Fran Hall

Someone needs to say it.

With the heaviest of hearts, today we are going against everything that the Good Funeral Guide has become known for over the years, and calling for funerals to be stopped completely.

Now. Today. Just stop.

The decision to exempt funerals from the current ban on social gatherings was undoubtedly made for compassionate reasons, but the current lack of clear instruction and direction is leading to anguish and suffering beyond imagination.

By allowing funeral ceremonies to continue in some form or other, bereaved people – and all those supporting them – are genuinely risking their health and even their lives by gathering together to try and have a funeral like the ones we are used to, yet in most cases, grieving people are ending up with a funeral that has been pared down to something almost unrecognisable. Almost everything we are familiar with in a funeral ceremony has been stripped away by the attempt to slow the spread of Covid-19. What we are left with is worse than nothing. 

This cannot continue. It’s breaking people’s hearts, hurting family members and friends. It’s confusing everyone. It’s putting lives at risk. It’s making everything impossible for people who are already reeling from shock and grief. Heart-breaking decisions are being asked of people – decisions which are too much to bear. The current situation is not compassionate or kind, it’s devastating and destructive.

We will probably never know the damage that is being done daily to people’s hearts and souls, their emotional and mental wellbeing, their ability to grieve and survive in a newly empty, frightening world. Confusion and uncertainty casts a heavy weight that is doing untold damage to individual people everywhere. Families are being made to choose who can attend and who must stay away. Friends and lifelong companions are being excluded from being present for a ceremony through multiple individual interpretations of the phrase ‘immediate family’. If numbers are drastically limited, someone has to decide who has the most right to be there. It’s unbearable.

Funeral venues and funeral companies are interpreting the new rules in different ways, meaning that, depending on whereabouts you are, you may only be allowed to have 25 – or 20 or 10 or 6 or 4 – people attending a ceremony. Crematorium staff in some places are being required to monitor the numbers of people arriving and restrict entry – one crematorium has stated that the chapel doors will be locked and the police called if more than a certain number of people gather for a funeral. Yet in other crematoria, no restrictions have been imposed. Everywhere is doing things differently.

You may have travelled in a limousine, or the cars you wanted may have been cancelled. You may be asked stay two metres apart outside the chapel while you wait. Or maybe nobody is willing to step in and tell you to stay away from other people gathering there. You may be asked to sit separately inside, or the seating might have been re-arranged to make sure you don’t come into contact with anyone. The coffin may be wheeled into the chapel, not carried. The curtains may have to close around the coffin to prevent anyone from touching the surface. Hymn singing may be discouraged – hymnbooks have been removed from many crematoria. Video-links may or may not work, leaving excluded mourners at home without a connection to those who are attending, unable to see or hear what is happening even remotely. There are licensing issues with music choices being broadcast, even where video links are available. It’s impossible for everyone who is trying to make things work right now.

Funeral ceremonies are where our deepest humanity is called for, to steady and support the faltering broken hearts of people whose worlds have been shattered by the death of a person they love. We show up to be silently present, to demonstrate our love by being there for the final time in the presence of the physical body of the person whose life has ended.

We come together to grieve as a family, a community, a society who stands together to bear witness to the loss of one of our own. We reach out our hands and our arms to comfort and hold each other, we lean on each other for support and safety. We weep together, we rest our heads against familiar loving shoulders and feel the warmth of strong arms holding us upright.

This is what a funeral is.

Now, none of this is possible.

The current confused and confusing situation is dangerous. It’s frightening. It’s unfair on everyone. It has to stop.

If a clear directive came from government that funeral ceremonies must stop now, we are certain that the incredible people who dedicate themselves to supporting bereaved and grieving communities will quickly find new ways of creating ritual and meaning in a safe way. Over the coming weeks we will share thoughts and ideas and ways of commemorating the lives of those who have died without risking the lives and wellbeing of those who survive. We welcome guest posts from anyone who would like us to share their ideas.

But for now, for today, for the foreseeable future, for your sake, for our sake, for the sake of all of us, please, please think the unthinkable.

