Gate Review for Mortuary and Coroner Service - Decision making

Report No.
ES13004
London Borough of Bromley
PART ONE - PUBLIC
Decision Maker:
Public Protection and Safety Portfolio Holder
Date: 22nd January 2013
For Pre Decision Scrutiny by the Public Protection and Safety
PDS Committee on
Decision Type: Non-Urgent Executive Key
Title:
Contact Officer:
Chief Officer:
Ward:
GATE REVIEW FOR MORTUARY SERVICE AND CORONER SERVICE
UPDATE
Jim McGowan, Head of Environmental Protection
Tel: 020 8313 4651 E-mail: Jim.McGowan@bromley.gov.uk
Nigel Davies, Director of Environmental Services
(All Wards);
1. Reason for report
The current arrangements for the Service Level Agreement for provision of mortuary services has
now come to an end and discussions are being held with regard to the possible need to re tender the
service on the open market. Members have also requested an update on the Bromley Coronial
services.
________________________________________________________________________________
2. RECOMMENDATIONS
The Committee is asked to:
(i) Consider and note the contents of the report with regard to the services provided to
Bromley Council for its Mortuary and Coronial services; and
The Portfolio Holder is asked to:
(i) Agree to a limited tender list of up to three mortuaries, being suitable mortuary
services within or adjacent to the HM Southern Coroners District.
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Corporate Policy
1. Policy Status: Existing Policy:
2. BBB Priority: Excellent Council:
________________________________________________________________________________
Financial
1. Cost of proposal: £484k
2. Ongoing costs: £96.7k pa
3. Budget head/performance centre: Mortuary and Coroners Budget
4. Total current budget for this head: £96.7k and £239.5k
5. Source of funding: Existing controllable revenue budget 2012/13
________________________________________________________________________________
Staff
1. Number of staff (current and additional): 0.1FTE
2. If from existing staff resources, number of staff hours: n/a
________________________________________________________________________________
Legal
1. Legal Requirement: Statutory Requirement
3. Call-in: Applicable:
Customer Impact
1. Estimated number of users/beneficiaries (current and projected): Approximately one million
residents within the HM Southern District.
________________________________________________________________________________
Ward Councillor Views
1. Have Ward Councillors been asked for comments? Not Applicable
2. Summary of Ward Councillors comments: n/a
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3. COMMENTARY
The Mortuary Service
3.1 The Coroners service is provided by a consortium of the Boroughs of Bromley, Croydon, Sutton
and Bexley as a shared service, on behalf of Doctor Roy Palmer, HM Coroner, Southern
District, as part of this service each Borough is required to provide its own suitable mortuary
service.
3.2 The provision of mortuary facilities was historically provided within the Borough of Bromley in its
own Public Mortuary, but in 2004/5 the Bromley Public mortuary, which was owned and
operated by LB Bromley, developed serious structural building faults and had to be partially
demolished.
3.3 The public mortuary facilities were moved on a temporary, informal basis to the Princess Royal
University Hospital (PRUH). The decision was subsequently taken not to return to the public
mortuary building and the building was returned to the LBB property portfolio; at the same time
it was agreed to continue using the PRUH for the Borough’s mortuary services. The
arrangements with the PRUH were subsequently formalised through an SLA until March 2012.
Concerns have been raised regarding the renewal of the agreement with the PRUH as a single
specialist contractor and whether this provides value for money; the contract has been extended
for twelve months to 31st March 2013, to allow for consideration of a public open tender for
these services.
3.4 Discussions have taken place with Doctor Palmer, the HM Coroner for Southern District, who
expressed a strong preference not to have the mortuary services outside his HM Coroner
District and he further informs that the mortuary cannot legally be positioned further than an
adjacent District.
3.5 Discussions have also taken place with the three Boroughs within HM Coroners Southern
District.
3.6 Bexley has now also closed their public mortuary in Queen Mary’s hospital and has moved all of
their mortuary work to the PRUH and the QMH public mortuary is no longer an option.
3.7 Sutton is in the process of moving its mortuary provision away from St Helier Hospital and is
unable to take on Bromley mortuary services, primarily due to the large number of cadavers
from LB Bromley annually.
