Agenda item

Registrar's Experience

[Julia Goudman (Business Development Manager – Registrar’s) and Martyn Sargeant (Head of Public Service Reform) will be present.  Briefing Note Attached].

Minutes:

The Business Development Manager summarised the points contained in the briefing note that had been distributed.  Legally deaths had to be registered within five calendar days, which included Weekends and Bank Holidays.  Deaths had to be registered within the District where they occurred.  A death had to be registered by a qualified informant who was usually a relative.  When a relative was not available they could accept someone who was present at the death, the occupier of the house or an official from a public building where the death occurred, or the person making the arrangements with the Funeral Director. 

 

The Business Development Manager commented that there were a number of reasons a death might have to be reported to the Coroner by the Registration Service.  This included if the Medical Certificate of Cause of Death detailed an unnatural death. 

 

The Business Development Manager remarked that in order to register a death the Registrar was required to see the Medical Certificate of Cause of Death from the qualified informant.  Once this had been seen and the Registrar was content with the certificate being legally valid, they could issue a form which enabled the burial to take place.  If the Coroner had been involved, the Coroner issued a separate form, rather than the Medical Certificate of Cause of Death.

 

The Business Development Manager detailed the latest statistics on the issuing of the Medical Certificate of Cause of Death and the registration of a death.  69% of Medical Certificates of Cause of Death were currently signed within two calendar days in Wolverhampton.  29% of deaths last year had been referred to the Coroner. 95% of Customers who contacted the Registration Office were offered an appointment within two days.  This had slipped in January, due to the high demand for registration appointments.  71% of deaths not referred to the Coroner were registered within five days.  The Registration Service performance target was 90%. The Registration Service was facing increased pressure from the Home Office to improve performance in this area.  28% of deaths that were referred to the Coroner, where no post mortem or inquest was required, were registered within five calendar days.  Where a post mortem was required, only five per cent of those deaths were registered within seven days. 

 

The Business Development Manager commented that in the last two years there had only been one formal complaint made about the Registration Service. This had been in relation to a customer believing that the Service could not offer an appointment within a reasonable timeframe.  They regularly measured customer service satisfaction through surveys.  98% or more of people said they were satisfied with the service they had received from the Registration Service.  They had recently been asking a further question to customers, where the registration of the death had taken longer than five days, if they had been happy with the time taken.  In September 2018, 94.1% had said they were happy.  

 

A Member of the Panel asked if there had been an increase of cases, where there were no known relatives of the deceased.  The Patient Services Manager responded there had been an increase in these cases, and the hospital arranged the funeral.  The Business Services Manager commented that she had not noticed an increase in cases, but it did occur.  The Council had made the funeral arrangements, if the person had not died in hospital.  They were required to advertise to make people aware of the death. 

 

Cllr Sohail Khan stated that in his experience the Registration Service had been very accommodating when an appointment was required promptly for religious reasons.  He asked if there was a formal policy to ensure a rapid Registrar’s appointment when a burial was required promptly.  The Business Development Manager responded that there was a Registrar on call, Saturdays, Sundays and Bank Holidays, with the exception of Christmas Day and Easter.  The Registrar was able to issue the “Green Form” in emergency situations, such as for specific religious reasons, to allow a burial to take place before the formal registration.  They could not do this if the body was to be cremated.  The On-Call Registrar could be contacted on the telephone between the hours of 8am-9am at Weekends and Bank Holidays (except Christmas Day and Easter).  She remarked that it was expected from 1 December 2018 to have a Registration Office based at Newcross Hospital, which would allow for a more efficient service for families. 

 

Cllr Sohail Khan asked if the On-Call timeframe was sufficient.  The Business Development Manager responded that for the usage so far, she had not been made aware of any problems.  She was of the view that it might not be the case in the future and considered that the timeframe probably did need consideration as to whether it should be extended.  She had been having conversations with Bereavement Services on the matter who dealt with the staff at the Crematorium who prepared the graves.  Cllr Khan commented that he thought the On-Call timeframe was inadequate.  His experience was that other Registration Services across the country normally had an On-Call timeframe of 8am-12pm or 8am-1pm.  The Business Development Manager commented that she had recently done a benchmarking exercise across the West Midlands Districts and the majority did operate the On-Call Service, 8am-11am or 8am-12pm.  She was going to continue consultations with Bereavement Services to see if the timeframe could be extended. 

 

The Consultant in Public Health asked if there was a pathway or system in place to ensure families were aware of the On-Call Registrar Service.  He gave the example of a family in a Hospital who’s relative had just died on a Friday evening requiring a prompt burial, he wondered how they would be made aware of the service.  The Patient Services Manager responded that the Bereavement Booklet given to relatives contained the numbers to contact the Registrar.  She thought that if this number was called it would give the details for the On-Call Service.  The Consultant in Public Health responded that he thought this was worthwhile checking, as it was a critical step.  If people were fully aware of the On-Call Service, it would give a true picture of the demand for the service.  A Member of the Panel commented that many residents believed the Council would not open until 9am, and so would probably call too late.  The Business Development Manager commented that the existence of the On-Call Service was mainly communicated to the local Funeral Directors, who would signpost the customer to call the number.  A Member of the Panel commented that it would be useful to review the policies, procedures and how information was shared by the Registration Service. 

