Written Evidence from Dr James Adeley: Senior Coroner for Lancashire and Blackburn with Darwen Summary This Submission Deals

Written evidence from Dr James Adeley: Senior Coroner for Lancashire and Blackburn with Darwen

Summary

This submission deals only with unevenness of Coroners' Services in England and Wales and comprises the following:

 Lack of usable statistics  Local Authorities' relationships with their coroner  Local failures-why not also ask about successes?  The case for a National Coroner's Service  Appendix 1: Messages of Thanks  Appendix 2: Views of Local Faith Groups  Appendix 3: NHS Acute Trusts

Lack of usable statistics

One of the principal causes of the unevenness of Coroner's Services is that it is extremely difficult to benchmark one Coroner Area against another. The Annual Coroner Statistics are calculated using the basis of deaths reported to each Coroner Area. Consequently, if there is unusual reporting of deaths in a Coroner Area, this can markedly alter the statistics for a Coroner Area. The number of deaths reported to a coroner is a principal determining factor in whether or not the coroner is full-time or part-time.

To illustrate the point that basing statistics on deaths reported to the coroner produces misleading results, the following are figures taken from the MOJ 2019 report:

2019 Reported Post Mortems PMs as a % of Inquests Inquests as a Deaths deaths % of death reported reported Area A 3586 1824 51% 641 13% Area B 6755 1691 25% 432 6% Area C 2089 814 39% 282 13%

Using the above figures a local authority cannot benchmark against another coroner area. A local authority has no idea whether the population of Area A is greater or smaller than the other two areas. It is only when the figures recalculated and based upon on the population with in a Coroner Area that a very different picture appears as follows:

2019 Reported Post Mortems Intentionally Inquests per Population Deaths per per 100k blank 100k size 100k population population population Area A 287 145 51 1.25M Area B 587 147 37 1.15M Area C 329 128 44 0.63m It appears that Coroner A may be undertaking too many inquests but for uncertain reasons. Coroner B has a significantly higher number of deaths reported to the coroner than in the other two jurisdictions. Coroner B's relatively lower numbers of post-mortems and inquests could indicate that these additional deaths require and only administrative action by the coroner signing a single form. This would be of interest to both the coroner and the Local authority as were local doctors to be trained according to the Chief Coroner's guidance on referrals, it is possible that the coroner's workload may be reduced along with the local authority's costs base. Rebasing the figures on a population basis allows local authorities to benchmark the service against other coroner areas on a level playing field. This would also assist with those local authorities that under fund their coroner being able to increase funding and for those that are profligate with the public purse to address budgetary issues. This would allow local authorities to assess their local needs and address these appropriately without the expense, bureaucracy and inconvenience of a National Coroner's Service. Objections have been raised to this approach on the basis of a fluctuating population, for instance where a coroner area has an influx of commuters. However, people do not come into existence during rush hour and one coroner's gain is another coroner's loss. It is the static population in prisons, hospitals, mental health institutions and those receiving care that produce the coroner's workload and the complex inquests. The Office for National Statistics has extensive figures on populations and would be able to assist in such an exercise.

Local Authorities' relationships with their coroner

The Chief Coroner in his training has highlighted the triangle of principal stakeholder relationships to run a successful Coroner Area is being the Local Authority, the local police force and the Coroner. None of the training delivered to date has required the local authority, local police force and the coroner to attend at the same time on how to achieve their goals.

Local Authorities have particular skill sets that make them substantially better at undertaking certain activities than the coroner. However, from anecdotal conversations with other coroners, the local authority's involvement with a Coroner's Service varies from fully integrated involvement to occasional contact, usually to provide the local authority with reassurance. The Local Authority could either undertake or be involved with certain tasks for, which they are best suited, as follows:

- Management, annual performance reviews, disciplinary processes concerning local authority staff - liaising with the local constabulary regarding coroner's officers - procurement compliance - Service Level Agreements with NHS trusts and toxicology providers - Recruitment - Information Technology, hardware, commissioning of bespoke software products and management of installation - liaising with third-party suppliers - liaising with local acute trusts - liaising with crematoria and crematoria referees - liaising with medical examiners - assisting with political queries from Members - completing the annual return - identification of unusual rises in budget items - liaising with Rota funeral directors - liaising with Muslim Burial Societies - resolving financial disputes between the local authority and stakeholders

