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The steep increase in the number of deaths occurring outside hospital during the Covid-19 pandemic brings a concomitant rise in the number of deaths requiring verification in the community.

Attending those who have died in the community clearly puts health care workers at increased risk of Covid-19 infection themselves.  In response the NHS has put out guidance (here) suggesting that GPs or another suitably qualified health care professional might now verify death remotely by video, or even by telephone, if family members are happy to support that verification process by, for example, reporting down the phone the absence of movement of the chest wall.

Unsurprisingly that guidance (also now promulgated by other organisations)[1]  has resulted in many calls to coroners and the ambulance service (particularly in London) from GPs and funeral directors who want clarification about the rules or advice about how to pronounce life extinct.

In response, London’s Senior Coroners, who have reservations about the NHS Guidance, have today produced a four-page document (here) setting out their agreed view of the death verification requirements, for the benefit of affected people in the London Area. They acknowledge that different approaches are being taken elsewhere. [2]

What follows is a summary and not a substitute for reading the document itself.

The purpose of the system

 Who can verify death

Effect of the Coronavirus Act 2020

Otherwise, the important safeguards are unchanged:

In contrast, the MCCD must be completed by a doctor and it specifies the cause of death, not the fact that death has occurred.

 Guidance during a pandemic

This includes:

The GRO document notes that during the pandemic, many doctors are not attending in order to verify death when death occurs in the community. An alternative independent check is still required.

Conclusions of the Senior Coroners in London

The Senior Coroners:

That Guidance permits a family member to verify death where the family member is given telephone guidance by a GP and uses checks of body movement and respiration (chest moving up and down).

They hold those reservations because Senior Coroners have been advised by the London Ambulance Service that such checks, performed by an untrained person with no clinical knowledge or experience, may not be a reliable basis on which to verify that death has occurred.

 

 

[1] See for example the 'Red Whale' fact sheet for GPs here which also suggests funeral directors and family members might verify deaths.

[2] Note that the similar document produced by the Senior Coroners in the Areas of Bedfordshire, Cambridgeshire, Hertfordshire, Essex, Norfolk and Suffolk (here from 9 April 2020) indicates that they have reached the same conclusions.