Unattended burial or cremations are the safest, kindest, simplest way to deal with our dead right now.

Funerals, as we know them, cannot go on.

Fran Hall

Guest post by Jo Williamson from Albany Funerals

BBC Breakfast today (2:22:02)

“I wanted to share this, mainly because it’s the first time I’ve heard or seen anything about funerals on TV since the beginning of the outbreak.

Nothing so far addressing the sheer devastation we face having to explain to recently bereaved people that we can not offer them our usual warmth, our safe and tranquil space to plan something together that would have been exactly what their friend or relative would have loved, the choice of spending time with the person who died at our cosy premises, or the comfort of coming together in sadness and smiles to remember and celebrate their lives. I understand why – it’s too heartbreaking.

However! I wanted to pick up on something the GP says in the clip, about the fact that she understands the dilemma for people with pre-existing medical conditions on whether to attend a funeral because it would be ‘their only chance to say goodbye’… I would like to challenge this!

As funeral directors it has been almost impossible to adapt to this necessary change in the way we do things which goes against every bone in our body – no face to face meetings, social distancing, only 10 people allowed at a service, immediate family only, no contact, no hugs, stripped back ceremonies, unattended cremations and burials.

But we have adapted and so have our amazing customers and this is what I wanted to say – please do not despair. I truly believe that we can still do things properly, we just need to change our perception of what a funeral should be.

Up until now, a funeral was two things together – the laying to rest of the body by cremation or burial, and the memorial aspect – the part where we mourn and come together to honour and celebrate the person, to laugh, to cry, to comfort one another. This virus has forced us to change this but I do believe we can adapt to this situation by understanding that it is maybe not so wrong to separate these two parts. Having had heartbreaking phone conversations with our families about this, their first reaction is total horror, utter devastation and the feeling that they are letting down their loved one in some way. These phone calls have been the most horrific thing we’ve had to do in this job so far. However, and this is really important, talking to them daily, we have realised that actually, in most cases this wears off very quickly.

Actually in most cases there is an element of RELIEF. Relief that at this horrific time of sadness and grief they do not have to rush around organising something they are dreading, that they have a little more time to process what has happened before catapulting themselves into trying, for the most part, to second guess the wishes of that person and make it all happen. The realisation that actually they are probably not in any fit state to even take in the ceremony, remember who was there, what was said, what the flowers or coffin even looked like.

We have been taking to local venues who have wonderful spaces little used during the week that cost less than a crematorium chapel. This is what we need to do, offer the second part of the ‘funeral’ in a few months – each one totally personal, more time, beautiful surroundings. Those families affected will be able to come together in a few months to say goodbye to those they have lost and they may possibly also be a little stronger and more able to cope, finding greater comfort and solace with the passage of time.”

Fran Hall

These are unprecedented times. Across the world, the Covid-19 pandemic sweeps everything before it, heralded by fear and confusion at conflicting government advice, with daily updates of the tens of thousands of people who have become ill, and rising numbers of deaths.

 And while much concern is rightly directed towards the wellbeing of the frontline medical staff battling to support and save the lives of people who are most severely ill, those in the funeral sector are waiting for consistent and clear advice about how to deal with people who have died – who may or may not be carrying the virus.

Currently, there are conflicting official documents relating to handling the bodies of people who have died who have been identified as testing positive for Covid-19, which is now a notifiable disease. (Details of the varying official advice as to levels of PPE required are at the end of this post.)

The guidance we shared from Public Health England in our blog post of March 2nd has now completely changed – something which we find inexplicable given the vast increase in numbers of people who have tested positive in the last two weeks, and the steady increase in the number of deaths.

14 days ago, Public Health England recommended full PPE, the use of a body-bag and disinfecting all external surfaces prior to moving the body of someone who has died who had tested positive for Covid-19.

Now, the official advice is now that ‘there is no requirement for a body-bag and viewing, hygienic preparation, post-mortem and embalming are all permitted’.

At the time of writing, Public Health England are prioritising testing and not testing either people who are symptomatic at home, or those related to a person who has tested positive.