As can be seen, each of these tasks is a local task that will be difficult to manage from a National Coroner's Service. It is also obvious that a senior coroner's role is a very different proposition to judicial officers in the Court and Tribunal Service requiring significant management expertise, strategic planning and interpersonal skills. Greater involvement of the local authority in a service delivered to bereaved local families would provide them with a greater understanding of a coroner's service: likewise, the coroner being involved in budgetary compliance, procurement compliance and internal local authority stakeholder interests would assist in achieving demonstrable value for money. The division of tasks and cooperative working arrangements set out above have allowed an annual budget reduction in the jurisdiction of Lancashire and Blackburn with Darwen from £3.5 million to £2.7 million over three years with an increased level of service.

The Guidance from the Chief Coroner on a Model Jurisdiction might be expected to produce equality between jurisdictions. Anecdotal evidence would not suggest this was the case and may be accounted for as there appears to be no LGA representative or Police representative in the Chief Coroner's Office whose responsibility it is to ensure these tasks are completed.

Local Failures? - Why not also ask about successes?

The Parliamentary Committee's call for evidence in respect of the "unevenness of Coroners (sic) services, including local failures" is pejorative. A fairer question when considering unevenness would also have included successes. I am unaware of any local failures in my Coroner Area that are of sufficient size to interest a Parliamentary Committee. However, the Committee may wish to be aware of the following successes generated at a local level with no national input:

1. Fully Integrated NHS post-mortem scanning

Post-mortem examinations are carried out on the instructions of a coroner to establish a cause of death which, in most cases, is on the balance of probabilities. Each coroner will order whatever post- mortem they consider best meets the needs of their enquiry/investigation depending on the resources available. It is important to understand the different types of post-mortem that a coroner can order.

An invasive post-mortem involves the following:

 An incision from the neck to the pubic bone opening both thoracic and abdominal cavities;  Removal of all organs from the thoracic and abdominal cavities from the back of the throat to the anus;  The pulling forward of the scalp, removal of the vault of the skull and extraction of the brain;  Examination and dissection of all organs and the brain; and  Replacing the dissected organs in a plastic bag in the abdominal cavity and reconstruction of the body

This causes substantial distress to all families particularly those of the Muslim and Jewish faith who regard a deceased person as a holy object. In 2016 Lancashire County Council, a private scanning company and Lancashire Teaching Hospitals NHS Trust cooperated to produce the first scanning service fully integrated into an NHS trust. The CT scanner is owned by the private scanning company who also organises the logistics of transfer of deceased persons to the state-of-the-art CT scanner centrally placed in Lancashire in Preston. The NHS Trust employs all the mortuary staff, radiographers and radiologists. Due to the shortage of histopathologists willing to undertake post- mortems, senior mortuary staff who have undergone intensive training by a Home Office pathologist undertake external body examination. To ensure standards are met, a consultant histopathologist audited the mortuary staff's performance and remains involved should an additional opinion be sought. In the first 12 months, the senior mortuary staff detected three murders that on subsequent investigation led to the three perpetrators being jailed.

Post mortem CT scanning in this Coroner Area is the principal method of investigation of unexplained death and is free at point of delivery to all families. The technique used is termed an "enhanced scan" in which specially trained mortuary staff place firstly, a small catheter to inject radiological dye into the coronary arteries (in a similar fashion to coronary angiography performed in living patients) and secondly, a small breathing tube into the trachea to ventilate the lungs. The diagnostic rate achieved using this technique is in excess of 93% over 3600 scans performed since April 2018 and Lancashire and Blackburn with Darwen performs more scans than any other Coroner Area in England and Wales. After the scan, the small incisions are repaired leaving the body largely unmarked. Bereaved families appreciate and are greatly reassured by this minimally invasive technique.

The maximum number of PMCT scans performed in a 24-hour period is 18, considerably more than could be performed using traditional invasive pathology and the reports are usually available within 24 hours. This combination of up-skilling senior mortuary staff and radiologists providing the cause of death, just as they would provide a diagnosis in the living, has returned NHS consultant histopathologists, whose skill set are in short supply, to treating the living. The financial cost of PMCT is often raised as an objection to its wider adoption by coroners. Lancashire Teaching Hospitals NHS Trust quantified the cost of traditional pathology services before moving to PMCT scanning. On this like-for-like basis, PMCT scanning is marginally less expensive.