3.8 Croydon would consider taking on additional mortuary services but would need to extend their
buildings, build in more capacity for body storage and take on more staff. They have, however
agreed to tender for this process.
3.9 The only suitable adjacent Borough to the HM Southern Coronial district is Lewisham, which still
has its own public mortuary but it lies in the Inner London Coronial district and Bromley would
need permission from the local Coroners to use this mortuary outside of the District. However,
it is in an adjacent Borough and they have been contacted to ask if they would provide a tender
quote. Further information on this particular option will be provided by officers at the meeting.
3.10 There are also other hospitals in districts neighbouring HM Southern district that the Coroner
might consider, e.g. The Queen Elizabeth at Woolwich and they have been contacted;.
However it is in the same National Health Trust and is managed by the same person as the
PRUH and Queen Mary’s Hospitals, negating this hospital mortuary as a viable financial option.
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3.11 Using a hospital outside the HM Coroner’s district would also mean varying the contract with
Dignity for body transportation within the Coronial District and would incur additional costs for
Bromley to transfer bodies outside of the District. If an inner London mortuary were to be
awarded this contract then this would involve a congestion charge for each cadaver as well as
the additional movement charge by the contractor. These additional charges would also need
to be factored in if Members choose an open tender from an Inner London Hospital.
3.12 The services provided by the PRUH mortuary service currently include the following:
24/7 access to the Mortuary facility
Use of the refrigerated body stores and the body freezers for the storage of up to 700
deceased persons in any year, under the jurisdiction of HMC Southern District
Mortician call-out outside normal working hours
Access to Post Mortem facilities and the use of hospital mortuary staff to support Post
Mortem examinations carried out on behalf of HMC Southern District
Provision of all post mortems as directed by the Coroner or his staff
Provision of all consumables and overspill nutwell cube supplementary systems
Provision of specialist Home Office Post Mortems
The Coroners Service
3.13 The London Borough of Bromley forms part of HM South London Coronial District, along with
the London Boroughs of Bexley, Croydon and Sutton. The Coroner is Dr Roy Palmer and he is
responsible for all of the Statutory Coronial duties within these four Boroughs.
3.14 The funding and resources for the Coroner Service are the statutory responsibility of these four
Local Authorities within his District (see sec 6 Legal Implications). The budget for this
service is currently managed by the financial services team at the London Borough of Croydon
and contributed to by each of the four Boroughs proportionally based on population. The
London Borough of Bromley proportion is approximately 30%, which for 2012/13 is £239,520.
3.15 The Coronial staff consists of the Coroner, his Deputy, two part time PA’s and twelve Coroners
Officers, currently provided by the Metropolitan Police, although this may change in the near
future (see sec 6 Legal Implications). These members of staff were accommodated in three
separate sets of office accommodation in three locations across the four Boroughs but, as part
of a cost saving exercise, this was recently re organised to put all officers into a single office,
located in the Bromley Civic Centre. One of the remaining locations is the Coroners Court
itself in Croydon, which contains the Court, the jury room, advocates room and waiting room as
well as the reception area. However, the Court itself cannot be used for large inquests and the
four Boroughs subsequently become responsible for procuring buildings of sufficient size to
accommodate these larger inquests. Bromley Council Chamber and Committee rooms have
been utilised recently for the large inquests, bringing income into Bromley.