It is, therefore, entirely possible that people who have died at home may have contracted Covid-19 prior to death but not been tested for it. Equally, it is entirely possible that funeral staff will come into close contact with bereaved people who may be carrying the virus when making arrangements for or carrying out a funeral. None of us know whether the virus is spreading among people as yet asymptomatic in our communities. Logic indicates that we should therefore assume that it is.

Until such time as there is consistent official advice to the funeral sector, and given the acceptance by the government that there are likely to be significant numbers of people in the community currently carrying the virus, potentially without displaying symptoms, we feel that we should be erring on the side of caution, particularly given the close exposure funeral staff can have to those in their care.

The Good Funeral Guide would therefore like to make the following suggestions to funeral directors and staff.

  • Assume that everyone in your company, all those in your care, all of the clients you are working with and everyone you encounter during daily activities could be carrying the Covid-19 virus. Put in place as many mitigating procedures as you possibly can.
  • Risk assess your daily operations in the light of this fast-developing situation: Have you got adequate handwashing facilities for staff and visitors? What guidance are you giving staff about handwashing throughout the day? Are they following it? Have you got paper towels? How are they being disposed of? Are you ensuring that all surfaces and handles in your premises are disinfected? What about pens? Cups? Kettles? Have you implemented screening questions when taking a first call to ascertain the level of risk to your collection team? Do you have adequate PPE for staff collecting or handling people who have died? How about body bags? Disinfectant? Hand sanitiser? Are any of your staff members in the potentially most vulnerable groups who are likely to be at most risk from contracting the virus? Or do any staff members have vulnerable family members? How are you minimising their exposure to potential infection? Are you minimising physical contact between staff members and between staff and clients? Are you offering clients the opportunity to make funeral arrangements remotely using email and telephone or video calls rather than physical meetings? What about at funerals? Have you advised staff not to shake hands or physically contact mourners? Are all staff members carrying and using hand sanitiser during the course of the day if they are unable to wash their hands? Are you working closely and communicating clearly with your colleagues to ensure everyone is ok, both physically and mentally? What more can you do?
  • Stay as up to date and informed as possible. The situation is changing minute by minute.
  • Connect with other local funeral companies. Louise Winter, of Poetic Endings, one of the GFG Recommended funeral directors, has set up a support network for London based companies to offer support and resources to each other and to enable a co-ordinated and efficient response to any crisis. Do the same in your area.
  • Plan ahead for the possibility that public gatherings may be prohibited. This move could potentially involve gatherings for funerals – either those where there are large numbers of people, or, in the worst-case scenario, completely. Client expectations will need to be managed sensitively and honestly.
  • Consider recommending that clients use their own cars to travel to funerals rather than offering limousines. Requiring a staff member to drive up to six people in close proximity in a limousine could be seen as asking individuals to undertake an unnecessary risk.
  • Stay in contact with your local crematoria and cemeteries. Some crematoria are already putting restrictions in place such as removing hymn books, prohibiting the carrying of coffins on shoulders and not permitting those who are self-isolating to attend funerals.

We will do our best to relay official advice for the funeral sector on this blog as we access it, however for the time being, common sense dictates that we recommend everyone takes the utmost care to minimise their potential exposure to Covid-19. Vulnerable members of our society need the rest of us to take as much care as we can.

NB Until such time as we consider it safe to do so, the GFG will be carrying out all our business remotely. Accreditation visits will be done using video calls rather than in person, and we will not be attending any conferences or mass gatherings for the foreseeable future.

As everyone should be, we are following the official guidance on hand hygiene, and, because we have highly vulnerable close family members, we are avoiding all unnecessary social contact.

Unprecedented, unknown, unknowable – this is our new normal for now.

 

The current official guidance regarding people who have died who tested positive for Covid-19 can be found in various documents – links below.

(It is worth noting that some local coroners are issuing guidance requiring that all those who die in the community MUST be brought into a mortuary in a body bag, regardless of whether or not funeral directors suspect the person has had Coronavirus. We have seen copies of these communications.)

The Health & Safety Executive document ‘Managing infection risks when handling the deceased’ advises that body-bags should be used for transporting people who have died from similar notifiable diseases (SARS & MERS) – see pages 48 & 49.

