Implementation of the Certification of Death (Scotland) Act 2011 - Scottish Government Response to the Consultation on the Expedited "not staying registration" Procedure

Scottish Government Response to Not Staying Registration ('The Expedited Procedure') Consultation

1. Scottish Government welcomes the high level of stakeholder support for the proposals within the consultation, which we will take forward both within Scottish Government (SG) Guidance and through discussion with stakeholders. An analysis of responses received is attached as an Annex to this document.

2. In relation to some of the most frequently occurring or significant points raised, we are already or will take the following additional measures:

Standardised Form

3. Scottish Government will include the requirement for a request form within pending SG Guidance. Whilst the form itself will not be statutory, the SG Guidance is produced under Section 22 of the Certification of Death (Scotland) Act 2011. Healthcare Improvement Scotland, in conjunction with National Records of Scotland and the Association of Registrars of Scotland, will have responsibility for developing a standardised form in relation to requests from people who are bereaved for the expedited procedure.

Timescales and Out of Hours Concerns

4. Our key implementing stakeholder, Healthcare Improvement Scotland, is aware and is ensuring that Medical Reviewer availability, including any necessary out of hours availability, aligns with that of registrars. Similarly, they are developing the necessary Key Performance Indicators to set appropriate timescales for the provision of responses and outcomes to registrars and to the bereaved.

Expedited Categories

5. We welcome the consensus agreeing the identified categories, and acknowledge the variation across responses as to how prescriptive or detailed the applicable situations within these categories should be and the level of awareness that will exist about them with the different parties involved.

6. Our view is that, from the perspective of the bereaved, the expedited procedure should generally be explained as available to request if they believe they have a compelling reason for the funeral to take place more quickly than the norm ie less than eg three working days from date of death/date of registration.

7. From the perspective of the registrar, our view is that identifying any such compelling need would arise naturally out of their discussion about the standard review process with the informant, if their case is selected for review. The registrar would then make the informant aware of their option to request the expedited procedure under the three broad categories, would assist the applicant to complete the details on the standardised form, and must then submit the request to the Medical Reviewers' office.

8. From the perspective of Medical Reviewers, requests received which clearly fall into the three identified categories and the spirit of the suggested exemplars within each one. Once that is established, the Medical Reviewer will then take a view, informed by any necessary and quick checks, as to whether the request can be approved or not.

9. There are no powers within the Certification of Death (Scotland) Act 2011 that would allow for an appeals process, therefore the Medical Reviewer's decision is final. Even if this were not the case, we would have concerns as to whether it would be beneficial to introduce any additional steps into a process that requires to be completed as quickly as possible.

10. Scottish Government will therefore set out the consulted-upon categories and exemplars in Guidance, in order to ensure there is both consistency of approach across the country combined with sufficient flexibility for any unforeseen circumstances, which was a concern of some respondents.

Consistency of Approach Across the Country

11. We note that a recurring concern of respondents was ensuring that Medical Reviewer decisions were reached consistently (which incorporates the issues of appeals, awareness and the use of specific exemplars, as mentioned above), regardless of from where in the country the request originated. The Guidance will therefore also set out clear expectations on the need for regular peer review and assessment of Medical Reviewer actions and outcomes, specific to the expedited procedure as well as in terms of the general monitoring and quality assurance requirements associated with the Medical Reviewers' role.

Clear Communications

12. Scottish Government acknowledges that the legal term 'Not Staying Registration' and the policy term 'Expedited Procedure' are unclear in meaning and do not convey, as titles, any helpful information on the intent of the process associated with them. Whilst it is obviously not possible to change the legal terminology, the Scottish Government and relevant stakeholders will ensure that the explanation of either term is clearly conveyed in any formal communications.

13. To assist with this, Scottish Government intends to produce a general information leaflet specifically on the new death certification system, which will be available to download from the Scottish Government website in due course and prior to implementation.