A number of constituents from both the muslim and jewish communities are campaigning for an improvement to death and burial services in the city.

Shabana works closely with a number of different organisations and individuals who are all pushing specific changes. Shabana's campaign for death and burial services focuses on the following points:

1) Non invasive post mortem facilities. There is a CT scanner in Sandwell which residents can pay to use for a non invasive postmortem. Unfortunately the scanner does not offer angiography which means for many post mortems it is unsuitable. 

 - Shabana is actively supporting the Birmingham Muslim Burial Council's campaign for a scanner which can perform angiography.

 - Shabana has asked the coroner to (i) ensure that all patients are aware of the existing non invasive scanner facilities in appropriate (non trauma) cases (ii) ensure that the uptake of the Sandwell scanner facilities is monitored

UPDATE Date: 1 July 2016 at 15:27:27 BST

Email form Mrs L Hunt, HM Senior Coroner

On the subject of CTPM I can confirm I have had no communication at all from Igene so am unaware of their plans or any time frame. However I have been making my own enquiries about the possibility of a CTPM service within a clinical setting, which is preferable and will comply with Royal College of Pathology guidelines which are due to be published shortly. I will keep you updated.

2) Pathology numbers. Concerns have been raised that the number of pathologists that can undertake postmortems is declining and furthermore that the fee paid to them is a significant disincentive

 - Shabana has laid parliamentary questions to both the Department of Health and the Ministry of Justice to ask for clarification on this point. Neither department has been able to clarify this as yet and Shabana is continuing to probe this issue via the House of Commons Library

 - UPDATE 7th July 2016

Health Education England produce workforce plans which show the relationship between demand and supply for key staff groups. The latest report for 2016/17<https://www.hee.nhs.uk/sites/default/files/documents/HEE%20Workforce%20Plan%20for%20England%202016%20180516_0.pdf> does not cover pathology, but it was mentioned in the 2014/15 workforce plan (https://www.hee.nhs.uk/sites/default/files/documents/Workforce-plan%202014-15.pdf) where it was predcited that the chemical pathology workforce would increase by an annual average of 1.4% by 2020 and the histopathology workforce by 1.3% per year to 2020.

This increase may not be enough to meet demand  - the BMA continue to report that there is a national shortage of pathologists: http://www.bma.org.uk/developing-your-career/medical-student/an-insider-guide-to-medical-specialties/nhs-career-choices/pathology

- UPDATE 25th July 2016

Figures have been received on pathologist numbers. Seeking clarity on which pathologists can conduct postmortums.

Update 19th September: We need to be focussing on forensic pathlogists and coronial pathologists. A review in 2015 concluded: "The future of the forensic pathology service is fragile. Although trainee recruitment is good, going forward, the specialty and its falling workload are too small to comprise a robust stand-alone national resource. The provision of sub-specialty opinions is at crisis point." https://www.gov.uk/government/publications/review-of-forensic-pathology-...

Shabana is has asked the Government for a copy of their action plan following this report.

- UPDATE 26 October 2016

Shabana has asked the Home Office what assessment the department has made of the implications for its policies of the conclusions and recommendations in the Hutton review of forensic pathology in England and Wales, submitted to the Minister of State for Crime and Prevention in March 2015, which said that 'although the forensic pathology service is functioning satisfactorily at the moment, its future is very fragile and corrective action needs to be taken now'.

The Government replied that the main recommendation in Professor Hutton’s review, namely for the establishment of a ‘National Death Investigation Service’ has been the subject of consultation with stakeholders since the review’s completion. Recommendations on the preferred option, it said, will be presented to Home Office Ministers in October 2016.

As the Government did not respond about the other recommendations in the Hutton review, Shabana has laid futher questions asking what steps the Government has taken on these points.

 

3) Removal of body from the country. There seems to be some confusion as to whether a body needs to be registered at the weekend for a body removal order to be signed by the coroner. At the moment, Shabana understands that the Coroner does require registration before the order is signed. This is slowing down the removal of bodies which need to be removed quickly from the country.

  - Shabana has written to the coroner about this issue to ask for clarification

4) Referrals to the coroner. When resources are scarce it is important that referrals to the coroner are made accurately and appropriately. Otherwise referrals may be made which "clog" up the system.

Deprivation of Liberty Safeguards: these are people who are detained under a form of state detention which is not prison eg elderly people who are not free to leave a care home. Deaths  of people under a DoL are automatically referred to the coroner. The number of people subject to DoLs has risen significantly from 2300 in 2014 to 35,215 as a result of a Supreme Court judgment. This is putting strain on coroner services. Click here for further information  (pages 8 and 9).

 - Shabana has asked parliamentary questions on this issue and will continue to put pressure on the Government to look at this issue

Medical Examiner Scheme: The Medical Examiner Scheme was recommended following the Shipman inquiry. Harold Shipman escaped scrutiny of his murders by certifying patients as having died of natural causes. Independent medical examiners would scrutinise all death certificates and prevent such a reoccurence. However an additional beneift would be to ensure that only the right deaths are reported to the coroner. 

The introduction of medical examiners was subsequently recommended by the Mid-Staffordshire NHS Foundation Trust Public Inquiry Report (2013), the Morecambe Bay Investigation Report (2015) and the Review of Forensic Pathology (2015).

The Royal College of Pathologists has lobbied to ensure a national system of medical examiners is implemented. It published a briefing on medical examiners in July 2015.

The Government has said it remains committed to implementing the scheme but it appears to have been delayed indefinately.