This is the only Coroner Area working in England and Wales in this fashion. The question is often put "if it's so good, why isn't everyone doing it?" Just try doing it and find out how difficult it is to achieve. Was it worth it? Ask yourself this, if it was your mother/brother/grandparent, who had just died, would you rather have them have an invasive post-mortem or be scanned?

2. Heart Valve Donation

England and Wales require heart valves from deceased donors in order to undertake operations on the living. As a result of the above CT scanning initiative, working with the NHS Blood and Transplant Service and a local trust, a service to expedite donors of heart valves through the Coroner's Service has been developed. It is expected that this will meet a significant proportion of the need for heart valve donation in England and Wales.

3. Full digitisation of all documentary procedures and storage

Lancashire and Blackburn with Darwen Coroner Area is required to gather large amounts of personal data concerning deceased persons and living persons. This data is used both to enquire into a death and to produce any documentation necessary to allow the cremation or burial to occur.

Cooperation between the local authorities, Lancashire Constabulary and the Coroner allowed the data gathered by the police in the initial Death Report Form to be digitally transferred directly into the Coroner Area's database and from there to the Registrars of Births and Deaths without any additional data input or paper being involved. In faith deaths, this allows rapid transfer of information and documentation.

No paper files exist in the Coroner Area for Coroner's investigations and all information is held digitally on the system. Disclosure of large bundles of documentation is by secure download removing the need for copying and couriers. All storage of coroner files is held electronically and, prior to Covid 19, large inquests held in the Preston Coroner's Court produced all documents on screens within court.

4. Merger of Coroner Areas

In 2017 three Coroner Areas in Lancashire were merged together to produce an enlarged coroner area serving 1.2-1.3 million souls. The merger was entirely successful and carried out to the satisfaction of local communities and local councillors who were initially sceptical. This is introduced standardisation of procedures across a large area, reduced unnecessary referrals to the Coroner's Service and empowered doctors to issue Medical Certificates as to Cause of Death where appropriate.

5. Financial savings

The above changes, renegotiation of SLAs, renegotiation of toxicology contracts et cetera has produced a reduction in the annual coroner's budget from £3 .7 million to £2.5 million and arguably has produced a better service for bereaved families.

6. Service to Bereaved Families

A Coroner's Service producing over 3500 bespoke products each year will have the odd complaint and make the odd mistake. I answer each complaint and either offer an apology or an explanation. However, the messages of thanks dwarf the complaints. A few of these messages received over the last six months that were readily to hand have been included at Appendix 1

7. Local Stakeholder Partnerships

The Coroner's Service has actively engaged local stakeholders. The Muslim communities in Preston Blackburn and Burnley were asked to establish a Muslim Burial Service of community elected members who would serve as the point of contact with the Coroner's Service, mortuary and Registrars. This has produced a streamlined service and the views of the faith community are included at Appendix 2. Letters from Medical Directors of acute NHS Trusts are included at Appendix 3.

The Lancashire and Blackburn with Darwen coroner area has for prisons and a high number of prison deaths due to the cohort of prisoners detained. Deaths in state custody have particular concerns for both families as these occur behind closed doors. An initiative between the Coroner, National Offender Management Service, Lancashire Constabulary, the four prisons and the healthcare providers has resulted in the development of a death investigation protocol that prevents duplication of effort, ensures all evidence is effectively gathered at the time of the event, attempts to ensure that prison officers are given a fair opportunity to explain their actions when events are fresh in their memories and reduces the stress to all stakeholders involved. This will be brought into effect in the last quarter of 2020. Letters reflecting the stakeholder engagement could have been included as Appendix 4, but such documents would only further illustrate the essential requirement of local stakeholder engagement.

The case for a National Coroner's Service When the members of the Parliamentary Committee consider the needs of local bereaved families, they may wish to consider whether centralisation in London of resource, bureaucracy and lack of local knowledge would have assisted in developing any of the above locally derived projects.

