NHS Quality Improvement Scotland was established as a Special Health Board on 1st January 2003. It was formed by integrating five existing clinical effectiveness organisations, one being The Clinical Standards Board for Scotland (CSBS). Its purpose is to improve the quality of healthcare in Scotland by setting standards and monitoring performance, and by providing NHS Scotland with advice, guidance and support on effective clinical practice and service improvements.

Part of its remit was the Development of The Standards for the Management of Post-Mortem Examinations.

Background
A review of post-mortem examination practices in Scotland, particularly in relation to organ retention and documentation on consent and guidance, was recommended by the Scottish Executive in response to strong public concern surrounding past practice.

The Independent review Group on the Retention of Organs at Post-Mortem, chaired by Professor Sheila McLean, was established in September 2000. One of its recommendations after publishing it's first report in January 2001 was that the Clinical Standards Board for Scotland should be encouraged to incorporate a standard relating to the post-mortem examination process in its generic standards as the most effective way of monitoring implementation of our Code of Practice for hospital post-mortem examinations.

A project group was formed to take this forward. The remit of the Project group for the Management of Post-mortem examinations was to:

Develop robust standards for the following in relation to the management of post-mortem examinations:
- Pathology Practice - Hospital Post-Mortem Examinations
- Authorisation and Information
- Storage, Handling and Disposal
- Record-keeping
- Education

Recommend a review process; and
Provide a baseline report.

Draft standards were published in March 2002 and two open meetings were held in Glasgow and Dunblane in April 2002. These were followed by two pilot visits, to test the measurability of the standards, in May 2002. The process has taken a number of months to complete but the standards are now in place.

The standards aim is to ensure clear, consistent standards across all aspects pf post-mortem care, which will have the confidence of both the public and the healthcare professionals. Reviewers are now visiting trusts in Scotland.

NHS Health Quality: Management of post-mortem examinations

Ali Anderson
AAPT (UK) Council