Service needs to meet needs of families, not the provider says Shabana Mahmood.

A landmark report into Coroner and Bereavement services in Birmingham has exposed several key areas in need of improvement to better meet the needs of service users.

The report, “Raising standards, delivering dignity – A new model for Coroner and Bereavement Services in Birmingham”, was authored by Birmingham Ladywood MP Shabana Mahmood, follows months of research and investigation, and echoes the claims and complaints that have circulated for a number of years. It will be launched on Friday, January 31^st.

Key findings in the report include:

• Aspects of the service, particularly the location, is operating in an opaque and remote manner, being geared to the wishes of the provider and not the needs of the families.
• That the service is overly politicised, riven by a refusal to accept criticism or change at a senior level, and is failing to properly serve many citizens.

Speaking ahead of the launch of her report, Shabana Mahmood MP said:

“While this report may make uncomfortable reading for some, the Coroner and Bereavement services in Birmingham are currently not fit for purpose. For too long, those delivering the service have called the shots, and done things in a way that works best for them – not the families using the service. This has to end.

“My report is unflinching in its nature, and shines a light on failings where they exist. And the truth is that the failings, as things stand, are deep-rooted and and institutional. But there is also a positive and deliverable way forward mapped out, which is followed, will end the unhealthy culture currently in place and refashion Bereavement and Coroner services into something our city can be proud of.”

The report also found that:

• Chronic maintenance and access issues at Birmingham Coroner’s Court with little modernisation or upgrading since 1912. £1.1 million is required for essential renovations to bring the building to the minimum legal standard, with a further £425,000 for ‘desirable’ work over 3 years.
• There are no parking for families at the mortuary, and vans delivering and removing bodies often have to queue on the road outside.
• Many faith groups have been poorly served by the services, with  families claiming to wait too long for bodies of the deceased to be released. Faith representatives also say the Coroner’s Court have not liaised with them well, and that concerns over invasive post-mortems were ignored.
• There is little to no opportunity for families to challenge the coroner’s processes without legal redress, and a notable unwillingness to engage positively with those who do ask questions of the service.
• There is a worrying culture of resistance to challenge and change from senior stakeholders within the service and Birmingham City Council. This has a damaging impact on the service provided, and also on those using the service.

Shabana Mahmood MP added:

“There are many real pressures on the service, and many staff working extremely hard in challenging circumstances. But the fact remains that things need to improve – and fast.

“I will be working closely with Birmingham City Council in the months ahead to ensure that the way forward this report outlines is looked at, listened to, and wherever possible implemented. Families in Birmingham deserve nothing less.

Key Findings and Recommendations

Full report available by email at marcus.bernasconi@parliament.uk

Birmingham and Solihull Coroner’s Court and Mortuary Services Premises and staffing

The Birmingham Coroner’s Court and Mortuary Services have occupied the same premises since 1912, with little modernisation or upgrading since then, except for essential repairs demanded by the Human Tissue Authorities.

In the mortuary itself, £1.1 million is required for essential renovations to bring the building to the minimum legal standard, with a further £425,000 for ‘desirable’ work over 3 years. There is widespread damp in the administration building, inadequate space in the courtroom, which also becomes uncomfortably hot in summer – there are even no power points for legal representatives – and a second (unsuitable) court room has to be hired in Solihull as space cannot be found in Birmingham.

Little in the building is fit for purpose for one of the busiest coroner’s courts in the country. Outside, there is no parking for families and vans delivering and removing bodies often have to queue on the road outside the mortuary.

Like the rest of the UK, Birmingham has also reported a serious lack of qualified pathologists and technicians. When allied with the growing demand for pathology services, this is leading to an acute difficulty in Birmingham managing workloads and maintaining standards. This is exacerbated by the poor fabric of the building staff work from.

Recommendations:

There are two options presented for the future of the premises: a ‘Super Facility’ or upgrading the existing premises. The recommendation is for the former, possibly at Sutton New Hall Cemetery (on land owned by Birmingham City Council and for which a £5 million capital bid is already envisaged), in collaboration with WMCA, which could contain state-of-the-art courtrooms, a multi-faith room, and modernised pathology facilities including non-invasive post-mortem technology, combined with Birmingham’s newest and largest capacity burial site. Uniting services could lead to significant economies of scale for councils. A feasibility study for this should be published by January 2020.

Concerns of Faith Communities

Faith communities have reported dissatisfaction with the Coroner’s Court in Birmingham. There have been accusations that although coroners are entitled to prioritise cases for religious or other reasons it does not happen in Birmingham. There have been instances where families have claimed to wait too long for bodies of the deceased to be released, where families have engaged faith representatives who say the Coroner’s Court have not liaised with them well, and that concerns over invasive post-mortems were ignored.

Recommendations:

There needs to be a clear mechanism for engaging with faith communities and working with them to ensure that the coroner’s services in Birmingham can provide a service that can adapt to their needs and requirements.

CTPM

In July 2019 Birmingham City Council announced that it had negotiated a deal to provide the Coroners Service with access to a CTPM scanner on a pilot basis. The introduction of the option of CTPM post-mortems has been welcomed by campaigners. Some religious groups believe that non-invasive post-mortems better align with religious beliefs. Campaign groups that seek to limit secondary post-mortems, such as Dignity for the Deceased, run by the families of deceased road traffic incident victims, have previously called for better access to CTPM post-mortems.

Recommendations:

The new provision for CTPM in Birmingham should continue in the short-term, with a view to maintain it past its initial twelve month trial period. The report notes continuing deep concern about how the CTPM pilot has been portrayed in official Council communications, and believes that it is in fact designed to fail at the point of its conclusion.

As a result, the report calls on  BCC to increase the publicity of CTPM as an option for bereaved families during the remaining pilot period and review its communications regarding the pilot.

Administration

There is significant concern that, although the coroner’s is a public service, it is not open to the same levels of scrutiny and challenge that monitor and oversee other public services. It is opaque, overly politicised and near impossible to navigate.

There is little to no opportunity for families to challenge the coroner’s processes without legal redress, and a notable unwillingness to engage positively with those who do ask questions of the service. The report notes with concern a worrying culture of resistance to challenge and change from senior stakeholders within the service and Birmingham City Council. This has a damaging impact on the service provided, and also on those using the service.

Recommendations:

The culture surrounding Coroner and Bereavement services in Birmingham has to change. The politics must be taken out, and the service refitted with the user at its centre – not the provider.

The report recommends creating a Citizens Bereavement Group to help take the politics out of this issue. The CBG would hold regular meetings and public sessions throughout the year to ensure scrutiny and accountability of the service and to allow concerns to be raised and addressed.

The report is firmly of the view that the Local Authority could and must do more to properly scrutinise Coroner Services – as they would any other service provided by the Council and administered with public monies. There should be clear recourse for bereaved families who wish to challenge processes of coroner services, which does not involve pursuing legal action.