When there are failings in the Coroners' Service, it is easy for central government to blame local institutions and remove power from them. This results in the local institutions being weakened and less able to deal with the next crisis. Britain is already one of the most centralised governments with local government raising less than 10% of its revenues compared with an average of 33% across members of the OECD club of rich nations. Such centralisation probably exacerbates inequality with resources being focused on the rich centre, creates alienation in the regions and runs contrary to the Prime Minister's stated aims of levelling up Britain. Centralisation is no guarantee of either quality, knowledge or innovation but will certainly introduce enhanced bureaucracy and delay. When regional resilience is advanced for mass fatalities, which engage all the same relationships, it is difficult to see why centralisation in a National Coroner's Service offers any significant benefit.

Should the Parliamentary Committee wish to ensure an efficient Coroner's Service I would suggest that they focus on ensuring that what is already in place functions efficiently. Initial actions could include the following:

 a full-time Chief Coroner: the Coroner's Service is the only arm of the judiciary led by a part- time appointment;  statistics on each coroner area would allow local authorities to undertake a like for like comparison based on the population served, accurately benchmark against comparable coroner areas and to determine whether or not the financial provision underfunds or over resources their coroner area;  on the basis of such adequate statistics allowing determination of an appropriate level of funding for the coroners service determine whether or not each element of the service delivers value for taxpayers money;  provide guidance on the tasks that a local authority and a constabulary are expected to undertake and ensure stakeholder engagement and compliance;  an overhaul of the archaic, inefficient and costly appointment of Assistant Coroners to one coroner area rather than a pool of Assistant Coroners from which the appropriate skill set can be drawn across the region. Consideration ought to be given to how, within the framework of judges' workers' rights rapidly being developed by the judiciary, an oversupply of Assistant Coroners can be addressed.

In summary, a National Coroner's Service is no answer to the complexities of local service provision to bereaved families. However, in a limited form addressing the issues of usable statistics, appropriate funding by local authorities and guidelines for the roles of local authorities and police forces that are appropriately enforced, it may provide the underpinnings for a modern Coroner's Service.

August 2020

Appendix 1: Messages of Thanks

Thank you Messages of the last six months (at least the ones the coroner's officers could easily lay their hands on)

Hi Jennifer Thank you for the record document & for all the help provided over the duration of this case & especially this week.

Both you and Coroner Galloway made a rather daunting experience less stressful, as a Family we'd like to thank both of you for the patience given whilst I navigated this rather alien environment on behalf of Family unable to face this.

My family all agreed on the findings of the hearing after I spoke with them last night explaining the series of events leading up to Docs passing and we thank Coroner Galloway for giving us the opportunity of the wider review which gave us the platform to see documentation & raise our concerns . many thanks

Hi Deborah,

I got an email back this morning regarding the Inquest for our brother and they'll be issuing a death certificate in the next few days.

But my main reason for emailing was that I just wanted to drop you an email to say a huge THANK YOU - you've been a massive help over the last couple of months, taking all my calls and answering all my many emails! Thank you so much, you're genuinely one of a kind!

Thanks

Hi Darren.

I just want to say a massive thank you for your assistance, during this sad time.

Jamie's service was on Monday, and it summed up Jamie's persona beautifully.

I must say that you must have one of the most difficult job, but you handle yourself in a very professional manner.

Once again thank you.

M Mr Newman and Claire thank you both very much for the kindness you showed me and my family. I feel you handle the information surrounding David's death with sensitivity and discretion, for which I'm very grateful. I also appreciate the effort you went to in highlighting the areas where care fell short. I realise your hands were tied by the limitations of this system.

I wish you both the very best

Debbie, thanks I didn’t think they would given the circumstances. Thank you for all your help and the professional manner you helped us through this difficult time Sheila and all her family very much appreciated the help.

S, S and family Thank you my lovely. I would much appreciate you sending me a copy of the inquest if that's okay. Again I would like to thank you, which seems pitiful after everything you've done for me, but nonetheless thank you so much. You have gone above and beyond in helping me sort things out. You've done it with empathy and caring whilst being professional. I would have struggled through this without you. You are, without a doubt, a true credit to the coroner's office. Thank you. Thank you. Thank you.

Regards

Good Afternoon, please can I express my sincere gratitude for your help throughout mum's inquest. He made us feel so at ease today during one of the worst experiences of our lives. Please also thank the coroner for his professionalism and understanding and I appreciated him adding a personal touch are not treating mum like another statistic. Thank you

Dear Deborah, thank you for answering my several questions, which has greatly helped me to understand the situation and I am sorry you have had to deal with such a mess. I have been in touch with Hayley who's been most helpful in getting me to people who can deal with other aspects of the death of my brother. Again my thanks for your professionalism which I am most grateful.