3.16 Under the existing Coronial legislation (Coroners Act 1988), the Local Authorities have a duty
to:
provide all necessary staff and accommodation to the coroner
recruit and appoint the Coroner
rubber stamp deputy/asst deputy appointments for the Coroner
pay the Coroners and his deputy/ assistants
pay all the reasonable costs associated with providing the Coronial services
provide all support to Coroners to enable them to discharge their legal obligations
indemnify the Coroners
Provide facilities for Inquests
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3.17 Under the Coroners and Justice Act 2009, new responsibilities apply to Local Authorities
The most significant change is that the Act has imposed a new duty for Local Authorities to
provide staff (coroner officers)
Establishes a new post of Chief Coroner to provide national oversight and leadership to the
coroners
greater flexibility – allowing movement of cases, directing where post-mortem examinations
are conducted and inquests held
new ‘coroner areas’ – and power to merge Coronial districts
changes to coroner titles and eligibility for Coroner appointments
new coroner powers – including power to require evidence to be given/produced and new
offences
new statutory guidance on how the system will operate in relation to the bereaved
new regulations on the investigation process and new concept of ‘investigations’ into
deaths
new coroner rules on the Inquest process and procedures
new system of death certification
Coronial services to be delivered locally but within a new national framework, with national
leadership;
3.18 Key Chief Coroner powers under the 2009 Act
The new Chief Coroner, His Honour Judge Peter Thornton QC took up post on 17/09/2012
and the first of his statutory powers came into force on the 24/09/2012.
He is currently preparing public consultation on proposed changes to the Coroners
services, including
New Draft coroners rules and regulations
New Draft order, mapping out new coronial areas
New Draft regulations on fees, expenses etc.
New Draft guidance for the bereaved
The Medical Examiner Service
3.19 The new legislation also makes provision for a new Medial Examiner (ME) role, to be
introduced from April 2014 and this new Statutory obligation is expected to be fully funded by
the Local Authorities.
The ME will also have a team of junior doctors and a support team to provide the service,
incorporating the normal overheads of building rental, admin, HR, Legal etc and it will be the
responsibility of the Local Authority to resource and fund all of this new service.
However, the Government is proposing to introduce a system of fees, which is expected to
cover the Local Authority costs in providing the new ME service. These fees will have to be
recovered locally, by the Councils. Details of the scheme/proposal are expected to be released
later this year.
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4.0 FINANCIAL IMPLICATIONS
4.1 The existing Mortuary Service is provided at the Princess Royal University Hospital and is
budgeted at £96,710 pa. A three year contract with an optional two year extension is estimated
to cost £483,550, although the competitive tender process may lead to an increase or possibly a
reduction on these figures.
4.2 Under the Coroners Act 1988, the accommodation, the H M Coroner and Deputy salaries and all
expenses for the H M Coroner services are all currently paid for by the four Local Authorities in
the Southern district (see paragraph 4.2) and the Coroners officers, have historically been
provided and funded by the Metropolitan Police. For Bromley, the current cost of providing the
Coroners service is approximately £240k, however this can vary year on year depending on the
number of inquests etc.
4.3 The most significant change coming from the Coroners Act 2009 is that it has placed a new
duty on Local Authorities to provide all of the necessary coroner officers. Although there are no
verifiable figures available at present, it is estimated that, if the Metropolitan Police choose to
remove this resource, it will place a significant financial burden on Bromley Council, which could
be up to £200k. However, officers have no details to substantiate the true cost of providing this
service and have no evidence of the level of efficiencies that could be introduced to reduce the
future costs of this new responsibility.
4.4 As mentioned in 3.19 above, through the new legislation, Local Authorities will also have to
provide and fund a new ME service, although the introduction of a new fee system is expected
to cover the additional costs. At this stage it is not possible to quantify what the expected costs
and income of this new service will be until the details of the scheme and/or proposal is
published later this year.
5. LEGAL IMPLICATIONS
5.1 The existing Coroners Act 1988 requires Local Authorities to pay to pay all Coronial expenses.
The Coroners and Justice Act 2009 (the Act) was given Royal Assent in November 2009 but
this part of the Act has only recently come into force, in September 2012. The most
significant change is that the Act has is imposing a new system of Medial Examiners on
Local Authorities and a new duty for Local Authorities to provide the Coroners Officers,
as well as all of the existing Coronial expenses. Although the Local Authority has previously
always paid for the accommodation and all of the running costs, the Coronial staff have
historically always been provided by the Police.
5.2 There is an existing duty on Local Authorities to provide mortuary facilities (S.198 Public Health
Act 1936) as amended by S.2 Local Government Act 2000 power of well being.
Non-Applicable Sections:
Policy and Personnel Implications
Background Documents:
(Access via Contact
Officer)
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