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Covid19 Death Certification Guidance
Following discussions with CHFT and considering the latest guidance that has been issued in relation to verification of death we have agreed the following:
CHFT have revised their Local Working Instruction based on the guidance issued during the COVID-19 pandemic. This means that the 28 day rule can be revoked if ALL the following circumstances are met:
• The patient is on the Community nursing case load and is receiving end of life care.
• There is clear documented evidence of advanced care planning and consideration of DNACPR has taken place.
• The death is expected and the attending nurse has the required competence to verify the death.
However, it is the right of the verifying nurse to refuse to verify a death and to request the attendance of the responsible doctor if there are any unusual circumstances or concerns.
It is not expected that community nurses attend instead of GPs, but should they be present or willing to do so, to be able to verify expected death regardless of when the patient was last seen by a doctor. It was recognised that this would reduce the stress and anxiety for the patient's family and carers.
We have agreed to review the position in one month and to understand how this is working.
The latest national guidance talks about opportunities for non-registered professionals to verify death with remote support. Discussions are underway as part of the work supporting the care home sector to enable this to be put into practice, however it is likely that this will need to be done in a considered way to ensure the homes feel confident in this. In the meantime registered professionals (both GPs or community teams) are likely to be asked to verify deaths of people within residential and other care settings. We will keep you updated on progress with this.
Within nursing homes, Overgate Hospice are already training nurses and this will continue.
The link to the national guidance is below and supercedes the local coroner’s letter.
Latest gov.uk Guidance on Verification of Death
BMA Guidelines on Verifying and Certifying Death
BMA Guidance on Remote Verification of Death
CQC and GMC Guidance on Death Certification
Latest NHS Guidance - Coronavirus Act, Excess Death Provisions
RCGP Death Certification update
Email of registrars for MCCD:
In addition to the electronic emailing of MCCDs to the Register Office, Parkwood Crematorium is now accepting electronically signed Cremation Form 4's (Part 1)
Please email: email@example.com for the attention of the Medical Referee Dr Howard Barnes
Information on Electronic signing of Crem Form 4 here