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6 - Miscellaneous agreed fees

Cremation
Before any cremation can take place there are a series of forms that have to be completed, which are laid down in the Cremation Regulations. Form B must be completed by the registered medical practitioner who attended the deceased during their last illness. Form C must be completed by a registered medical practitioner who is neither a partner nor a relative of the doctor who completed form B. Form F is completed by a doctor appointed by the Home Office as a medical referee who undertakes a final check of the preceding forms. With the introduction of new regulations at the beginning of 2000, medical referees also have to complete form FF regarding the cremation of body parts retained for medico-legal and other purposes. The fees for forms B and C are paid by the funeral director (who will almost invariably pass the cost on to the relatives) and the fees for forms F and FF by the cremation authority.

After completing form B, it is necessary to confirm that no pacemaker or radioactive implant has been left in the body. A separate fee is charged if a doctor has to remove a pacemaker from a body (see Fees guidance schedule 11 section B).

Medical referees at crematoria are paid by local authorities to scrutinise cremation certificates. If not satisfied, medical referees are required to contact the doctors completing certificates B and C and, if necessary, order a necropsy examination. They also have a duty, where appropriate, to refer a case to the coroner.

Important note: From 31 March 2008 medical referee fees for forms F and FF will no longer be negotiated on a national level by the British Medical Association, through the Joint Negotiating Committee (JNC) for Doctors Assisting Local Authorities. The JNC’s decision to no longer uprate fees at a national level is available in a management side circular issued by the JNC. This circular is available on the BMA website under ‘Fees’.

While it is the legal responsibility of local authorities to set a schedule of fees, it is expected that in most cases authorities will wish to agree new fees. Doctors are therefore advised to agree fees for this work, with their local authority. As the fees will no longer be agreed nationally, the BMA will not be publishing them. However, the current (2007) fees still exist until they are replaced at local level and therefore may still be used as a reference point by local authorities.

Both death certification and the cremation regulations are under review by the Home Office following the Shipman case. This may result in changes to the forms and procedures in the near future.

Forms completed by medical attendants (agreed with the National Association of Funeral Directors, NAFD, the National Society of Allied and Independent Funeral Directors, SAIF, and Co-operative Funeralcare)

Effective date: 1 April 2008
Allowances: Mileage at 56.4p per mile

a) Form B - certificate of medical treatment : £71.00
b) Form C - confirmatory medical certificate : £71.00

Note: These fees only apply to funeral directors who are members of NAFD and SAIF. For funeral directors who are not members of either organisation, doctors should negotiate their own fee in advance of doing this work.