Chamber and committees

The overall death certification process spans different sectors and organisations including the National Health Service Scotland, National Records Scotland and private funeral director businesses. It will also dovetail with new death certification systems being introduced elsewhere in the UK. Integrating the many IT systems, as well as ensuring every relevant individual has access to the necessary hardware is a significant challenge.

The new death certification system will strengthen quality assurance and improve the accuracy of the Medical Certificates of Cause of Death (Form 11). A key component of the Medical Reviewers’ role will therefore be to discuss, support and, when appropriate, explain the significance of achieving high levels of accuracy with certifying doctors.

The overall death certification process spans different sectors and organisations including the National Health Service Scotland, National Records Scotland and private funeral director businesses. It will also dovetail with new death certification systems being introduced elsewhere in the UK. Integrating the many IT systems, as well as ensuring every relevant individual has access to the necessary hardware, is a significant challenge and therefore remains an area for development in the future.

In the meantime, however, Scottish Government and the key implementing organisations are jointly liaising with each other and other key groups to ensure that the transfer of any necessary information can be carried out efficiently and securely.

Since the passing of the Certification of Death (Scotland) Act 2011 at the beginning of Session 4, we have established the Death Certification National Advisory Group, which includes representation from all key organisations with an interest in this work. The Group has been instrumental in ensuring that any issues such organisations may have can be discussed and resolved. The process has led to a continual refinement of the new process over the implementation development period.

A concern that was raised early in Session 3 related to the possibility of the new review procedures causing significant delay to funerals. The Act therefore contains provisions which allow for an ‘expedited procedure’, whereby reviews can be conducted in parallel with the registration process in certain circumstances. We have now progressed to ensuring that this expedited procedure will be applied consistently across the country. The Death Certification National Advisory Group, which includes representation from both the Muslim Council of Scotland and the Scottish Council of Jewish Communities, has discussed this matter on more than one occasion. As a result, we are confident that the required consistency will be achieved through Healthcare Improvement Scotland’s delivery model. This includes Medical Reviewers located regionally with opportunities for peer review, working to agreed guidance, and under the direct management of one national Senior Medical Reviewer.

The Scottish Government has not undertaken any financial and governance examination of the takeover by Mears of Independent Living Services.

However, the Care Inspectorate would require information from Mears before registering the service as a care provider. The Care Inspectorate is entitled to ask for information about governance and financial matters before registering a service under both the Public Services Reform (Scotland) Act 2010 and accompanying regulations.

Ethnicity is not recorded on the Medical Certificate of Cause of Death (Form 11) and therefore did not form any part of the test sites or their evaluation.

Since 1 January 2012, however, the ethnic group of a deceased person has been recorded as part of the subsequent death registration process, with the consent of the informant.

Over the first six months of 2012, 96.4% of informants provided this information, as publicised at the Ethnic and Health Research Conference in Edinburgh in November 2012.

There is no requirement within the Tobacco and Primary Medical Services (Scotland) Act 2010 for retailers to display a certificate of registration. The advice to retailers selling tobacco is that they do not need to display the certificate but it should be retained and kept available for inspection purposes.

Rather than recommend modifications to the overall process, the test site evaluation highlighted a number of practical issues that could be addressed prior to national implementation in order to make the agreed process run more smoothly.

These issues were mainly related to improving the content and transfer of any required data at different points in the process. They were subsequently discussed by the collective stakeholders who comprise the Death Certification National Advisory Group.

A small panel of key implementation bodies has been established, and work is progressing to address the points raised in advance of the planned national implementation date of April 2014.

General practitioners in Scotland will see 1.25% uplift to the GMS contract, which includes a one per cent increase in salary, in line with Scottish Government Pay Policy. The pay increase for GPs in Scotland has been calculated based on their salaries, using information they have provided for the year ending April 2011.

For GPs this means an increase in funding of around £8 million for all GP practices across Scotland. In addition to this the equivalent of £10.5 million has been transferred from QOF (Quality Outcomes Framework) points into core (contract) thereby increasing the stability of practice income, a key issue for GPs during the 2013-14 contract negotiations.

It was not possible to accept the recommendations whilst also adhering to the Scottish Government Public Pay Policy. The uplift we have agreed is fair to GPs and affordable to Scotland where we have a negotiated contract with GPs, not an imposed one.

The Scottish Government is opposed to the UK Government policy known as “market facing pay”. John Swinney made clear our opposition when he met with Treasury Ministers and the Finance Ministers of the other devolved administrations on 5 March last year, and it is a position we have reiterated in various contexts since. There are therefore no plans to introduce regional pay differentials for staff in NHSScotland.