Experiences of West Midland Funeral Directors in arranging for GPs to complete Cremation Form 4

Background
When someone dies in the community, the registered General Practitioner (GP) must physically examine the deceased and complete Cremation Form 4 to allow a cremation. This work is not paid for by the NHS and may come second to increasing NHS workload. Financial cost is often a factor for families in choice of Funeral Director, leading to potential difficulties when the GP is located some distance from the Funeral Home. The Funeral Director acts as an intermediary in arranging for the GP to complete the cremation paperwork to enable cremation, yet their role has been understudied.

Methods
We interviewed seven Funeral Directors from the West Midlands using semi-structured interviews to collect qualitative data. Participants were recruited by email and five were interviewed face-to-face and two by email. Thematic analysis was conducted on interview transcripts using NVivo v.10.

Results
Participants told us of the consequences the current system has and its impact on GPs, Funeral Directors and the bereaved. Participants reported that GPs were sometimes too busy to attend to complete Cremation Form 4 in good time, leading to delays to funeral plans. It was reported that Funeral Directors had to act to facilitate the physical examination, sometimes by moving the deceased. Funeral Directors reported considerable distress from the bereaved when they became aware of this. COVID-19 has led to changes to the administration of the deceased and we hope this work will increase our knowledge of this area.

Key Messages

This research highlights a conflict between the duty the GP has to their living and deceased patients and the way the cremation paperwork system fails to work effectively for families in the experience of the Funeral Directors we interviewed.