Cremation forms in the UK
When you start working on the medical wards, you will be asked to do cremation forms for patients who have passed away. The purpose of this guideline is to give you a basic idea of what it is all about.
This is the official guidance on this:
https://www.gov.uk/after-a-death
What happens when a patient passes away?
The on call doctor/ doctors on the ward are asked to verify the death.
How do we do that?
Ensure that there is no relative in the room by confirming with the nursing staff. Ask for a pen torch. Ensure that you have drawn the curtains/closed the door. Verify the identity of the patient by checking the identity tag.
Check pupils for reflexes, carotid pulsations, auscultate for heart beat, breath sounds, check if responsive to painful stimulus and voice.
Documentation varies from trust to trust. Some trusts have stickers which mention the above and you have to tick the boxes. Document the time of death and time of verification with your details.
What happens next?
The body is transferred to the mortuary which is a room in the hospital where dead bodies are kept till they have have been cleared by the coroner for burial/cremation.
What is cremation?
The body is burnt in an incinerator in a crematorium and the ashes are given to the family.
Why are people cremated?
Some families prefer it this way. Some are unable to pay for the high costs of funerals (which can be in thousands of pounds - whereas cremations are cheaper).
What do I have to do as a junior doctor?
Once the death has been confirmed, the team looking after the patient is asked to do 3 forms:
1. GP notification of death.
2. Death certificate
3. Cremation certificate
How do I know what to fill out?
You must always ask the consultant looking after the patient what to put in the cause of death and any events which lead to the death.
What is GP notification of death?
The GP notification of death is a letter you type on the computer informing the GP of the cause of death and the events which lead to the death.
These are the sections (which may vary from trust to trust):
- Date and time of death
-Cause of death
- Events leading to death
- Palliative team/chaplaincy involved?
- Was the patient supported with a care plan?
- DNAR?
- Your name and details.
What is the death certificate?
This is a form you have to fill which mentions:
-details of the patient
-time of death
-cause of death which has 4 parts all of which should be discussed with the consultant in charge of the patients care.
- your details.
What is the cremation certificate?
This is a handwritten form which contains:
- The patients details
- Whether you are a relative of the patient
- Whether you have any pecuniary interest in the patient
- Details of events leading to the patients death
- Cause of death
- Any operation in the past one year?
- If the operation has lead to the death?
- Nurses looking after the patient and their details
- If there was anyone with the deceased and if they were concerned in any way.
- If you think that the death was violent or unnatural.
- Whether the case has been discussed with the coroners office and if yes, what is the outcome?
- Whether you have issued the death certificate.
- Whether the patient had a pacemaker or any device which can explode in the incinerator - This is very important! Check the patients chest X ray, other imaging to ensure that there is nothing which can cause issues when the body is cremated as you, as the doctor who has filled the cremation form will be responsible.
- Your details.
What should I do once I have filled the forms?
You have to go to the mortuary and confirm the identity of the patient. You should also hand the cremation form to the team there.
What happens next?
You will get a call from the pathologist asking for a summary of the events- they usually call within a few hours so you will clearly remember the whole history which you can narrate to the pathologist.
This seems very complicated.
It does seem complicated initially and it is advisable to observe another junior doctor doing this.
In some trusts, there are bereavement offices where the bereavement officers are very helpful.
Are we paid for this?
The funeral services/crematorium pay the doctor who has done the cremation form a certain amount-
This is 82 GBP as mentioned here:
https://www.bma.org.uk/advice/employment/fees/cremation
My trust pays only 62 GBP for doing cremation forms.
This is the official guidance on this:
https://www.gov.uk/after-a-death
What happens when a patient passes away?
The on call doctor/ doctors on the ward are asked to verify the death.
How do we do that?
Ensure that there is no relative in the room by confirming with the nursing staff. Ask for a pen torch. Ensure that you have drawn the curtains/closed the door. Verify the identity of the patient by checking the identity tag.
Check pupils for reflexes, carotid pulsations, auscultate for heart beat, breath sounds, check if responsive to painful stimulus and voice.
Documentation varies from trust to trust. Some trusts have stickers which mention the above and you have to tick the boxes. Document the time of death and time of verification with your details.
What happens next?
The body is transferred to the mortuary which is a room in the hospital where dead bodies are kept till they have have been cleared by the coroner for burial/cremation.
What is cremation?
The body is burnt in an incinerator in a crematorium and the ashes are given to the family.
Why are people cremated?
Some families prefer it this way. Some are unable to pay for the high costs of funerals (which can be in thousands of pounds - whereas cremations are cheaper).
What do I have to do as a junior doctor?
Once the death has been confirmed, the team looking after the patient is asked to do 3 forms:
1. GP notification of death.
2. Death certificate
3. Cremation certificate
How do I know what to fill out?
You must always ask the consultant looking after the patient what to put in the cause of death and any events which lead to the death.
What is GP notification of death?
The GP notification of death is a letter you type on the computer informing the GP of the cause of death and the events which lead to the death.
These are the sections (which may vary from trust to trust):
- Date and time of death
-Cause of death
- Events leading to death
- Palliative team/chaplaincy involved?
- Was the patient supported with a care plan?
- DNAR?
- Your name and details.
What is the death certificate?
This is a form you have to fill which mentions:
-details of the patient
-time of death
-cause of death which has 4 parts all of which should be discussed with the consultant in charge of the patients care.
- your details.
What is the cremation certificate?
This is a handwritten form which contains:
- The patients details
- Whether you are a relative of the patient
- Whether you have any pecuniary interest in the patient
- Details of events leading to the patients death
- Cause of death
- Any operation in the past one year?
- If the operation has lead to the death?