 

The Scrutiny Officer asked if the Registration Service had cases where the Medical Certificate of Cause of Death had been incorrectly completed by a Doctor.  She confirmed that this did happen on occasion and in such circumstances, it would have to be referred back to the Hospital or to the Coroner. 

 

Dr Parkes commented that in his experience delays could occur in booking a time slot for a cremation at the Crematorium.  He was aware of people waiting up to three weeks during the winter season.  A representative from Sanderson Funeral Services commented that sometimes they were told there would be a two-week delay at the Crematorium but when they went to the site, they found that there were slots available.  He expressed an interest in understanding why there were delays at the Crematorium.  The Chair stated that this was an area which the Panel could explore in the future and asked for it to be added to the recommendations. 

 

Cllr Sohail Khan commented that the Funeral Directors he had spoken to recently had referred to delays being caused by a backlog at the Mortuary, in addition to paperwork delays and booking a time slot at the Crematorium.  He made a general comment that the whole process needed to be made more efficient.  A representative from Sanderson Funeral Services commented that one of the main causes of delay was due to paperwork and agreed that it needed to be more streamlined to reduce stress for families. The Chair stated that one of the recommendations should be for the Health Scrutiny Panel, working with relevant partners, to investigate how the official paperwork processes could be more streamlined. 

 

A Member of the Panel asked about how the date of death was determined on the Medical Certificate of Cause of Death and on the official registry entry.  Dr Parkes responded that on the Medical Certificate of Cause of Death, the date would be the same day the doctor certified the death.  The Business Development Manager stated for the official registry entry the date was taken from the informant and so could differ to the Medical Certificate of Cause of Death, in certain circumstances.  As an example, if a person had died at 11pm but a Doctor did not visit until 2am, whilst the Doctor would certify the death as the day after the person had actually died, the informant could give the date of actual death for the registry entry.  The Medical Certificate of Cause of Death was normally provided to the Registrar by the family in a sealed envelope and so it was not normally seen by the family until the registration appointment.  The Registrar was required to ask the informant registering the death, as a specific question, the date of the death.  Several Members of the Panel felt that the process needed to be clarified as they were of the belief that the family had to use the date that was on the Medical Certificate of Cause of Death.  The Panel agreed to add it to the list of final recommendations.  The Coroner’s Lead for the Black Country remarked that the Coroner would always use the certified time of death given by a Doctor and not from what the family had said. 

 

A Member of the Panel asked if the date of death in the official death registry entry could be corrected.  The Business Development Manager responded that it was possible to correct the register, but it was a formal process which required evidence. The correction request had to be submitted to the General Registry Office based in Southport, who made the decision. 

 

A representative from Sandersons Funeral Services remarked that it would be useful for families or next of kin to have all the relevant information on the processes following a death collated as one document, which could be given to them when their relative had died.  Cllr Sohail Khan commented that practices varied amongst GPs, with some being more accommodating than others.  A central document would therefore be useful.  The Consultant in Public Health commented that there was potentially a need for a combined partnership-based information resource which could assist families following a death.  He cited several areas it could cover, such as “Rapid Release Policy,” explaining the Medical Certificate Cause of Death processes and registering a death requirements.  It could cover all the processes from the death right up to cremation or burial. 

 

The Head of Public Service Reform stated that there was clearly value in collaborative working regarding the provision of information.  He requested that the Panel give some consideration to what key information the families required.  He was mindful of not overloading families with information during what was often an emotional and difficult time.  Certain information such as a “Rapid Release Policy” would be irreverent to many families.  He understood that families relied heavily on Funeral Directors for guidance and in some cases, it was more important for them to have certain information rather than the families directly.  A Member of the Panel felt that it was important to cover all eventualities, particularly given the diversity in the Wolverhampton area. They commented that Funeral Directors were often not involved until a certain stage in the process and it was vital to have key information at an early stage.  There was a discussion about how much information should be given to families with differing views given.  A Member of the Panel commented that a visual pathway, simplifying the process, would be of value.  The visual reference could be supported with more detailed information. 

 

The Patient Services Manager commented that in addition to the Hospital booklet, they also gave out a Government Booklet at the Hospital, which was titled “What to do after a death.”  She felt it was important to consider these documents in full before commencing work on any new resource.  Cllr Sohail Khan commented that all the information needed to be publicly available all year round so people were well educated and prepared. 

 

 

 

 

 

 

 

 

 

 

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