Public Health England’s ‘Interim guidance for first responders and others in contact with symptomatic people with potential Covid-19’ states that personnel handling bodies of those who have died at home where Covid-19 may be suspected should wear gloves and perform hand hygiene – see section 11.

Their ‘Infection prevention and control guidance for pandemic coronavirus’ document is far, far more proscriptive for those caring for people who are alive, recommending that  droplet precautions should be used for patients known or suspected to be infected with COVID-19 in all healthcare settings, and that ‘In all healthcare settings: A FRSM (fluid resistant surgical mask) must be worn when working in close contact (within 2 metres) of a patient with COVID-19 symptoms.’and that ‘Filtering face piece (class 3) (FFP3) respirators should be worn whenever there is a risk of airborne transmission of pandemic COVID-19 i.e. during aerosol generating procedures (AGPs)’

Recommended Personal Protection Equipment for the care of patients with Covid-19 is shown in the table below (page 24 of Public Health England’s ‘Infection prevention and control guidance for pandemic coronavirus’)

 

Fran Hall

It feels almost ridiculous to be asking readers of this blog to find the time to read and respond to the second set of working papers from the Competition and Markets Authority at this time of national crisis.

We’re fully aware that all sensible funeral directors are likely to be far too busy making certain that they and their staff are prepared to cope with the impact of Covid-19. (So far, there has been no official advice for the funeral sector other than the information we reported on in this blog post last week, but we understand that those who have been monitoring the situation in other countries are taking far higher level precautions).

We are, however, very conscious of the importance of this second consultation by the CMA, so for anyone who can possibly make time to send their observations to CMA team, we are sharing the questions below.

As with our other recent post on the CMA consultation, you can simply copy and paste the questions and then add your answers

Comments should be sent by email to funerals@cma.gov.uk by 19 March 2020.

The updated overview of key research and analysis can be found here.

Remedy options for regulating the price of funeral director services at the point of need

Working paper can be found here.

Table 1 (shown below) describes some possible elements which could be included in a benchmark package. We consider that these are the most commonly purchased funeral products and services. 

Table 1

Suggested benchmark funeral package for consultation

Collection and transportation of the deceased (no time restrictions)

Storage of the deceased

Care of the deceased

Customer advice and support (may also be referred to as funeral director contact)

Legal and administrative services (including completing required documentation, liaison with third parties such as coroner)

Managing arrangements relating to burial, cremation, cemetery, church, ceremony, officiant

Date and time flexibility for funeral service

Arranging payment of third-party disbursements

Viewing of the deceased (suggested during the hours 8am – 6pm)

Dressing the deceased in their own clothes or gown

Provision of a ‘standard’ coffin

Provision of hearse and personnel

Choice of route for funeral profession (within defined radius)

One limousine

Embalming

We would welcome views on this proposed benchmark package, in particular:

(a)  Are there are any products or services which are not currently included in the suggested benchmark package (Table 1) which should be included? What is the evidence to support this view?

(b)  Are there are any products or services which have been included in the suggested benchmark package (Table 1) which should not be included? What is the evidence to support this view?

(c)  Do you consider that there is evidence to suggest a lower or declining demand for any products or services in the suggested benchmark package, in particular we seek views on the use of limousine/s and embalming?

d)  What is your view on including or excluding time-based restrictions on certain services, for example should collection, transportation of the deceased be available 24 hours a day, seven days a week or should viewing of the deceased at the place of storage/funeral director’s premises be limited to “office hours” such as 8am to 6pm. Also, should there be any restrictions on the route for the funeral procession?

(e)  Are there any funeral director providers for whom the suggested “standard” benchmark funeral package (Table 1) would not be a suitable product/service to offer, for example a funeral director offering highly specialised or unique services?

(f) We are also considering whether an alternative approach, in particular a cap on average revenue per funeral, could be effective in addressing any AECs and customer detriment, whilst also addressing unintended market distortions such as the risk of a focal point for prices. Do you think this could be a better approach for price regulation?

