DH - Summary of responses to the consultation on improving the process of death certification - 21 May '08

• Extract from : http://tinyurl.com/5hskjv

This document provides an overview of respondents  comments on the proposals to address weaknesses identified by the Shipman Inquiry in the process of death certification in England and Wales. The consultation ran from July to October 2007.

• Local Copy

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Introduction
1.1 The consultation paper Improving the Process of Death Certification was published by the Department of Health in July 2007. The paper sought views on proposals to address weaknesses identified by the Shipman Inquiry in the process of death certification in England and Wales. Consultation on the proposals closed on 24 October 2007.

1.2 The key proposals set out in the consultation paper are that:  all Medical Certificates of Cause of Death (MCCDs), with the exception
of cases referred directly to the coroner by the certifying doctor, would be subject to scrutiny by an independent medical examiner appointed by a Primary Care Trust (or an equivalent organisation in Wales) and with strong links to NHS clinical governance1 teams;

•  the medical examiner was satisfied that all was in order, he/she would issue an authorisation enabling the family of the deceased to register the death and proceed to burial or cremation;
• where the medical examiner was not satisfied that the MCCD told the full story, or felt that there were other unusual circumstances, he/she would refer the case to the coroner for further investigation, along with his/her reasons for doing so;
• the medical examiner would have full access to medical records and would be empowered to discuss the circumstances of the death with the doctor signing the MCCD and with the family of the deceased; and
•  NHS clinical governance teams would collate information from MCCDs and would use this to analyse trends and patterns, looking out for unusual features, such as those revealed by Shipman’s pattern of deaths.

1.3 The Department of Health believes that these proposals represent a transparent, proportionate, consistent and affordable response to the weaknesses identified by the Shipman Inquiry that will provide greater protection for the public and improve the quality and accuracy of death certification. The proposals will also improve local public health surveillance and remove current inequalities in the way burials and cremations are dealt with.

1.4 This paper summarises respondents’ comments to the proposals set out in the consultation paper and other matters of interest they raised. The paper also refers to, and takes account of, a related public consultation undertaken in 2007 by the Ministry of Justice concerning the statutory duty for doctors and other public service personnel to report deaths to the coroner.2 The response to that consultation was published alongside this paper.

1.5 In 2007, the Ministry of Justice also carried out a consultation on consolidating and modernising the existing Cremation Regulations.3 The intention is to make
interim improvements in advance of death certification reform. The Cremation regulations, in so far as they apply to an application to cremate a body and certification of cause of death, will no longer exist once the proposed improvements to the process of death  certification referred to in this paper are implemented.

1.6 From 1 April 2008, Local Safeguarding Children Boards (LSCBs) have a statutory requirement to collect and analyse information about the deaths of all children in their area and put in place procedures to ensure a co-ordinated response to the unexpected death of a child. In taking forward the proposed improvements to the process of death certification, the Department of Health will ensure that appropriate interfaces are established with these new functions now being delivered by LSCBs.

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