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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.