With all regards, yours sincerely,

T B

We did really want to thank you for the help and support you have given, we were all a bit upset in court and I didn’t really get chance. So thanks again for all your help with this, your kind and friendly manner has made a horrible process that bit easier. I also really appreciated the coroner making it brief and to the point, so the press did not get too many details, and if you could pass on my thanks to Simon Jones for this kindness and for his professionalism, I'd appreciate it. It must be such a difficult job dealing with bereaved families every day, when you are grieving you are raw and looking to blame or get angry at someone, it’s such a delicate situation. I want you to know what a valuable job you do and how much it made a difference to me and my family that you did it so well at a time when we really needed it.

Mark/Alice,

Just wanted to let you know S**’s body has been repatriated. He was put on an Air India cargo flight to Mumbai this morning from Heathrow Airport. As you can appreciate, this was a very difficult task in the current situation due to restrictions and lockdowns, however, a number of individuals came together and made it happen. Alice – I understand you are very busy as it is and this case created a lot more work for you with lots of emails and phone calls, but the feedback I have received has been very positive from those that spoke to you.

Kind regards

Thank you for the information and for your empathetic professionalism today Debbie.

Kind regards

R R

Dear Fiona,

I'm just sending you a quick note to say thank you very much for your support and handling of the Paula Rose case over the past month. You and your team show great professionalism and sensitivity handling what are traumatic situations for those of us dealing with such tragic circumstances.

You've made a difference, helped me enormously and that is greatly appreciated.

Many thanks and regards

D R

Hi Deborah,

It was nice to meet you today. I just wanted to thank your behalf of the family for all that you have done in the lead up to today's Inquest and for keeping us informed at all stages. We really appreciate it. I think I speak on behalf of us all when I say that today's inquest has really helped to give us closure on the sad circumstances surrounding M's death and it was helpful to be given the opportunity to raise our concerns directly with the Trust.

Many thanks again, best wishes

J W

Alice,

Many thanks for your help with this and today's proceedings. I thought you have been first class going through what is required and leading me through what is likely to happen. I am certain some Police Officers think they know it all but I always like to ask and know rather than get stung. Your involvement made my job a lot easier today, as I knew what to expect. Please also pass on my thanks to Richard for equally making me feel at ease and explaining the process.

I am sure the family were also impressed in what are difficult circumstances for them.

Please pass this on to your line manager if you wish.

Best Wishes and thanks again,

M (police officer) Dear Deborah thank you for your email about my brother's inquest. I'm so relieved that it's all been finalised! I would like to thank you for all the work you have done regarding my brother in such an efficient way and I wish you well in the future.

With very best wishes

From a juror: thank you for being understanding and so kind to me. You are all

Debbie,

I just wanted to say thank you, thank you for getting back to me and letting me know about my dad. Means a great deal being so far away.

Your work is priceless.

I must take this opportunity to bring to your attention, although I expect that you already know, the wonderful person that you have in your office called Lesley. Throughout this whole case she has handled everything in an extremely professional and friendly manner. I have felt totally at ease talking with her and although I have never met her, it is like talking with an old friend, and I thank her most sincerely. She is wonderful and an asset to the Coroners Office, though like I say, you probably know that already.

Many thanks for your time and the kind and empathetic way Karen has dealt with me during such a sad time for the family.

S R

Appendix 2: Views of Local Faith Groups

To Whom it May Concern

Dear Dr Adeley,

I have recently come to learn that a Parliamentary Committee has been set up to consider whether or not a 'National Coroner's Service' should be created. I do not believe that creating a National Coroner's Office will be in the interest of the local community, especially when 'Faith Deaths' occur. Over a number of years now, in my capacity as a Mosque Committee member and a Community Welfare Officer, I have come to realise that Local Coroner Services serve a vital role for local communities in dealing with deaths within a timely and efficient manner. As a member of the Muslim Community in Lancaster, having been involved with Death and Bereavement & Burial departments, I believe creating a Central Coroner's Service to deal with local concerns pertaining to Death & Burial would be a step backwards, whilst a local Coroner would be better suited to be involved.

