1. The Gloucestershire Experience Sally Bye
Meeting the challenge
The Gloucestershire Experience
Sally Bye

2. BACKGROUND ( in 2009)
Gloucestershire merged two jurisdictions into one County Jurisdiction in 2006
Appointed a part-time Coroner
Deaths Registered ~6000
Referrals ~2000
Post Mortem Examinations ~1200
Inquests ~325
Coroner revenue spend £ 1.07M

3. Context NHS facilities not fit for purpose
Clear that they would not be upgrading them
Not their responsibility to provide mortuary
Their usage decreasing and ours increasing
Constructive discussions on options

4. DRIVERS legal :
NHS closing mortuary-gave us notice to leave
Statutory duty on second tier LA to provide mortuary facilities (S.198 Public Health Act 1936)
S.2 Local Government Act 2000-power of well being
Coroners Act 1988-Council to pay expenses

5. DRIVERS financial :
Lack of court accommodation-inappropriate and costly to use hotels
Rising mortuary charges from NHS
Potential for capital costs to be added in the future – long since indicated this may happen

6. NHS Mortuary
Advantages
Don’t have to worry about managing staffing/procuring supplies/managing premises/HTA compliance etc – just get the bill!

7. NHS Mortuary
Disadvantages
Little control over fee charged
Little influence over practices and procedures
Little control of pathology services

8. Public mortuary – LA run Able to manage costs
Able to manage staffing resources
Presents opportunities
Bringing together other services
Use of building bereavement services/training
Different ways of working
Different ways of contracting – funeral directors/ NHS

9. OPTIONS APPRAISAL Do nothing – not an option
Put capital funding into NHS – not an option
Lease an industrial unit – not an option
Build a new mortuary
Build a new mortuary with a court and office accommodation

10. BUILDING THE BUSINESS CASE
OPTION ONE – MORTUARY
£ 4.2M
OPTION TWO – CORONERS COURT COMPLEX
£ 4.6M

11. SEPTEMBER 29TH 2009 GCC CABINET AGREE CAPITAL FUNDING FOR OPTION TWO CORONERS COURT COMPLEX

12. POTENTIAL SAVINGS £315K Mortuary charges from NHS (rising yr on yr)
Officer travel costs £10K
Staff/systems efficiency savings £10K
Court hire costs ~£10K
Office and other premises costs £5K
Income from hiring facilities £25K

13. A Centre of Excellence to deliver Coroner’s services for the bereaved
VISION
A Centre of Excellence to deliver Coroner’s services for the bereaved

14. PROJECT DESIGN Appoint Project Managers – Sally Bye and Maria Boon
Develop fuller design brief with costs
Experts – Coroner, Pathologists, APT and other users
Mortuary advisors
Property services

15. PROJECT TEAMS
User group
Design group
Technical group
HR group (TUPE)
Comms plan
Financial and risk management
ICT group

16. Storage for 60 bodies inc bariatric 5 PM Tables Body viewing
INITIAL DESIGN BRIEF – Mortuary
Storage for 60 bodies inc bariatric
5 PM Tables
Body viewing
Staff facilities
Interview & training rooms
Court room to hold 50 + jury

17. DETAIL DESIGN BRIEF –MORTUARY
Fridges
- 8 Obese and 45 semi-obese
Freezers
5 Obese and 4 semi-obese
Tray transfer system
4 tables in the main area and I table separate area with observation facilities and link to training room via camera

18. WHERE? Design dependant on site Issues to consider : Public access
Public transport and parking
Sustainability GCC green agenda
Funeral directors
Pathologists

19. TIMELINE FOR BUILD
September 2009 funding agreed
December 2009 Kier Moss Build Contractor appointed
April 2010 Planning permission submitted
July 2010 Planning agreed and site secured
July to August 2010 Tendering and contracting
Value engineering – save £500K
September 2010 work starts on site
November 2011 partial commissioning and coroners move in
April 2012 fully commissioned and mortuary opens
October 2012 Judge Thornton officially opened the building

20. OTHER WORK STREAMS
Ongoing research with colleagues around the country (Flax Bourton mortuary)
Restructure of the services – TUPE mortuary staff to GCC, bring all Coroners Officers and admin staff into one office
Consultation and communication with key staff and stakeholders – faith groups, local residents, councillors, funeral directors etc.
Prepare revenue budget
Develop Standard Operating Procedures and Policies
Compliance with HTA
Appoint Centre Manager –Scott Riddell

21. Senior Coroners Officer
Pathologists
Coroner
Head of Service
Centre Manager
Senior APT
Senior Coroners Officer
Coroners Officers
APT Team
Admin team

22. BODY REMOVAL OPEN ALL HOURS - how to staff it?
OPEN OFFICE HOURS – how do funeral directors access mortuary?

23. PAY BACK Actual cost £4.1m Annual savings £370K ~ 11 years
Already saved more than anticipated
Income not explored yet
Improved quality of service to the public

24. LESSONS FROM THE PROJECT
Have a clear vision and get a mandate to proceed – comes from your business case
Research as many relevant projects as you can
Consult with users and experts
Listen but make decisions based on the long term – tray transfer
Team Work-trust and confidence in each other to challenge decisions

25. Benefits so far Managing costs for the mortuary
Cost of mortuary supplies reduced
Reduced APT from 6fte to 3fte
Manage costs for coroners service
Coroner has reduced histology costs
New removal of bodies contract in place
Reviewing systems and processes
Managing staffing resources
Saving of 0.5fte Coroner officer post

26. Benefits so far Improved service for the bereaved
One place with all services
More inquests dealt with
Opportunity to learn from other members of the team
SLA agreement with NHS to provide body storage and mortuary facilities
SLA with Flax Bourton to provide emergency back up