Funerals Taking Three Weeks Longer Than Usual Across England And Wales As System Struggles To Cope With New Regulations
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Funerals across England and Wales are typically taking up to three weeks longer than usual as the system struggles to adapt to new death certificate regulations, according to leading industry figures.
A new legal obligation for certifying deaths was introduced in September to ensure better scrutiny of causes of death. It is now mandatory for the death certificate of anyone dying of natural causes to be signed off by both a medical professional and a medical examiner. Certificates for deaths not requiring a coroner’s investigation were previously signed off by doctors only.
These changes were prompted by the case of doctor Harold Shipman, who murdered nearly 300 patients through lethal injection, signing the death certificates himself. The reforms were first introduced on a non-statutory basis in 2019 but became legally mandatory in September.
However, bottlenecks in the system are exacerbating existing delays to the time between deaths and funerals across England and Wales, according to the two bodies representing funeral directors in both areas.
Speaking with The House magazine, director of external affairs at the National Association of Funeral Directors (NAFD) Rachel Bradburne said the association is seeing delays between deaths and funerals increasing to four or five weeks “all over England and Wales”, with delays going “beyond” this in worse affected areas. In the UK, funerals had usually taken place one to two weeks after death prior to the changes.
With GPs, hospitals, registrars, funeral directors and crematoria all involved in death management, Bradburne explains the biggest problem is there is “not enough capacity in the system”.
“As you move through this pathway, you have to go through all these different agencies which generate different paperwork,” she said. “At each point, there's a bottleneck being caused.”
She added that the introduction of medical examiners has “overloaded” an already stretched process. A lack of medical examiners means those working in this role “can’t cope with the volume of deaths”, while GPs are “overworked”, causing delays in sending certificates to examiners.
Terry Tennens, chief executive of the National Society of Allied and Independent Funeral Directors (SAIF) “absolutely” agreed that funeral delays are happening across England and Wales due, in part, to the new regulations.
Tennens explained that sometimes GP surgeries are “not familiar” with the new system. He added that medical examiners are having to work “all the hours” to clear backlogs of death certificates in certain areas.
Together, the NAFD and SAIF represent around 85 per cent of funeral directors across England and Wales. Both organisations run surveys among members to gauge where there are drops in storage capacity for the deceased. Evidence from members suggests there are delays to funerals “everywhere in every area, but to different degrees and for different reasons”, Bradburne said.
Mike Birkinshaw, chief executive officer of the Federation of Burial and Cremation Authorities, said delays could be “for a myriad of reasons”, but that the introduction of the medical examiner has “most definitely” caused problems in certain areas of England and Wales.
However, he pointed to “other systemic problems” that existed before the death certificate reforms came in causing delays, such as the lack of availability of registrars and funeral directors.
Deaths previously had to be registered by representatives of the deceased within five days of death. However, under the new regulations the five day limit will begin only once the death certificate has been signed by the medical examiner.
One Liverpool-based coroner said if it took two or three weeks for the medical examiner and the qualifying attending practitioner to sign, the body of the person who died has “got to be somewhere”, leaving the grieving family “somewhere in the ether” while waiting to register the death.
In response to a written question on the subject of death certificate reforms, Health Minister Andrew Gwynne said that “the median time taken to register a death since the introduction of the reforms in England and Wales has typically been eight days”.
He added: “the expectation on doctors and medical examiners is clear, that they should complete certification as quickly and efficiently as possible, and the Department is working with all stakeholders to make sure this is the case”.
But Rhys Price, funeral director at Gwilym C. Price Son & Daughters, said the new system is a “backwards step” in the process that is bringing “uncertainty” for families.
“When someone passes away, it's one of the most distressing times in a family's life. Our job is to try and help them through it,” he said. “We were able to advise them on the system as it was for 50 years. I know how the new system works, but a lot of people are still getting to terms with it. It’s a backwards step, really, because it's another layer.”
One such family member, based in Wales, reported waiting five weeks for the funeral of his uncle after the GP surgery failed to send the death certificate to the medical examiner for sign off.
“It was the not knowing,” he said. “Lots of relatives were from England, so quite a distance. Most of them would have to travel a long way to come to the funeral. So we needed to know when the body would be officially able to be buried, so we could then plan the funeral.
That cost us an extra week and a half then planning the funeral. So it was the delays. It all felt very rushed at the end, and we were a little disappointed with the local surgery to be honest.”
Cat Smith, chair of the Funerals and Bereavement All-Party Parliamentary Group and Labour MP for Lancaster and Wyre, said that the regulation changes were “long overdue”. However, she said the “lack of medical examiners available” is having a “massive impact on those who have lost loved ones and are grieving”.
A Department of Health and Social Care spokesperson said: “Our sympathies are with all families who have lost a loved one. Changes to the death certification process support vital improvements to patient safety and aim to provide comfort and clarity to the bereaved in the difficult moments following a death.
“They were clearly communicated to the health system, and prior to the reforms taking effect, almost all hospital deaths and a significant proportion of community deaths were already scrutinised by a medical examiner.”
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