We would welcome views regarding how might the Burial and Cremation (Scotland) Act 2016 interact with any price control regulation implemented by the CMA, or a new regulator and whether the price level of any price- controlled package should be set as one price across the UK.

We would welcome views on the proposals outlined in this working paper and any other comments on the proposed price control remedy. In particular we would welcome comments on the following questions:

Aims and approach of a price control remedy

(a)  Do you agree that the introduction of a price control likely to be an effective solution to remedy any AECs and any resultant, or expected, detrimental effects on customers should they be found in this market investigation?

(b)  Do you agree that the introduction of a price control remedy to be a necessary and proportionate solution (paragraph 19) to remedy any AECs and any resultant, or expected, detrimental effects on customers should they be found in this market investigation?

Price control design considerations

 (c) Do you agree that all funeral directors should be subject to a price control remedy (paragraph 38)?

(d)  Do you think there is a requirement to limit the application of any price control regulation to exempt certain providers and if so, what should the criteria for exemption be (paragraph 39)?

(e)  Do you agree or disagree with the suggestion that a maximum price could be applied to a benchmark package of products and services (paragraph 59)?

(f)  Do you agree with the suggested products and services within the proposed “standard” benchmark funeral package (paragraph 60)?

(g)  Are there any funeral director providers for whom the suggested “standard” benchmark funeral package (paragraph 60(e)) would not be a suitable product/service to offer, for example a funeral director offering highly specialised or unique services?

(h)  Do you consider that there is evidence to suggest a lower or declining demand for any products/services in the suggested benchmark package, in particular we seek views on the use of limousine/s and embalming (paragraph 47)?

(i)  What is your view on including or excluding time-based restrictions on certain services, for example should collection, transportation of the deceased be available 24 hours a day, seven days a week or should viewing of the deceased at the place of storage/funeral director’s premises be limited to “office hours” such as 8am to 6pm. Also, should there be any restrictions on the route for the funeral procession (paragraph 60(d))?

(j)  Do you consider that we should include a requirement for cost reflectivity for all disbursement costs within any price control regulation? If not, are there particular disbursement costs, for example cremation costs, which should be included (paragraph 57)?

(k)  Alternatively, do you think that price control cap on average revenue per funeral, would be as effective in addressing any AECs and customer detriment, whilst also addressing unintended market distortions such as the risk of a focal point for prices (paragraph60(f))?

(l)  Do you think the same approach to the design of a price control is required across the UK, or whether there should be any variation at a regional or devolved nation level (paragraph 69(a))?

(m)  Do you think that one maximum price should be set for a benchmark package across the whole of the UK? Alternatively, what are your views on setting different regional or devolved nation prices (paragraph 69(b))?

(n)  What are your views on the interaction of the Burial and Cremation (Scotland) Act 2016 with the proposal of price regulation in the UK (paragraph 74)?

Implementation, monitoring and enforcement

(o)  What is your assessment of whether the option of setting a maximum price for a benchmark package of products/services (paragraph 60) is capable of effective;

(i) implementation?

(ii) monitoring?

(iii) enforcement?

(p)  Do you think that compliance reporting requirements to the CMA or a regulator, should be the same for all funeral directors (paragraph94(b))?

(q)  Do you have any views or suggestions on designing and implementing an effective communication strategy to ensure that consumers, funeral directors and relevant third parties understand their rights and responsibilities if price regulation is introduced in the funeral industry? In addition, how could we ensure that a benchmark package is sufficiently promoted and visible to consumers (paragraph 94(c))?

(r)  What preparation would be required and how long do you think funeral directors might require in order to prepare for the implementation of any price control regulation?

(s)  What would be the likely costs of implementation, monitoring and enforcement for funeral directors?

(t)  Do you consider an initial duration of five to seven years is an appropriate period for the implementation of a price control remedy and achievement of its aims (paragraph 24)?

(u)  Do you consider there to be other risks or options for mitigation which we have not considered (paragraphs 75-77)?

Please provide any other comments or questions.

 

Remedy options for regulating the price of crematoria services

Working paper can be found here.

