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.