Verification of Death – 10 April 2020
Despite our efforts last week on verification of death, which we thought we had, it now seems that this is not the case and this has caused unnecessary confusion for practices, which is exactly what we were trying to avoid.
We have been working this week to seek further clarification and agreement on verification with the Coroner’s Office; on this, we appear to have been unsuccessful, as we received this letter earlier this afternoon from the Coroner’s Office for distribution to relevant parties.
The main points are:
- Despite our trying to work with the Essex Coroner’s office and agree the position on verification of death, which we thought we had, prior to sending out the LMC crib sheet to practices last week, we have just received the attached very unhelpful letter from the Coroner’s Office, with a request to share with relevant parties, i.e GPs!
- It states that only qualified professionals can verify a death – doctors, nurses and paramedics. It completely disregards BMA / CQC advice. The Coroner’s office has not changed their view at all.
- At present this is restricted to a registered healthcare professional who has undertaken the appropriate training. In the majority of areas, this is restricted to doctors, nurses and paramedics. In specific circumstances such as decapitation, decomposition other professionals such as police officers may verify life extinct.
- This remains the position.
- “It is inappropriate for a person who is not medically trained to recognise death, this would result in the body being moved from the place of death with no independent check on the body.”
It goes on to state that more nurses can be employed to verify deaths in the community, but this is something that the CCG needs to consider.
This has been the topic of much national discussion and completely flies in the face of national advice from the BMA General Practitioners Committee and from other LMCs across the Country.
Whilst the LMC finds it only fair to inform you of the current position of the Coroner’s Office, the view of Essex LMCs remains unchanged. In the circumstances, you may find the following helpful, received from a senior member of GPC, when considering your own position:
“Take the remote verifying route. Your responsibility is to place yourself in a position to be able to make a reasonable decision regarding the care of the patient. That can range from having your hand on their appendix inside their belly to exchanging texts thousands of miles apart. If a person contacts you and reports that they think their spouse has died, at the end of an arranged EOLC plan, following a diagnosis of an untreatable condition, where they’ve been seen over the weeks and months by doctors nurses and carers – you get the picture, if a person contacts you and reports that the patient has died, you take a history, you ask pertinent questions and on the basis of the information, you make a decision to verify the death. The important point is you are moving the verifying onto the doctor at the end of the phone. All the relative has to do is describe what happened and is now going on. In a nursing home, you ask for the 5 observations. Then on the basis of information received you verify”.
I am sorry that we have been unable to bring a satisfactory conclusion on this for all this week and we will pursue further next week. In the meantime, we wish you all the best for Easter in these difficult and unusual working times.