Thematic report on organ retention

5.1 The pathology service required by COPFS has been procured by a number of contracts negotiated with NHS Boards or Universities in each Federation area. The extent of the provision of pathology services differs between the different pathology service providers and the result is a complex and fragmented provision of services. The provision of pathology services across Scotland broken down by forensic specialisation is set out in Table 2.

Table 2: Pathology Provision in Scotland^[40]

Contractual Provisions

5.2 Each pathology service provider has an individualised contract with COPFS but there are a number of mandatory requirements that apply to all pathology service providers. These include:

• Timescales for the submission of post-mortem reports.
• Provision of forensic pathology on call resource including, when required, conducting post-mortems outwith normal working hours.
• To prepare and present reports on examinations, provide statements and appear as expert witnesses in criminal courts or FAIs.
• All post-mortems to be performed by qualified personnel following best medical practice and in accordance with any guidelines issued by The Royal College of Pathologists and the Scottish Government Justice Department.
• To attend case conferences in homicide cases and/or meet the families to explain their findings.
• Attendance at formal monitoring meetings to be held once per quarter to review performance levels against targets.
• Provision of quarterly and annual management reports to COPFS.
• Where organs and/or tissue blocks and slides require to be retained for further examination in order to reach a diagnosis, this should be made known to the Procurator Fiscal on the same day as performance of the post-mortem.
• To issue the Death Certificate on the same day as performance of the post-mortem.
• Pathologists should take part in COPFS training events.

5.3 Other than imposing a duty to inform the Procurator Fiscal if organs, slides or blocks are retained for further examination on the same date as the post-mortem, the current contractual arrangements do not provide any other obligations relating to organ retention. To reinforce and strengthen procedures, the following amendment and additional provisions should be agreed and included in the pathology providers' contracts.

Recommendation 8

The existing contracts between COPFS and the pathology service providers should be amended:

• To provide a presumption that the death certificate should be issued when the body is released.

The contracts should be revised to include:

• A requirement to provide immediate and written notification to COPFS if an organ is retained beyond the deceased's body being released. (It is envisaged that this will be done by submitting the organ retention form.)
• To provide monthly returns within specified timescales to a nominated contact person/post holder in COPFS specifying details of any organs being held. A physical check should be undertaken each month and reconciled with the information provided by COPFS.
• To dispose of any organs in accordance with a written instruction provided by the Procurator Fiscal.