification process in early 2013, which will centre on the draft regulations.

The consultation will be available on the Department of Health website and will be open to everyone to respond.

Further information

Further information on the Death Certification Programme can be obtained from the DH website at www.dh.gov.uk/deathcertification

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