Poor form filling makes medical referees essential

EDITOR—I was one of the medical referees who received and completed Horner's questionnaire on cremation forms as part of the BMA survey in June 1997.1 I was interested to learn that only 21% of cremation certificates presented to Horner were complete, and this prompted me to survey the forms presented to me in Chesterfield.

From September 1997 I looked at 1000 consecutive sets of papers presented to me for authorisation of cremation. At the same time as starting the survey I produced a handout giving guidance on how to complete certificates B (completed by the attending doctor) and C (confirmatory certificate from independent doctor of 5 years' standing), which was distributed to all junior doctors at Chesterfield and North Derbyshire Royal Hospital. The table shows the papers received and numbers requiring intervention. Ninety seven forms had incomplete or incorrect details of name, address, or age; 64 had incomplete or incorrect details of pacemakers or radioactive implants; 39 required investigation of medical details; in 29 the patient had not been seen within 14 days of death; 24 had discrepancies in date, time, or place of death; 22 did not state whether the coroner was informed of the death; and …