Mortuary review group: response

Mortuary provision

Deaths on average have mainly remained the same over the last few years 55,000 per annum. However, this may increase as the age profile of the population indicates a greater proportion in the older age group.

The number of deaths dealt with by COPFS vary year on year (between 10,000 and 11,500), with 11,000 deaths dealt with in 2016-17. Post mortem examinations, which are instructed by the COPFS where it is absolutely necessary, are carried out for approximately half the number of deaths dealt with by COPFS.

Numbers of hospital post mortem examinations are declining and on average, the number of hospital post mortem examination performed is less than 550 per year (less than 10% of COPFS-instructed post mortem examinations).

Winter death rates fluctuate with an occasional spike which levels out across the five year moving average. There are currently around 2,720 additional deaths over the four month winter period (see link below).

The seasonal increase in mortality in the winter is the difference between the number of deaths in the four month winter period (December to March) comparing them with the four month periods before and after.

https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/deaths/winter-mortality

Most of the deaths in the community, which are not reported to the COPFS, are managed by the funeral directors.

Mortuary services have been broadly divided into:

• Body storage facilities only
• Body storage and viewing facilities
• Body storage, viewing and post mortem facilities
• Body storage, viewing, post mortem facilities, teaching and research

Details of mortuary provision are included in Annex E . The majority of provision is currently provided within NHS facilities with only 3 facilities provided within local authority and police facilities.

Local authorities are required to make provision for mortuary services (including post mortem services) but may enter into an agreement with any person or organisation (including the NHS) for the provision of the facilities. Health Boards may also enter into such agreements with other Health Boards. Where such an agreement has been made, local authorities and Health Boards must monitor the capability and capacity of the provider against current mortuary standards ( SPHN 16-01 (revised HFS SPHN 20)) to ensure adequate provision. This is of particular importance when multiple organisations have contracts/agreements with one provider.

Recommendations:

• Public services that provide post mortem examination should work towards the facilities being provided in Health Board ( NHS) facilities, including those to be accessed by Crown Office and Procurator Fiscal Services - COPFS via agreements with Local Authorities.
• The capacity and capabilities of the service and facilities must be monitored.
• Health Boards and Local authorities must work with other partners within the Regional Resilience Groups to plan for normal and extensive events as part of their duties under the Public Health Act.