Death Occurring in GP Premises: Guidance for GP Practices

A practical guide for GP practices on managing the immediate aftermath of a death occurring in surgery premises, including roles, responsibilities, dignity and privacy considerations, and liaison with police and coronial services.

Deaths occurring in GP premises are fortunately rare, but they can present significant practical and operational challenges for practices.

Surrey and Sussex LMCs worked with the Sussex Coroner Services to develop these agreed principles, which aim to provide clarity around responsibilities, escalation routes and reasonable expectations following a death occurring in GP premises.

The guidance recognises both the need to preserve dignity for the deceased and the practical realities of delivering care within busy general practice environments.

The Guidance

Purpose

Deaths occurring within GP premises are fortunately rare. However, when they do occur, they can present significant practical and operational challenges for practices, particularly where surgeries are operating at full capacity and accommodation is limited.

These principles are intended to support a consistent understanding of responsibilities following a death occurring in GP premises, while maintaining dignity for the deceased and recognising the practical realities of primary care environments. They recognise that GP premises are healthcare environments rather than places intended for the accommodation of deceased individuals.

This document is intended to support general practice and does not replace statutory duties, coronial requirements, ambulance service procedures, police procedures, or professional clinical judgement.

Where a patient becomes unwell within a GP surgery, the first priority is the provision of appropriate clinical assessment and emergency treatment, including summoning emergency services where required. Decisions regarding attempted resuscitation, cessation of resuscitation and verification of death should be undertaken in accordance with professional standards and local procedures.

Following verification of death, responsibility for subsequent arrangements will depend upon the circumstances of the death.

General practices should not ordinarily be expected to arrange transportation of a deceased patient from surgery premises.

Where a death occurs within GP premises and is unexpected, the police will ordinarily be involved in accordance with coronial processes.

Where ambulance services have attended and death has been verified, the ambulance service will notify their control room and appropriate onward referral pathways will be initiated

Where death has occurred before ambulance attendance, or where ambulance attendance is not required, contacting 999 may result in police attendance to support the coronial process.

Where a death falls within the jurisdiction of the coroner, the Coroner’s Service will coordinate the appropriate next steps, including arrangements for removal of the deceased where required.

Practices should take reasonable and proportionate steps to maintain the dignity and privacy of the deceased while awaiting attendance by police, the Coroner’s Service, or their representatives.

It is recognised that GP premises are designed for the delivery of healthcare and are not equipped as mortuary facilities. The physical layout of practices varies considerably and many surgeries will have limited ability to provide complete privacy following a death.

Practices are not expected to have dedicated facilities, specialist equipment, privacy screens, or accommodation specifically designed for the care of the deceased.

Reasonable steps may include restricting access to the area, using available rooms or screens where these already exist, and making local arrangements to minimise unnecessary exposure to patients, relatives and staff. What is reasonable will depend on the circumstances and the facilities available at the individual practice.

Practices should not normally move the deceased following verification of death and should await attendance by the appropriate agencies.

Depending upon clinical safety, staffing levels and available accommodation, practices may need to:

  • restrict access to a clinical room or area
  • redirect patients within the building
  • temporarily rearrange clinical activity
  • temporarily close part of the premises
  • use alternative rooms where this is safe and practical

Decisions should be guided by practicality, dignity and the safe running of the service.

Where available, it may be helpful for practices to have ready access to:

  • next of kin details
  • relevant demographic information
  • a GP summary record
  • details of the circumstances leading to attendance and death verification

The sharing of information should be consistent with legal and professional duties.

The circumstances surrounding certification of death will vary according to the individual case.

Where a Medical Certificate of Cause of Death can appropriately be completed, practices should follow the usual death certification and Medical Examiner processes.

Where there is uncertainty regarding certification requirements or coronial involvement, advice should be sought from the Coroner’s Service in accordance with local arrangements.

Practices are not ordinarily expected to:

  • provide mortuary facilities
  • transport or arrange transport of the deceased
  • move the deceased following verification of death unless specifically advised by the appropriate authorities
  • undertake coronial functions
  • investigate the circumstances of death beyond normal clinical responsibilities
  • provide facilities or equipment specifically intended for the management of deceased persons
  • provide continuous supervision of the deceased beyond reasonable measures required to maintain dignity and privacy

Escalation of concerns

If there are significant delays in attendance, or uncertainty regarding responsibility for the next stage of the process, practices should seek advice from the police, Coroner’s Office, or other relevant attending agency as appropriate.

Practices should also be aware of their regulatory obligations. Where a death occurs while regulated activity is being provided, or where notification is otherwise required, practices should comply with Care Quality Commission notification requirements.

Summary

When a death occurs in GP premises:

  1. Provide appropriate clinical care and emergency response.
  2. Verify death in accordance with professional standards and local procedures.
  3. Initiate appropriate emergency service or police contact where required.
  4. Maintain reasonable dignity and privacy for the deceased within the constraints of the premises.
  5. Support attending agencies with relevant information where available.
  6. Allow police and coronial processes to coordinate subsequent arrangements.

These principles recognise both the need to preserve dignity for the deceased and the practical realities of delivering healthcare within busy general practice premises.

Further Resources

Guidance on Medical Certification of Cause of Death and the Medical Examiner system

West Sussex, Brighton and Hove Coroner Service

East Sussex Coroner Service

GP Mythbuster 21: Statutory notifications to CQC