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Mortuary Managers and Senior APTs study event 21st March 2025 recap

21 March 2025

Discussion item: Fuller Inquiry Phase 1 Implementation

Summary of Key Points from the Fuller Inquiry Phase 1 Implementation Meeting:

1. Security Enhancements:

   • CCTV Implementation: Installed at entry points and fridge doors (not PM tables) to balance security with dignity/legal compliance. Cameras are restricted to avoid capturing sensitive procedures (e.g., forensic PMs).

   • Access Control: Shift from generic to individualized access cards, with audits to remove leavers’ access. Some Trusts restrict access to working hours for non-essential staff (e.g., pathologists, trainees).

2. Audit Processes:

   • Regular audits (daily, weekly, or monthly) of CCTV footage and access logs. Some involve security teams or independent oversight to avoid "marking their own homework."

   • Cross-referencing access logs with CCTV to flag anomalies (e.g., unauthorized entries).

3. Operational Changes:

   • No Lone Working: Staff must work in pairs; porters access mortuaries in pairs and use designated trolleys stored outside the mortuary.

   • Stock Management: Wards and porters maintain their own supplies (e.g., body bags) to minimize unnecessary mortuary entries.

4. Governance & Reporting:

   • Quarterly reports to executive boards to ensure accountability, addressing the Fuller Report’s criticism of poor senior oversight.

   • Some Trusts restructured governance, placing mortuaries under direct oversight of senior roles (e.g., Chief Nurse).

5. Challenges & Concerns:

   • Legal Risks: CCTV in PM rooms must be turned off during forensic procedures to avoid evidence disclosure issues.

   • Staffing: Concerns about underqualified locums managing mortuaries, highlighted as a systemic issue for Phase 2.

   • Regulatory Gaps: Inconsistent governance in non-NHS/public mortuaries and reliance on HTA effectiveness.

6. Future Steps:

   • Phase 2 Focus: Broader regulation of all deceased care settings (e.g., funeral homes, hospices), locum oversight, and HTA reforms.

   • Peer Reviews: Proposed inter-Trust reviews to identify gaps and share best practices.

Key Themes: Improved security protocols, strengthened governance, and the need for systemic reforms to ensure compliance and accountability across all mortuary settings