 - Shabana is continuing to push the Government to implement the scheme

 - Shabana has written to local hospitals to ask whether they are considering a medical examiner scheme

Correct referral by attending doctors A study in 2008 found that doctors were wrongly classifying deaths in 1 in 4 cases. Alan Fletcher who led the Medical exminer scheme in Sheffield said "Doctors had not always understood when they must refer matters to a coroner". He added "Doctors receive little or no training in death certification or coroner referral." Click here for further information.

 - Shabana believes that Doctors must be given better training and that this needs to be refreshed throughout their careers; Shabana would like to see a dedicated phone line for GPs so they could contact the coroners' office directly, which in turn might reduce the number of incorrect referrals.

 - Shabana has written to local hospitals to ask how they ensure consistency of death certification and referral by their medical practioners

5) Burial costs: burial costs in the city seem high compared to other cities. 

 - Shabana will try to find out why prices are so high and whether there is room to bring costs down

Average burial cost by city:

:: Birmingham - £2,815

:: London - £2,617

:: Norwich - £2,452

:: Leeds - £2,223

:: Edinburgh - £2,162

:: Glasgow - £1,980

:: Manchester - £1,870

:: Newcastle - £1,682

:: Liverpool - £1,620

:: Sheffield - £1,605

:: Bristol - £1,555

:: Southampton - £1,415

:: Nottingham - £1,360

:: Cardiff - £1,275

:: Belfast - £980

:: Average - £1,841

Average total cost of funerals    

Death and burial updates

  • Cost of coroner services in Birmingham

    Anyone who has tried to read the Council's budget documents will know difficult it can be to understand exactly how much is spent on what.

    These are the headline figures explaining the budget for Birmingham and Solihull's coroner services. I'm sharing for interest.

    ============

    The expenditure and income relating to the Coroners/Mortuary Services from 2012/13 to 2016/17 

    I have summarised below some of the key highlights from the analysis;

    ·         the net expenditure on the service at £1.5m in 2016/17 is broadly the same with the net expenditure of £1.6m in 2012/13 (this consistency is reflected in the trends in the deaths registered in Birmingham and those referred to the Coroner for investigation and the post mortems carried out.  This is also set out in the schedule and shows that on average over the past 4 years, the number of post mortems carried out were 14% - about 1,600 per annum compared to the total deaths registered).

    ·         more resources are being spent on employees (£1.1m in 2016/17 compared to £0.6m in 2012/13) –this is partly a reflection of cost inflation but  also includes additional investment in employee expenditure of £0.110m in 2016/17 that was approved by the Leader on an on-going basis for the Service.  In addition, the service has secured a contribution from the West Midlands Police £0.25m in 2016/17 and this resource has also been substantially used for staffing.

    In terms of financial governance, the monitoring of the expenditure and the setting of the budgets is all completed as part of the existing arrangements in the Council for setting the budget and Cabinet for in-year monitoring.  Of course, regular meetings take place between senior officers to review the service and financial position.
     

     

  • Shabana Mahmood MP questions Government action on improving forensic pathology

    As part of Shabana's campaign for better death and burial services in Birmingham and nationally, Shabana has demanded answers from the Home Office on the actions that the Government have taken in the last year and half following Professor Hudson’s independent review of forensic pathology, which concluded that the future of forensic pathology services is ‘fragile’.

    The Royal College of Pathologists describes the profession as the discipline of pathology concerned with the investigation of deaths where there are medico-legal implications, for example, suspected homicides, death in custody and other complex medico-legal cases.

    It is therefore important that the Government takes action to ensure that this essential part of the judicial and coronial systems remains fit for purpose, particularly in light of the recent independent findings.

    As such, Shabana has asked the Government to reply to the following questions:

    •  What assessment the Department has made of the conclusions and recommendations contained in the Hutton review of forensic pathology in England and Wales submitted to the Minister of State for Crime Prevention in March 2015.
    •  What actions the Government has taken on the conclusions and recommendations contained in the Hutton review of forensic pathology in England and Wales submitted to the Minister of State for Crime Prevention in March 2015.
    •  What other actions, aside from any based on the Hutton review of forensic pathology, the Government has taken to improve forensic pathology services in the UK.

    An update will be provided when the Government responds to Shabana's questions.

     

  • Step forward for CT Scanner with angiography

    The Birmingham Muslim Burial Council have emailed to let me know that they are making headway in their campaign to have a scanner in the vicinity of Birmingham which can do angiography during a post mortem. 

    Most post mortems are done invasively but a number of religious communities would prefer to have the post mortem done in a non invasive manner. For those who wish to pay to have a non invasive post mortem there are several facilities across the country including a CT scanner in Sandwell Borough. Unfortunately this scanner does not offer angiography - required for most deaths that do not involve trauma. In those case, very often, the coroner will have to insist on an invasive post mortem.

    Shabana has been very supportive of bringing angiography to the post mortem process in the West Midlands and was delighted to receive the following information from the Muslim Burial Council in Birmingham.

    CT/MRI SCAN UPDATE:

    BMBC officials met Mr Darren Brown (Head of Business) from iGene on Thursday 26th May 2016 following the Extraordinary Meeting of all the officials at Heartlands Hospital on Tuesday 10th May 2016.

    Mr Brown has promised BMBC the MRI/CT Scan with the option of Angiography would be made available at the Sandwell Site by the end of July 2016. At present all the software has been purchased and some staff have already been trained to work with the Angiography process, iGene have also purchased a new central server which will be installed in Leeds to facilitate the process and will be accessible to all the  iGene pathologist in the country to share the reports and view cases from each site. BMBC will follow up on the progress and update everyone in due course.