Derogation of Legislation
In the most severe extensive mass fatalities emergencies, including the reasonable worst case planning assumptions for an influenza pandemic, it may be unrealistic to expect normal compliance with some aspects of legislation such as:
- the number of deaths may increase the workload
- staff absences due to the emergency may reduce capacity
- assigning resources to meet normal legislative objectives may reduce the ability to respond to more critical aspects of the incident.
Under circumstances such as these derogations to legislation may be introduced. These can be grouped as those derogations needed:
- to facilitate a more effective response to the management of the incident
- as business continuity measures, because of the impact of the emergency on particular services or sectors.
Agencies should consider both groups of derogations.
Certification of Death
It will be important to avoid delays in the completion of the various certificates and documents required for the verification of death, certification of the medical cause of death, registration of death and application for burial and cremation to allow the series of events that follow a death to proceed in a timely way. To assist in this, the Scottish Government’s Chief Medical Officer and the Crown Office and Procurator Fiscal Service have issued doctors with revised guidance on the certification of death during a pandemic.
Registration of Death
The National Records of Scotland (NRS) has issued guidance about the Scottish response to pandemic influenza to local registration authorities. It raises issues that local registration authorities should consider when drafting their own contingency arrangements and provides information on what NRS will do.
Death Certification Review Service
Deaths in Scotland which are not part of the procurator fiscal process are subject to random scrutiny. This means that in roughly 10% of these deaths the Medical Certificate of Cause of Death (MCCD) will be reviewed by the Death Certification Review Service (DCRS) operated by Healthcare Improvement Scotland (HIS). These reviews are designed to check the quality and accuracy of certificates and to improve how this information is recorded.
If an emergency situation such as a pandemic was declared then the DCRS would be suspended country wide by Scottish Ministers using powers available under the Certification of Death (Scotland) Act 2011.
The DCRS is also responsible for the scrutiny of death certificates in cases where a body is being repatriated in to Scotland. This aspect of the service would continue to run during a pandemic unless the Foreign and Commonwealth Office (FCO) has taken the decision to prevent bodies from entering the country. In this instance the repatriation service run by DCRS would also be suspended.