Over the past few years, during my time serving the Muslim Community of Lancaster and South Cumbria, I have had much contact with the Registration Office and Superintendent Registrar; Susan Walsh at Lancashire County Council based in Preston. Due to the nature of matters, I have also developed a very positive relationship with the local Coroner's office based in Preston. I have had regular meetings with Dr. Adeley, the Senior Coroner and his staff. They have kindly given me the opportunity to discuss issues and Protocols when dealing with Faith Deaths and religious practices e.g. the urgency of carrying out funerals without delay in line with religious guidelines.

I am deeply humbled to mention to anyone that the Senior Coroner, Dr James Adeley and his team have an excellent understanding of matters pertaining to Faith deaths. They have been working together with other local faith organisations, and have implemented a system whereby it is even possible to obtain the services of the Coroner and Registrars on Weekends and Bank Holidays. We, the community of Lancaster, deeply appreciate this local service which I doubt would continue to exist with the current efficiency, if the Coroner Service became a Nationally based one. I have nothing but praise and as an individual dealing with these departments on a regular basis, I cannot convey enough thanks or compliments for the exceptional service, cooperation, and dedication with which Yourself and Your team have served the community of Lancaster. Whenever possible, to speed up and to establish a Cause of Death, the Coroner's office have opted to use the CT Scanner to identify the cause of death as opposed to the invasive traditional Post Mortem

I hope that the Parliamentary Committee can realise that the benefits outweigh the negatives, if any, and recognise the crucial services that the Local Coroner's offices provide.

Yours sincerely

S A Master

To Whom it May Concern

Dear Dr. Adeley,

I hope you, your family and your team are all in the best of health during these unusual times that we live in. I understand that a Parliamentary Committee has recently been established to consider whether or not a 'National Coroner's Service' should be created. I believe as a result of creating such a National organisation, one of the critical consequences would lead to the removal of local Coroner's Services, 'up and down' the country. Over the years, I have observed that in the 'eyes' of the community, Local Coroner Services serve a Crucially Important role for all local communities, in dealing with deaths, in a timely and efficient manner. As a member of the Muslim Community in Preston, being involved in the Education, Welfare and especially with the Death, Bereavement & Burial aspect of things for the last 30 years, I believe creating a Central Coroner's Service, hundreds of miles away, trying to deal with unique, local issues and challenges, would really disrupt the way that deaths of such a nature, where a Coroner is required to be involved, are processed.

Over the years, the Muslim Community here in Preston has developed a wonderful working relationship with the Coroner's office. As we are well aware, due to your great efforts and the efforts of your dedicated team, we have had regular dialogue and have been given the opportunity to inform and educate yourself and your team members of the religious relevance and the urgency of carrying out funerals without delay. I am very honoured to say to anyone that the Senior Coroner, Dr. James Adeley and his team have a very good understanding of matters pertaining to Faith deaths. In fact, I would go as far as saying that they should be taken as an example for all other authorities. Working together, we have put in place a system whereby it is possible to obtain Coroner and Registry services over the Weekend and Bank Holidays. We greatly appreciate and respect this local service which would not be replicated if the Coroner Service became a nationally based one.

I have nothing but kind words and compliments for the Level of Service, Professionalism, Co - operation, Quick Turnaround in processing deaths, Sensivity and Empathy with which Yourself and Your whole Team have accommodated, are accommodating and hopefully continue to serve the wider Community of Preston.

I say this not Just as a member of the Muslim faith. Only yesterday, the Hindu Faith Representative in Preston was overwhelmed with the efficiency of service offered to their community by the Local Coroner's office, in processing a death. In Preston, all the different communities work very well with each other and with the relevant authorities. The Hindu faith representative, despite there being a death of a gentleman belonging to the Hindu faith, contacted me with a rather urgent dilemma. A gentleman from the Hindu faith, residing in Preston had been in hospital for a couple of weeks with Respiratory issues, suffering from Pneumonia and then as his health improved sufficiently, he had been discharged with medication. Four days later, he collapsed at home and sadly passed away. As it was an unexpected death, as per protocol, the death was referred to the Coroner's office. Now on the one side, the family was very anxious and panicking because similar to the Muslim faith, they also on religious grounds, have an urgency to carry out the funeral, yet the Coroner's office, equally importantly needed to establish and be satisfied with the Cause of Death.

