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GPs must report deaths to coroners in writing under new rules

New rules requiring all GPs to report deaths to the coroner in writing came into force yesterday, however GPs have warned the extra time it will take will cause delays to funerals.

GPs will need to provide key information on the deceased, including the name of any consultant medical practitioner who attended the deceased person in the last 14 days of their life. 

Previously, GPs could phone a coroner directly to discuss the cause of death and get permission to issue a death certificate. But new national rules require this process to be done in writing, unless in exceptional circumstances.

The new guidance from the chief coroner said: ‘A registered medical practitioner who must notify a relevant senior coroner of a person’s death under regulation must do so as soon as is reasonably practicable after the duty arises.

‘If at that time there are exceptional circumstances to justify doing so, the registered medical practitioner may notify a relevant senior coroner orally, otherwise the registered medical practitioner must notify the relevant senior coroner in writing.’

But GPs have warned that the extra time to communicate in writing will cause delays to funerals alongside increasing workload. 

Dr John Allingham, medical secretary at Kent LMC, said the new system is already causing delays to funerals after his region switched to the new process earlier this year.

He said: ‘In the good old days we rang the coroner’s office and discussed what we thought the cause of death was and they rang back an hour or so later with permission to issue a medical certificate for confirmation of death (MCCD).

‘Now we have to do an online referral via a portal. Acknowledgment takes a day and it is often another day before we get a phone call to discuss. If the doctor who can certify isn’t in that day then it gets delayed further.’

He added that in August, three funerals were delayed due to this issue.

He said: ‘In one case it took nearly a month for permission to issue and for the appropriate doctor to be available in a death which had a perfectly simple explanation.’

Nottinghamshire has also already seen delays due to this change. 

Dr Greg Place, chairman and director of Nottinghamshire LMC, said: 'Our coroner changed everything a few years ago. A written submission via email is now required for all deaths that previously would have been discussed over the phone. This was a unilateral change and certainly caused quite a lot of disquiet, and indeed delay in issuing a MCCD, hence registration and subsequent funeral arrangements.'

However, Dr Place suggested that the system had become smoother since it was implemented.

He said: 'Although many of us may pine for a return to the arrangements from previous years, this process now works a lot more smoothly that it did do at its introduction. We explain why this is happening to families; assuming there are no problems a reply from HMC rarely takes more than a few days, local funeral directors are aware of how the process works and can start to plan ahead, and it is rare that this causes an overall delay in the majority of cases that I have had to handle over the last few years.'

The BMA said it ‘made sense’ for there to be a single process, however it warned that IT systems need to be better in order to make this change work.

Dr Richard Vautrey, BMA GP Committee chair, said: ‘It makes sense for there to be a uniform process in how GPs contact coroners, but some practices already using electronic-only systems are having to input more information than they would have done when calling a coroner’s office directly.

‘GP workload is soaring, so it’s vital that any changes made to our processes are effective and help to free-up more time for us to spend with our patients.

‘That’s why, if this change is going to work, we need the right IT systems to support these kinds of interactions, systems that take the necessary information from GPs, reduce the need for other forms of communication, and ultimately, make general practice more efficient.’

It follows the news that GPs were being asked to contact patients taking fluoxetine to check what supplies they have at home in response to national shortages of the drug. The move was criticised by GPs who said it would lead to a lot of extra work

Readers' comments (20)

  • More increase workload yet to see any of the promise decrease!

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  • Genius. More work for GPs, delays for grieving families and for their loved one's funeral.

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  • Get agreement on phone and send a covering email
    Too easy!

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  • No extra time at all but it is a token dick move.

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  • Ambiguous headline, Pulse: please make it clear that this only applies to deaths that legally HAVE to be reported to the coroner, rather than the non-problematic ones.
    "New rules for reporting deaths to coroners" would do the job nicely.

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  • but if the coroners office ring us they expect a quick, verbal response. Time to turn the tables BMA/LMC.

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  • Can we please have a standard template/letter in Emis and other IT systems that populate the letter and reduce workload. Emails are as old fashioned as writing letters. Template/prepopulated communications substantially reduce workload.

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  • When funerals are delayed it will be us GPs the grieving families get angry with, not the bright spark of a pen-pusher who came up with yet more paperwork for us!

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  • Can we have
    A) a format of letter explaining to relatives it is a national change not of our mkaing and they should,not book a funeral till they have mccd
    And
    B)can they also stop police turning up in uniform to interview the family after a death?

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  • This has been the case in Scotland for a while. Electronic MCCD, notification or queries to PF through same system (SCI) and get very quick responses, much better than waiting on the phone trying to get to speak to somebody, also got rid of crem forms which are incorporated into the eMCCD.
    As with all changes it took a little getting used to but works far better.

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  • In London, Coroners have a policy of no more phone calls

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  • My sympathy with the Coroner's office as they get inundated with information. They just need to have a new efficient shredder handy I suppose.

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  • How is this 'New'? We've been told we have to do that for donkey's years in MK!

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  • Dear All,
    There's a mass of myth and mistake here and elsewhere. I've poured over the 1953 and 2008 Acts and amendments and its actually like this.
    If you participated in the care of the patient during their last illness you are required by law to complete an MCCD. That's it. No 14 day rule, no time limit at all. And its every doctor who did. so in theory there could be several MCCDs for each patient; GP, OOH doc, oncologist etc.
    There's no option or permisssion needed from the Coroner, no matter what they say.
    There was never any need to speak to the Coroner or get agreement, you just issue the MCCD, job done.
    It's the Registrar who has to decide what to do with it. They are the ones who have to apply the imfamous 14 day rule, not the GP.
    All that has changed with this new legislation is that there is now a legal duty to report to the Coroner any MCCD that you sign with any of the qualifying conditions. You still issue the MCCD.
    The only circumstance in which you may be given permission by the coroner to issue an MCCD is if you did not particpate in the last illness, and thus are not bound by law to complete one, but the doctor who could do it is unavailable (the GP on holiday scenario). In those circumstances any GP who becomes aware of the death is required by law to report it to the coroner. The coroner may then instruct the non participating GP to complete an MCCD.
    I hope this helps.
    Regards
    Paul C

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  • This is like fit note. Nothing changed and nothing will change. Coroners are not medically qualified in Uk.they are guided by us to say cause of death.

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  • Rogue1

    We have emailed concerns to the coroner for the last year, and it is just another form (bureaucracy+). Now however they are being sent back saying they must all be signed as well, which means us then having to print off the form, sign and fax it. Though they wont accept faxed info in the first instance?
    Truly joined up thinking here!

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  • I think MCCD is cause of.. not confirmation of..

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  • This already happens in Surrey. It is pretty timee consuming.

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  • What a bunch of bollocks. Used to work in Devon, call the nice lady, leave a message, she chats with coroner, certificate done next day at absolute latest. Why is serving the gods of data collection driving patient care backward?

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  • What is the fee for this. Just been working in Denmark where they have an item of service contract which works very well. They would have no problem with this: it would be just a question of agreeing a reasonable rate for the work.

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