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GPs face heightened scrutiny on cause of death

By Craig Kenny

GPs will have to complete extra paperwork during death certification and face tougher scrutiny of their medical opinion, under proposals outlined by the Department of Health.

Key changes prompted by the inquiry into the Harold Shipman case include the creation of a new official, the medical examiner, whose role is to scrutinise death certificates completed by doctors and advise the certifying doctor on cause of death.

Cremation certificates, for which GPs are currently paid a fee, are set to be abolished and a new form introduced, the ME-1, which provides additional information and must be completed by the attending doctor or their staff.

There will also be a requirement for the GP to transmit the deceased's medical records to the medical examiner.

Dr George Fernie, chair of the BMA's forensic medicine committee, said it was holding talks with the DH about how the costs of the new system would be met.

The BMA wants the costs of death certificates, the medical examiner (including out-of-hours cover) and any additional payments for doctors to paid for centrally, possibly via a tax, rather than be borne by the deceased's relatives, he said.

‘At present the only payment to doctors is for cremation forms, which will be abolished,' said Dr Fernie. ‘If there's significant extra work involved, for example with the ME1 form, that will have to be negotiated. We haven't signed up to anything yet, and we won't know the details until the pilots have been completed.'

The new system is being piloted in Gloucestershire, Sheffield, Powys and Essex. ‘Early indications are the process works better than now,' he said.

The Department of Health has outlined new proposals for death certification by GPs The Department of Health has outlined new proposals for death certification by GPs