We would welcome views on our current thinking that any price regulation in the form of a maximum price would apply to all crematoria operators in the same way.

We welcome views on the approach to defining the scope of products and services included in the benchmark package, in particular:

a)  Are there are any products or services which are not currently included in the suggested benchmark package which should be included? What is the evidence to support this view?

b)  Are there are any products or services which have been included in the suggested benchmark package which should not be included? What is the evidence to support this view?

c)  What is your view on time-based restrictions relating to the benchmark package, for example the length of the chapel slot?

We welcome views on how the maximum price could be determined and reviewed, in particular:

a)  Do you consider that using pricing information from the sector is a sensible approach for designing a price cap for crematoria? Do you think a rate of return approach would be more appropriate in this sector?

b)  Do you have any views on the design variants we have outlined above (for example, whether the price level of any price regulated package should be set as one price across the UK, whether we should make allowances for certain higher cost areas such as London or whether any cost base should be assessed on a crematoria by crematoria basis or otherwise)?

c)  Do you have any suggestions as to the criteria we should use to set the benchmark for the initial level of the price cap?

d)  Do you have any views on how the Burial and Cremation (Scotland) Act 2016 should interact with any price regulation implemented by the CMA, or a new regulator?

We are also interested in responses to the following questions relating to implementation, monitoring and enforcement of the price control:

h) What is your assessment of whether the option of setting a maximum price for a benchmark package of products/services (paragraph 49) is capable of effective;

  • implementation?
  • monitoring?
  • enforcement?

i)  Do you think that compliance reporting requirements to the CMA or a regulator, should be the same for all crematoria?

j)  Do you have any views or suggestions on designing and implementing an effective communication strategy to ensure that consumers, crematoria and relevant third parties understand their rights and responsibilities if price regulation is introduced? In addition, how could we ensure that a benchmark package is sufficiently promoted and visible to consumers (paragraph 105.b)?

k)  What preparation would be required and how long do you think crematoria might require to prepare for the implementation of any price control regulation?

l)  What would be the likely costs of implementation, monitoring and enforcement for crematoria?

m)  Do you consider an initial duration of 5 to 7 years is an appropriate period for the implementation of a price control remedy and achievement of its aims (paragraph 108)?

n)  Do you consider there to be other risks or options for mitigation which we have not considered (paragraphs 83-86)?

Please provide any other comments or questions.

 

Local authority tendering remedy proposal

Working paper can be found here.

We would welcome views on the proposals outlined in this working paper and any other comments on a proposed LA tendering remedy. In particular, we would welcome comments on the following questions.

LA tendering as a remedy option

(a)  To what extent do respondents think that wider introduction of tendered LA low-cost funeral schemes, intended as a response to problems identified on the demand side of the market would be: (a) effective; (b) proportionate. Please answer with respect to each of the implementation options available, that is:

(i)  a CMA Order applicable to all LAs;

(ii)  a CMA recommendation to LAs;

(iii) a CMA recommendation to central government(s) that it/they should create a statutory responsibility on LAs.

(b)  How should the specification of the funeral product to be provided under a LA scheme be determined?

(i)  Should the focus be on delivering a competitive negotiated price for a ‘standard’ funeral package, or addressing funeral poverty through ensuring availability of a low-cost respectful funeral option.

(ii)  How much scope, if any, should there be for variations between LAs?

(c)  What might be potential unintended consequences of wider LA tendering for low cost residents’ funerals?

(d)  What are the current barriers to LAs establishing tendered low cost funeral schemes (eg available resources, other priorities, not regarded as a LA responsibility, etc)? How might they be overcome?

(e)  What are the barriers to funeral director participation in LA tenders for resident schemes? How might they be overcome?

(f)  What are the barriers to take-up of LA resident schemes by bereaved families? How might they be overcome? What types of bereaved people/families would be most likely to use such schemes?

(g)  What impact have existing LA schemes had on wider pricing for funerals in their respective local areas?

(h)  What should be the CMA’s priorities for further analysis or evidence gathering on existing schemes?

