Consultation on Reforms to Death Certification

We need your help!
Cruse would like to hear what you think about proposed changes to death certification in England and Wales. Please can you answer the following 4 questions so that we can better reflect the views of bereaved people in our response to this government consultation. Some background information is provided below but you can go straight to the questionnaire if you would prefer.

The closing date for responding to us is 13th June 2016

What are the key changes?
When somebody dies, before a death can be formally registered a doctor has to issue a medical certificate giving the cause of death. The proposed reforms include introducing a new role of medical examiner. This will be an experienced doctor (with at least 5 years’ experience) who will scrutinise and confirm the cause of all deaths that are not referred to the Coroner for investigation. They will review medical records, speak to the GP and talk to the family/representative of the family about the cause of death.

Why is the system changing?
These proposals follow on from the Shipman Inquiry after Dr Harold Shipman was convicted of murdering 15 patients (and possibly killing over 200) having signed the death certificates himself and also the Francis Inquiry into concerns in Mid Staffordshire NHS Foundation Trust.
The changes aim to:
• Improve safeguards for the public with relatives having the opportunity to ask questions and raise concerns
• Simplify the process and make it more open for bereaved people
• Improve the quality and accuracy of medical certificates of cause of death (MCCDs)

The consultation includes a detailed background and overview and questions aimed at professionals involved in the process and at the wider general public. The full consultation document can be found here
The Welsh government has devolved powers for appointing medical examiners and an additional consultation will be published in Wales in due course.

What does this mean for bereaved people?
The new process will provide increased transparency because the cause of death will be explained to the family. They will have the chance to discuss any concerns they might have e.g. about care prior to death, or what is being put on the death certificate. All deaths apart from those referred to the Coroner will be scrutinised in the same way, whether the person is going to be buried or cremated.
Under the current system, only those being cremated require additional medical scrutiny before the cremation can go ahead.
The consultation is suggesting that the costs will be reduced for those who currently opt for cremation and a new additional fee will be introduced for those who opt for burial.

Cruse welcomes:
a) a system which safeguards the public and makes the process simpler for bereaved people
b) that families will have the cause of death explained and be able to ask questions and raise concerns  

Cruse has concerns that:
a) the cost of the new medical examiner system will be passed on to bereaved people
b) this is an additional cost for those who opt for burial
c) the costs may be higher than predicted by the consultation and more than existing costs

How is Cruse Bereavement Care Responding?
Cruse would like to hear what you think about these proposed changes.  Please can you answer the following questions so that we can better reflect your views in our response.

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* 1. Should there be a 28 day or three month period for payment of the medical examiner fee or longer?

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* 2. Who should pay this fee?

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* 3. How would you prefer to pay this fee?

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* 4. Do you feel that the cost of the medical examiner system should be funded by bereaved people?

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* 5. If you answered No to question 4 how do you think these costs should be met?

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* 6. Please use the space below to add any other comments

Thank you for completing this survey we appreciate your feedback.

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