‘Death care sector’ crumbling as families wait six weeks for funerals

Grieving families are waiting up to six weeks for funerals in some parts of the country, undertakers have warned.

The National Association of Funeral Directors (NAFD) said the “death care sector” was crumbling as a “snowball effect of delays” had left many relatives struggling to understand why burials were being postponed for weeks.

A shortage of pathologists, an increase in the number of GP referrals to coroners, delays in the coronial system itself and in plans to fully introduce medical examiners had exacerbated “bottlenecks” in a system still reeling from the pandemic, the trade body said.

More than a quarter of a million people die in NHS hospitals each year. In England, a death has to be registered with councils within five days. While a doctor may often register a cause of death, more complex cases may be referred to a coroner.

In such cases, the registration of a death cannot be completed until the coroner concludes his or her investigations.

A post-mortem examination should be carried out as soon as possible, with the NHS stating it should be completed usually within two to three days.

Andrew Judd, the chief executive for NAFD, which represents 4,100 funeral directors, said that although the lower death rate associated with spring was “easing the system”, with waits dropping to an average of about two to three weeks, problems within a “jigsaw of services” were leading to regional spikes in waiting times.

“This is leading to delays and frustration for families in saying goodbye to a loved one, causing untold distress,” he said.

“While things have eased a little, compared to during the pandemic, there are still significant delays affecting funerals in some parts of England and Wales - with post mortems taking anything up to six weeks to complete in some areas.”

In a 10-page report submitted to MPs, Rachel Bradburne, the director of policy and public affairs for NAFD, explained how “over-cautious” doctors were referring more cases – many unnecessarily – to coroners to establish a cause of death.

A Dorset and Wiltshire coroner was quoted saying deaths from “natural causes” can pass “back and forth” between a GP or hospital doctor and the coroner creating an initial two-week delay.

“Delays in the release of deceased people by the coroner continues to be a problem,” the report said.

Ms Bradburne added that the “long awaited” full rollout of “medical examiners” to “scrutinise” deaths not sent to a coroner “is adding [to] delays.”

The Department of Health and Social Care announced recently that all deaths not investigated by a coroner would be independently scrutinised from September by medical examiners, senior medical doctors contracted to the role for a set number of days a week.

The move was first recommended 20 years ago by Dame Janet Smith, who examined the failings in the serial killings of Dr Harold Shipman.

Medical examiners are working now in many trusts, with the Royal College of Pathologists having recently trained nearly 3,000 medical examiners and medical examiner officers.

Junior doctors are still currently often asked to establish a cause of death, with recent strikes adding to the backlog in death certificates being issued by local authority register offices.

A Sheffield undertaker said doctors “are not trained correctly in respect of completion of medical certificate of cause of death”.

The report added that once deaths are referred to the coroner, “the shortage of pathologists and access to postmortem arrangements across the country is an increasing issue”.

The problem was also exacerbated by a lack of mortuary capacity, with some having poor refrigeration systems.

One Shropshire funeral director said despite one mortuary “doesn’t keep natural changes at bay”.

He added: “We are dealing with very distressed families daily in regard to the condition of the deceased.

“Unfortunately, once the coroner is involved with a death you know you won’t be issued a release for at least two weeks which then leads to a high chance the condition of the body would be bad and can’t be seen.”

A Stoke-on-Trent funeral director was quoted as saying wait times for bodies to be released for burial can “be up to six weeks” because “out of the area” bodies sent for analysis by the mortem scanner “can then result in our [local] bodies being left in a mortuary awaiting for a space”.

Ms Bradbourne wrote: “It is our opinion that the whole system is lacking in capacity, exacerbated by the turbulence of the pandemic and the evolving policy environment – including the implementation of the statutory elements of the long-awaited medical examiner scheme, and that the impact on bereaved people of the consequences of this is not fully appreciated or understood.”

She noted how many families are unable to contact coroners’ officers by phone, with “poor communications” being limited to email.

Mr Judd said: “For deceased people to be properly cared for, an intricate jigsaw of services – involving GPs, pathologists, coroners, registrars, and others - must work seamlessly from the point of death to the funeral.

“The infrastructure underpinning this death management jigsaw has been crumbling under the strain for many years, becoming progressively more fragmented and with a myriad of government departments and local authority teams each owning a part of the process.

Earlier this month, Judge Thomas Teague, the chief coroner of England and Wales, said “an unacceptable level of avoidable delay” in coroners’ courts was compounding families’ grief.

The number of cases waiting more than a year for a coroner’s verdict has increased by more than a quarter to a record high of 6,149, new figures show.

The NAFD dossier was handed to the justice select committee which is looking at the role of the coroner service.