Time to Allow Specialist Nurses to Sign Death Certificates?
Is it time for specialist nurses to be allowed to do death certificates?
Palliative care and end of life care has for years been increasing done by specialist nurses in palliative care teams. They provide excellent holistic care and while I know they are busy too with large case loads - I might say with more time than I have. We are now at the stage where some people don’t really see or interact with their GP in their dying few weeks. In some cases it might not be the same GP who sees them through working days/hours, though here is a group where continuity of care should be strived for if at all possible.
With the new death certification process we now have the weird situation where the new rules say the doctor seeing the patient has to have seen the patient at some point in past. At a meeting yesterday it was discussed that in theory you could do a baby check on a person and be asked to certify them 40 years later having never seen them in the meantime.
Given the palliative care teams often know the patient really well. Given they and the medical examiners (who are to my knowledge doctors) have access to the full records - why cant where appropriate these teams put forward a cause of death for the death certificate?
If needs be make it two of them needing to counter sign they agree - or have the GP sign off from the notes that the COD provided makes sense. Is it an anachronism that it has to be the GP doing this?
Now where is the IT you say? well… the whole current process seems a mess with paper and emails and variable access to records in different parts of the country.
Surely something like GP connect to provide access to records and a decent website - where details could be uploaded and tracked and email reminders or tracking of which persons details needed doing and who was tasked and where we were up to shouldn’t be that hard to develop?