In part two of SAIFInsight’s review of COVID-19’s impact on our sector, we look at what lessons were learned by the Deceased Management Advisory Group. Click here for part 1.
This overview, taken from the Deceased Management Advisory Group’s (DMAG) report, illustrates the breadth of the challenges and importance of the solutions DMAG was involved with.
It was known that the pandemic would result in an unprecedented increase in deaths.
The three key objectives for the sector at this time were:
- Ensuring mortuary capacity was not overwhelmed
- Delivering an increased number of dignified, limited funeral services
- Delivering an increased number of dignified, limited cremations and burials. To achieve the increase in capacity it was necessary to introduce a range of initiatives and radically alter operating procedures. These changes had varying results, and in view of a possible ‘second wave’ this interim paper considers learning which could be applied to enable the sector to deliver a more effective response.
The Government has responsibility to define the framework and culture of the response to the pandemic through legislative changes, sector engagement, communication and implementing the pandemic planning which the sector organisations had contributed to as recently as 2019. It was questioned why the 2007-2009 pandemic planning by the NAFD and SAIF with the Civil Contingencies Unit was not deployed.
Legislative changes and guidance
- Streamlining statutory cremation documentation and enabling registration of deaths via phone; increased capacity and was widely welcomed across the sector
- Closing crematoria, except for funerals, enabled cremation authorities to focus on delivering cremation services Closing cemeteries was also welcomed for the same reasons, however, the original legislation in England was poorly drafted and caused confusion
- Guidance for managing funerals was welcomed throughout the sector. However, the variations between the UK and devolved administrations led to confusion and unnecessary complexity. As did the guidance on social distancing at funerals which varied between those elements held in places of worship and those taking part in cemetery and crematorium chapels.
Overall, the legislative changes were viewed as being extremely supportive to the sector in achieving its objectives; particularly the General Register Office (GRO) introducing fast tracked death registration and certification.
There were some reports of delays by coroners’ offices, which added to storage capacity issues in funeral homes. DMAG asked whether deploying additional resources in any future event could be explored with the Office of the Chief Coroner.
However, it was recognised that if Government had shared its draft proposals with a representative group from the sector before finalising them, the legislation could have been more effective and not required amendment.
- The primary channel for Government to engage with the sector was through the Cabinet Office. The weekly meeting was extremely inclusive, involving representatives of trade organisations, individual companies, Government departments and devolved administrations. While the meetings were informative, the large number attending (approximately 40) and being limited to an hour did not allow for any in depth discussion, exploration of topics or resolution of cross cutting issues.
- The introduction of the Deceased Management Advisory Group (DMAG) provided a sector-wide point of contact for central and devolved governments. The dialogue which developed proved extremely useful for sharing information, exploring issues and inputting into the development of policy. The Group welcomed, and continues to do so, the regular interaction with the various Government departments and devolved administrations at their regular meetings.
- Despite the channels available on occasion, especially at the start of the emergency, it was felt that Government was not taking the opportunity to engage with the sector over specific initiatives, for example, the varied responses from Local Resilience Forums (LRFs) in England and Wales, or the failure to take the lead in coordinating their activities.
- Overall, the engagement through DMAG was extremely productive, enabling both Government and the sector to explore issues, seek solutions and share a wide range of information. It is hoped this will continue in the medium and longer term.
- In addition, DMAG proved to be an early warning system of the prevalence of the virus across the regions and notably occurrences of deaths in care homes 10 days prior to other streams of information being collected by the Government.
The lack of communication over key information, for example death rate modelling, was felt to be a significant issue and remains a concern for preparedness in the sector for a further surge in COVID-19 deaths.
- The introduction of Pandemic Multiagency Response Teams (PMARTs) without any prior discussion or communication was felt to have undermined local funeral directors. No information has been shared justifying why it was necessary to introduce this measure of ‘last resort’, especially as there is evidence that the PMARTS were inadequately trained and led to the delay of some funerals.
- The wide number of Government departments issuing communications and advice relating to the death management sector was confusing.
- The delays in receiving guidance on crucial issues such as PPE usage and coming out of lockdown, and a lack of consultation on the guidance, led to confusion and low levels of confidence among sector colleagues once the guidance was issued. This was further exacerbated by devolved administrations issuing guidance which sometimes differed on fundamental matters, such as the use of body bags.
- Excessive requests for information from LRFs led to survey fatigue and a reluctance from some in the sector to engage.
The desire on the part of Government to communicate was recognised and welcomed. However, it is believed that there should have been a central point in Government clearing and issuing information as it was unclear when it would be issued and which department was dealing with what.
Furthermore, if the sector could have had an input into the development of communication, guidance, and advice, that experienced and expert input would have been a benefit.
The funeral, as a process, is delivered through a partnership of two distinct providers, funeral directors and cemetery and crematoria operators. A significant increase in capacity can only be delivered through both groups of providers co-operating to deliver the agreed outcome.
- The development of DMAG provided a high-level cross sector working group, providing all representatives with valuable insights into each other’s ways of working, issues and solutions.
- The creation of DMAG sent out a strong message of closer working and co-operation across the representative trade bodies. The culture of working more closely together for the benefit of all was one which delivered benefits to all parts of the sector.
- The Group became the first point of contact for central and devolved Governments, and as a small group, focusing on strategic issues worked well.
- DMAG provided a single voice to Government on behalf of the entire sector.
The DMAG website provided a central point for disseminating information to all parts of the sector.
The creation of DMAG has worked well for the benefit of the sector and it is intended to continue beyond the current emergency for the benefit of the sector and, importantly, the bereaved.
The ability to deliver increased capacity requires partnership working between funeral directors and cemetery and crematoria providers. Embracing flexibility and innovation enables new and different ways of working.
Among the changes which have delivered benefits are:
- Regular meetings (weekly) between funeral directors, and cemetery and crematoria operators and suppliers to the industry provided a forum for issues to be discussed and better ways of working explored.
- Service delivery was streamlined through the adoption of electronic working, registration, electronic statutory forms and greater use of digital meetings.
- Closure of places of worship and catering facilities, along with reduced numbers of mourners, shortened the time taken on funerals. As a result, it was possible to increase the number of funerals undertaken during normal working hours.
- It was best to increase funeral capacity incrementally to meet demand in the following order:
- Additional cremation slots Mon-Fri through shortening service times
- Additional early and late slots, outside normal times
- Provision of slots during weekends and bank holidays.
- Families being encouraged to use the ‘out of hours’ times through funeral directors and cemetery and crematoria operators not adding additional charges.
- Encouraging maximum use of crematoria availability through:
- Allowing mourners to attend chapel services, following risk-based assessments. Experience suggested families wished to use crematoria where mourners could attend.
- Streaming and recording of services so those beyond the immediate family could feel involved. (Live streaming can be problematic when there is a high demand for broadband in an area.)
- Promoted availability of slots at different crematoria to encourage families to use facilities with capacity.
While a small number of ‘hotspots’ developed at busy crematoria, the overall response enabled the sector to cope with the increased number of deaths resulting from COVID-19.
Greater clarity on the ‘hotspots’, along with identifying capacity nearby, could have been achieved if a UK-wide, central service availability portal had been available.
The deceased management sector was able to add capacity to meet the demand of the increased death rate, enabling scaled back funerals, burials and cremations to continue in a caring and dignified manner.
To read this report in full, click here.Tags: coronavirus, COVID-19, DMAG, pandemic, SAIF