- Nurses looking after the patient and their details
- If there was anyone with the deceased and if they were concerned in any way.
- If you think that the death was violent or unnatural.
- Whether the case has been discussed with the coroners office and if yes, what is the outcome?
- Whether you have issued the death certificate.
- Whether the patient had a pacemaker or any device which can explode in the incinerator - This is very important! Check the patients chest X ray, other imaging to ensure that there is nothing which can cause issues when the body is cremated as you, as the doctor who has filled the cremation form will be responsible.
- Your details.
What should I do once I have filled the forms?
You have to go to the mortuary and confirm the identity of the patient. You should also hand the cremation form to the team there.
What happens next?
You will get a call from the pathologist asking for a summary of the events- they usually call within a few hours so you will clearly remember the whole history which you can narrate to the pathologist.
This seems very complicated.
It does seem complicated initially and it is advisable to observe another junior doctor doing this.
In some trusts, there are bereavement offices where the bereavement officers are very helpful.
Are we paid for this?
The funeral services/crematorium pay the doctor who has done the cremation form a certain amount-
This is 82 GBP as mentioned here:
https://www.bma.org.uk/advice/employment/fees/cremation
My trust pays only 62 GBP for doing cremation forms.
Yes this may be less especially if the cremation fees is paid via your pay slip (as this is taxed).
When do we get paid?
This is usually within one to 2 months.
I did not get paid for a cremation form I did.
It is possible that the family decided to do a burial instead. Kindly ask your bereavement office as well.
I received a call from the pathologist stating that this case will be referred to the coroner.
In some trusts, the bereavement officers ask us to refer to coroners especially when
- The cause of death is uncertain
- The patient underwent a procedure during admission.
- The patient had an operation in the past 1 year.
In some trusts, the pathologist call us and inform us that they will refer the case to the coroners themselves.
What do coroners do?
They go through the forms you have filled and see if there is any suspicion to warrant a post mortem to ascertain the actual cause of death.
How do we do referrals to the coroners?
The bereavement office will be able to guide on this - in some trusts there is an online form. The coroners then contact the bereavement office if they need to do a post mortem or not.
The patient I did a cremation form for is undergoing a post mortem. Should I be worried?
No-as long as you have mentioned the cause of death and events leading to the death after discussing with your consultant, you will not have any issues.
When do we get paid?
This is usually within one to 2 months.
I did not get paid for a cremation form I did.
It is possible that the family decided to do a burial instead. Kindly ask your bereavement office as well.
I received a call from the pathologist stating that this case will be referred to the coroner.
In some trusts, the bereavement officers ask us to refer to coroners especially when
- The cause of death is uncertain
- The patient underwent a procedure during admission.
- The patient had an operation in the past 1 year.
In some trusts, the pathologist call us and inform us that they will refer the case to the coroners themselves.
What do coroners do?
They go through the forms you have filled and see if there is any suspicion to warrant a post mortem to ascertain the actual cause of death.
How do we do referrals to the coroners?
The bereavement office will be able to guide on this - in some trusts there is an online form. The coroners then contact the bereavement office if they need to do a post mortem or not.
The patient I did a cremation form for is undergoing a post mortem. Should I be worried?
No-as long as you have mentioned the cause of death and events leading to the death after discussing with your consultant, you will not have any issues.
I work in surgery. Why do I not get any bereavement forms to do?
Post op cases are slightly complicated which is why senior doctors prefer doing these themselves. However talk to your consultant and ask if (s)he can allow you to do the next cremation form
Some top tips:
- Never rush to do cremation forms for patients you do not know about.
- If you junior has seen the patient, ask them to do the cremation form as they will know more.
- Always discuss the case with your consultant before filling any forms
- Never make up stuff.
- Try to do these as soon as possible (within the same day you have been asked to do it) to avoid delays in transfer of the patient to the crematorium or graveyard.
- Do not be shy to refer cases to coroners if you and your consultant are unsure about it.
- Keep a list (without mentioning names or details) of when you did the cremation form to know when to expect a cheque.
- If you made a mistake, put a line through it and sign on top of it.
- Do not forget to mention if the patient had a pacemaker or anything which can explode in the incinerator.
- The pathologist may call you in 4 hours. Sometimes even out of hours, therefore keep an eye on your phone.
- Ask your bereavement officers if you have any issues in filling the forms.
- Always observe someone filling the forms before you do these yourself.
- If you and your junior have seen a patient, let you junior colleague do the cremation form - This is common courtesy in the UK.
All of this is mentioned in details in the Oxford handbook for Foundation Doctors. Kindly purchase it and go through it - it has very useful information in it.
Some top tips:
- Never rush to do cremation forms for patients you do not know about.
- If you junior has seen the patient, ask them to do the cremation form as they will know more.
- Always discuss the case with your consultant before filling any forms
- Never make up stuff.
- Try to do these as soon as possible (within the same day you have been asked to do it) to avoid delays in transfer of the patient to the crematorium or graveyard.
- Do not be shy to refer cases to coroners if you and your consultant are unsure about it.
- Keep a list (without mentioning names or details) of when you did the cremation form to know when to expect a cheque.
- If you made a mistake, put a line through it and sign on top of it.
- Do not forget to mention if the patient had a pacemaker or anything which can explode in the incinerator.
- The pathologist may call you in 4 hours. Sometimes even out of hours, therefore keep an eye on your phone.
- Ask your bereavement officers if you have any issues in filling the forms.
- Always observe someone filling the forms before you do these yourself.
- If you and your junior have seen a patient, let you junior colleague do the cremation form - This is common courtesy in the UK.
All of this is mentioned in details in the Oxford handbook for Foundation Doctors. Kindly purchase it and go through it - it has very useful information in it.
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