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A faulty production line

The first confirmed death by pro forma


Number 1,831 in a series of things designed to inconvenience and annoy GPs that stretches all the way from 1 to your local mental health unit. This month: trying to speak to the coroner’s officer.

On account of an elderly man who hadn’t been seen for aeons being discharged to an out-of-area nursing home for palliative care and very inconsiderately dying before he’d had time to register and in fact going out of his way to be awkward by doing this at the start of a bank holiday weekend, leaving me being asked by the undertaker in the middle of an eye-wateringly hectic post-bank-hols day duty to complete a death certificate and cremation form which, of course, I couldn’t, I found myself in the position of having to talk to the coroner’s officer. Which was precisely when I found out I couldn’t.

I know this, because I tried. Multiple times. And I was told, repeatedly, that the coroner’s officer would not talk to me, and that I had to complete an online form. This line was adhered to even when I pointed out that a quick chat had always resolved these situations in the past, and that I was a busy, hassled and irritated GP.

So, in desperation, I filled in the online form. I won’t talk you through the whole molar/soul-destroying process. But I will highlight the following: a large narrative box to outline the case that flags up a word limit of 20, but only after you’ve written 500 and pressed ‘save’; mandatory drop-down boxes with only yes/no options (as opposed to the ‘Haven’t a friggin’ clue’ I really needed); technically perplexing demands that I upload the medical history and repeat template from our clinical system; and, finally, after half an hour of box-ticking, typing and cursing, a final click that led, with sickening predictability, to an ‘error’ message.

This is typical of the dysfunctional system we work in. The agencies we’re supposed to liaise with are faceless, unapproachable and unaccountable. So, as well as coroners going incommunicado, we have hospital secretaries permanently on voicemail, community nursing insisting on faxed request forms four pages long, community and mental health services responding to referrals with a standard ‘This does not meet our criteria’ bounce-back, and so on.

This vogue for constructing firewalls to constructive and efficient communication may be understandable given that every service is stretched to the point of dyscopia. And it makes me think we GPs might be missing a trick, as a five-page online request form that doesn’t ‘send’ might put off the odd inappropriate visit request. But we’re the final common pathway, we have no capacity limit and people moan already about the gatekeeping role of receptionists – so we’re excluded from the self-preservation strategy of battening down the hatches.

So I phoned the coroner’s officer back and told them I was giving advance warning of another death I’d need to report if they didn’t bloody speak to me, this time involving an axe-wielding GP. They said, okay. And, with beautiful irony, the line went dead.


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Readers' comments (8)

  • Fight forms with forms

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  • National Hopeless Service

    I have started fighting fire with fire and send this back to stupid request;
    As everyone within the NHS is now insisting on the use of pro formas we have introduced our own.

    This form may subtly change in due course and we will not respond if you have used an out of date form.

    Thank you for your enquiry. So that the correct information can be acquired from the correct practice professional enquiries will be answered ONLY after the following has been completed.

    Name of patient.
    Date of birth of patient NHS No of the patient
    Home address of the patient.
    BMI & Waist measurement of patient
    Smoking status of patient
    Does the patient have any allergies YES NO

    Do you have the patients consent to contact us about the issue? YES NO

    Do you require information from (please underline);

    1) The General Practitioner
    2) Practice Nurse
    3) Administration staff.

    What is the nature of the enquiry;

    Can you confirm;

    1) That you have read all relevant BMA guidance on the issue YES NO
    2) That you have read all relevant GMC guidance on the issue YES NO
    3) That you have read all relevant NICE guidance on the issue YES NO

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  • X-Ray - I like it, you may have out copperfielded copperfield

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  • for some time I have thought about developing a form unique to our practice. Every hospital department seems to be creating them so why don"t we? We accept a nice simple letter from the hospital doctor so this needs to stop. There are 100 local practices so each one could come up with a different form for Consultants to fill out after each patient attendance. This will enhance and secure information governance processes in the practices.

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  • Cobblers

    As far as I know you are not compelled to fill in someone else's forms.

    So you don't fill in the Coroner's form. Death cert does not get done. Rellies kick off. They pressure GP and then Coroner having been forwarded there by former.

    Now I am aware that the last laugh can be the Coroner's in that their power is magisterial but they too want to avoid a costly inquest and if made aware that the online system ain't working might strive to do better.

    Or maybe not. Truly Britain is broken. Please fill in this form attached to indicate your satisfaction at this letter. 0 for awful to 10 effing brilliant.

    Gotta go as Direct Line want me to tell them how 'Luke' did on the telephone yesterday. As if Luke gives a shit on his wages.

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  • Sounds like coroner needs to be in contact with hospital if they were last to see him

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  • Just say not happy to fill in a leave in coroners hands.

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  • In Wales we are blessed (I gather that word can mean both firtunate and injured!) by the sensible idea of a set of standardised 'All Wales' forms for many of the things we do like prescription charts (inpatient), DNAR, etc.
    This is wonderful, but it seems to have a slight flaw: other service staff do not accept the 'all wales' form we filled in because it is not the same as theirs. So we repeated the filling in on a slightly different 'all wales' form the DNs had (although it should of course have been identical, shouldn;t it?); 'Oh, no, we can't accept that one either, it hasn't got our service's logo on it' Well of course it hasn't, it doesn't need it, it has an 'all wales NHS-Wales' emblazoned on it indicating it covers all services in Wales. 'Not ours!'. Oh, well, get someone else to fill it in then, I have only been trained to complete the ones supplied to the Practice from BSC!'. so there.

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