Bodies ‘left to decompose at NHS hospitals across England’

Bodies have been left to decompose at NHS hospitals across England, according to reports by inspectors.

Officials from the Human Tissue Authority (HTA) have told how inadequate storage facilities and lack of freezer space means some bodies have been left for too long at unsuitable temperatures.

Official HTA guidance says that bodies should be moved into frozen storage after 30 days in fridges or before, depending on the condition of the body.

However, a series of reports show NHS trusts are not always adhering to these rules and keep bodies for far longer in fridges.

Body showed ‘signs of decomposition’

In one case at Leeds General Infirmary last year, a body had been not moved into frozen storage for 70 days and showed “signs of decomposition and had soiled shrouding”. 

The HTA report said: “The inspection team noted a body that had been in storage for 70 days that had not been placed into frozen storage despite being released by the coroner.

“This body showed signs of decomposition and had soiled shrouding.

“A second body had been in storage for 47 days, had also been the subject of a coroner’s release notification and had not been placed into frozen storage and showed signs of decomposition.”

‘No cleaning schedule for body’

Inspectors also said there was no cleaning schedule for the body store at Leeds General, and “the door from the visitors area to the staff office is not fitted with a lock…This allows potential access to the main mortuary.”

It comes after the publication of an independent inquiry report into the case of David Fuller, who sexually abused the bodies of more than 100 deceased women and children in mortuaries in Kent, called for tighter restrictions on access to the facilities and the introduction of CCTV. 

In 2022 inspectors from the HTA also found major flaws at the Royal Blackburn Hospital after they discovered “two bodies in an advanced state of decomposition as a result of not being moved into frozen storage after 30 days”. 

King’s College Hospital ‘critical’ shortfalls

King’s College Hospital in London had “critical” shortfalls in 2022 with mouldy and infested conditions for body storage.

“At the time of the inspection there were several adult bodies which had been stored in excess of 30 days in the fridge units,” inspectors said.

“Whilst these bodies were subject to regular condition checking, signs of deterioration were present. Bodies required movement to freezer storage to prevent further deterioration however the long-term storage unit was at capacity.”

The John Radcliffe Hospital in Oxford also had inadequate storage space and “identified a number of bodies which had been held in refrigerated storage longer than the recommended 30 days which were beginning to show signs of deterioration”.

The Health Service Journal (HSJ), which first reported on the issue, said it had found at least 10 cases across the country since 2022 where inspectors discovered one or more bodies had started to deteriorate.

Delays in death registrations

More than a quarter of a million people die in NHS hospitals each year. In England, a death has to be registered with councils within five days. While a doctor may often register a cause of death, more complex cases may be referred to a coroner.

In such cases, the registration of a death cannot be completed until the coroner concludes his or her investigations, but experts warn that delays are building up because “over-cautious” doctors were referring more cases – many unnecessarily – to coroners to establish a cause of death.

A post-mortem examination should be carried out as soon as possible, with the NHS stating it should be completed usually within two to three days.

But delays have meant that bodies are held at hospitals for longer – and many hospitals cited a lack of storage space as a reason for them not being transferred to a freezer.

The National Association of Funeral Directors (NAFD) previously told The Telegraph that the “death care sector” was crumbling because of the “snowball effect of delays”.

The trade group said the causes included a shortage of pathologists, an increase in the number of GP referrals to coroners, delays in the coronial system itself and plans to introduce medical examiners had exacerbated “bottlenecks” in a system still reeling from the pandemic.

‘Improved systems in place’

A spokesman for the HTA said the concerns were discovered through its “on-site inspection process”.

“The deceased should be stored at temperatures that preserve their condition and there should be sufficient storage provision and alternatives in place if needed,” he said. “We expect all licensed establishments to be compliant with our standards and ensure the dignity of the deceased is maintained.

“When we find shortfalls we work with establishments to ensure an action plan for improvement is put in place, lessons are learnt and the issue is escalated within the establishment where necessary.”

Many of the hospitals in question said they had improved processes since the inspection’s findings.

Dr Magnus Harrison, chief medical officer at Leeds Teaching Hospitals NHS Trust, said: “Our aim is to provide a safe and dignified service in our mortuaries for people who have died, and unfortunately in this instance, this was not the case.

“We now have improved systems in place including better communication with our coroner and respective partners to ensure this doesn’t happen again.”

A spokesman for King’s College Hospital NHS Foundation Trust said it had “significantly increased the size of our mortuary provision”.

OUH mortuary expanded

An Oxford University Hospitals spokesman said: “We take great care to ensure that our patients are always treated with compassion and dignity, including after death.

“Some deterioration of the deceased is expected in refrigerated storage, even for short periods, and would not normally fulfil criteria for notification under duty of candour guidance.”

He explained that the “usual practice is to transfer deceased to frozen storage if they are to be stored for more than 30 days, though this depends on the condition of the deceased, location and availability of appropriate freezer space, and the likely timing of transfer to funeral directors, for whom receiving the deceased in a frozen state brings additional challenges and could delay a funeral”.

“Freezing itself affects the appearance of a body, and therefore tends to be avoided when the deceased is likely to be moving to a funeral director’s care in the very near future,” he added. “The OUH mortuary has recently been refurbished and expanded to increase its capacity in the context of rising regional and national demand for mortuary facilities.”