NAFD tackles the issues surrounding release from hospital

Where death occurs in hospital, funeral directors are finding it increasingly difficult to obtain permission for the deceased to be released into their care. The National Association of Funeral Directors (NAFD) has been lobbying Andrew Lansley CBE MP, Secretary of State for Health, for a common approach by NHS Trusts that will allow a speedy release of the deceased, and has now joined a government working group set up to address the issues.

“In a nutshell, there is no consistency, because NHS Trusts are operating independently and taking their own legal advice in the absence of guidance from the Department of Health,” says NAFD chief executive officer Alan Slater.

“While the situation is frustrating for funeral directors, it is creating further upset for families and resulting in unnecessary delays to funeral arrangements.”

In some areas of the UK hospitals are insisting that the deceased can only be released to the funeral director on sight of the registrar’s Green Form to permit burial or cremation. However, a green certificate is not even issued in all cases – if the Coroner is issuing the certificate for cremation or if the deceased is being moved out of England and Wales, for instance – and, even when it is, does not confirm that the death has been registered.

Adopting this approach means the hospital can be sure the deceased is clear for burial, but the NAFD has pointed out that the green disposal provides no confirmation that the deceased is ready for collection for cremation. Furthermore, possession of the Green Form does not give someone the authority to collect the deceased and since the name of the person who registers the death is not recorded on the green certificate, the hospital has no way of knowing on whose authority the funeral director is acting when he arrives to collect the deceased.

Nigel Lymn Rose, the NAFD’s legislation representative, says the fact that the Medical Certificate of Cause of Death and all paperwork for registration may be completed well before an appointment can be made to actually register the death and issue the green disposal certificate, means that the hospital would be keeping the deceased unnecessarily and would remain responsible for any deterioration during that period.

Some funeral directors are using a consent to release form, which is signed by the executor or next of kin and not only ensures the hospital is in possession of a signed authority, but that it also has the contact details and signature of that individual in the event of a dispute.

“As the release form can be signed before the death is registered, the funeral director is able to move the deceased from hospital at an early date and this has the dual benefit of reducing the risk of any deterioration while the deceased is in the hospital’s care and minimising the maximum mortuary capacity required by the hospital,” adds Mr Lymn Rose.

“This system is inherently more robust because the identity of the deceased is checked physically and against the mortuary register by both hospital and funeral director staff, resulting in shared accountability in the event of an error.”

The NAFD acknowledges that the deceased could be released from hospital before all the paperwork has been completed – although his would only be equivalent to moving the deceased from a nursing home, residential home, private address or hospital without mortuary facilities – and that the funeral could conceivably be held without the correct paperwork. However, if this were to occur, it would be the funeral director and/or the Cemetery Authority, Church, Medical Referee and crematorium that would be responsible and accountable to the Coroner and/or the Ministry of Justice, rather than the hospital.

Following the working group’s inaugural meeting the Department of Health is proposing to introduce a new ‘Release for burial, cremation or other form of disposal’ form, which is to be issued by hospitals in certain Trust areas in a pilot programme.

“Some hospitals will still insist on seeing the Green Form so, as far as we are concerned, this does not address the real problem,” adds Mr Slater.

“We will therefore continue to reiterate the profession’s desire for a system that will ensure a consistency of approach across all NHS Trusts.”