The Coroner's office had very kindly opted for a Non - Invasive CT Scan option to speed up the process but due to some other priority at the hospital, there was a postponement of possibly another week, this caused the family of the deceased to panic and become rather distressed.

For anyone unaware, working with the local NHS Trust hospitals, the Muslim community in Preston and Lancaster managed to collectively raise something in the region of £70,000 to help with the cost of acquiring a CT Scanner to be used by All Communities in Preston, to speed up and aid the Coroner's office with establishing a Cause of Death as opposed to the lengthy traditional Post Mortem / Autopsy. So the Hindu Faith representative contacted me through the Muslim Faith Representative of Preston as she was unaware of the process involved and the possible delays and complications.

I, in turn contacted your office Dr. Adeley and credit to your staff, they very effeciently, without any delay on their part, as always, processed the paperwork and informed me that the Coroner's office was satisfied with the results of the medical information they had received from the hospital and had now closed the case. Within minutes, your office had forwarded the paperwork to the appropriate Funeral Director involved and the Registry office. To me this demonstrates such professionalism and empathy on the part of your staff, which I doubt that this approach would be replicated if the Coroner's office was to move away from being a 'local entity'. The way in which this death was dealt with by the Local Coroner's office relieved the grieving Hindu family of some of their burden and left them with a very positive experience.

We, as a community, have always been able to sit down and raise any concerns with the Coroner. You have always to endeavoured to make yourself available to serve the needs of the community. The way in which 'Faith Deaths' are processed by your office, in a timely, efficient manner, with the sensitivity of the grieving families in mind, is a benchmark standard, which we in the Muslim community Do Not feel will be maintained or even replicated if the Local Coroner's Office is eliminated.

I sincerely hope that the Parliamentary Committee can see the many Benefits and Crucial service that Local Coroner's offices provide. I would deeply appreciate it if there is some way for you to convey this message to the relevant Parliamentary Committee.

May the Almighty take care of you.

Yours sincerely,

Zuber Isap (Zubes)

To Whom It May Concern, Muslim Burial Societies up and down the country serve a Muslim population of approximately 2.5 million people (circa 5% of UK population). Preston Muslim Burial Society has been in operation for over half a century and services a Muslim population in the region of 20,000 people. All of our Muslim Burial Societies around the country are based on the following key principal :- “Funerals in Islam follow fairly specific rites, though they are subject to regional interpretation and variation in custom. In all cases, however, Islamic religious law, calls for burial of the body as soon as possible, based on the saying of our beloved Prophet, peace be upon him, "Hasten the funeral rites." This is done to respect the dignity and privacy of the deceased. Thus, it is not permissible for Muslims to delay the burial in order for the maximum number of relatives to see the deceased, as is common practice among other communities. The practical implementation of this, is that once death is evident, and once all the statutory obligations are fulfilled, the body is prepared and taken out of the house/mortuary for ritual bathing, shrouding, prayer and burial as soon as possible. In this way, contact with the dead body is minimized, which keeps the grief and hurt of seeing the dead down to a minimum. “ Taking the above into consideration, we are very strongly opposed to the regional Coroner’s office being replaced by a national, centralised system. At the moment, over 95% of deaths that occur before 12 noon are buried on the same day. One of the key factors by which we have achieved this, is that we are able to work with our regional office closely, and have built up relationships over time. Over the years, many, many burials would have been delayed, had it not been for the determination of our regional coroner and his officers, by being flexible and responsive, to help facilitate burials in line with the needs and wishes of the community. To give one example of this, our chairman mentions of a funeral where he agreed to meet the coroner half way on the A59 on a Saturday, so that the relevant documentation can be signed and handed over to enable the booking of a burial slot at the cemetery, just before the cut-off time for bookings was to end, which would have meant a delay of the burial of 3 days due to a bank holiday weekend. There are countless other less dramatic examples, mainly administrative in nature, that had it not been for a regional office relationship which is accessible in person, burials would not have been able to take place without delays. This can never be replicated on a nationalised model.

As a community, we very much appreciate the other services offered, including the availability of CT scanning instead of traditional post-mortems, and that is why the Preston mosques have donated approximately £70,000 to the local NHS Trust for additional body storage to assist with scanning, and also regularly donate to causes that benefit every community.

Appendix 1: Acute NHS Trusts