LA tendering as basis for price benchmarks

(i) Do respondents think that the outcomes of current and future LA tendering exercises for provision of resident funeral schemes could provide useful data points for benchmarks to feed into price controls?

Other comments

(j) Please provide any other relevant comments or observations on these proposals.

 

Fran Hall

After today’s COBRA meeting, the prime minister warned that the spread of coronavirus Covid-19 is likely to become more significant, with government sources warning that it could be “months rather than weeks” before the outbreak peaks.

In the absence of any new information or guidance, and while we await the revealing of the government’s ‘major UK-wide action plan’  we have heard from many funeral directors who are concerned about their potential involvement with caring for people who have tested positive for the virus and subsequently died.

We thought it worth putting the official government advice for those handling the bodies of people who have died from Covid-19 here on the blog in an easy to find place – full details can be found here.

Here’s the official guidance:

  1. Handling dead bodies
  • the act of moving a recently deceased patient onto a hospital trolley for transportation to the mortuary might be sufficient to expel small amounts of air from the lungs and thereby present a minor risk
  • a body bag should be used for transferring the body and those handling the body at this point should use full PPE
  • the outer surface of the body bag should be decontaminated (see environmental decontamination) immediately before the body bag leaves the anteroom area. This may require at least 2 individuals wearing such protective clothing, in order to manage this process
  • the trolley carrying the body must be disinfected prior to leaving the anteroom
  • prior to leaving the anteroom, the staff members must remove their protective clothing
  • once in the hospital mortuary, it would be acceptable to open the body bag for family viewing only (mortuary attendant to wear full PPE)
  • washing or preparing the body is acceptable if those carrying out the task wear PPE. Mortuary staff and funeral directors must be advised of the biohazard risk. Embalming is not recommended
  • if a post mortem is required safe working techniques (for example manual rather than power tools) should be used and full PPE worn, in the event that power tools are used. High security post mortem suites are available if needed and can be discussed with the PHE incident team
  • after use, empty body bags should be disposed of as category B waste
  1. Putting on and removing personal protective equipment

This PPE ensemble is more enhanced than pandemic flu requirements due to COVID-2019 being a novel coronavirus and the evidence base for transmission limited. Therefore, this is based on expert opinion to date and may be revised as the situation evolves.

Use safe work practices to protect yourself and limit the spread of infection:

  • keep hands away from face and PPE being worn
  • change gloves when torn or heavily contaminated
  • limit surfaces touched in the patient environment
  • regularly perform hand hygiene
  • always clean hands after removing gloves

Pre-donning instructions:

  • ensure healthcare worker hydrated
  • tie hair back
  • remove jewellery
  • check PPE in the correct size is available

21.1 Putting on (donning) PPE

The order for putting on is gown, respirator, eye protection and gloves. This is undertaken outside the patient’s room.

Perform hand hygiene before putting on PPE

  • put on the long-sleeved fluid repellent disposable gown, fasten neckties and waist ties
  • respirator. Note: this must be the respirator that you have been fit tested to use. Where goggles or safety spectacles are to be worn with the respirator, these must be worn during the fit test to ensure compatibility. Position the upper straps on the crown of your head, above the ears and the lower strap at the nape of the neck. Ensure that the respirator is flat against your cheeks. With both hands mould the nose piece from the bridge of the nose firmly pressing down both sides of the nose with your fingers until you have a good facial fit.

If a good fit cannot be achieved, do not proceed.

Perform a fit check. The technique for this will differ between different makes of respirator. Instructions for the correct technique are provided by manufacturers and should be followed for fit checking.

Eye protection: place over face and eyes and adjust the headband to fit.

Gloves: select according to hand size. Ensure cuff of gown covered is covered by the cuff of the glove.

21.2 Removal of (doffing) PPE

PPE should be removed in an order that minimises the potential for cross contamination. Unless there is a dedicated isolation room with anteroom, PPE is to be removed in as systematic way before leaving the patient’s room i.e. gloves, then gown and then eye protection.

The respirator must always be outside the patient’s room.

Where possible (dedicated isolation room with anteroom) the process should be supervised by a buddy at a distance of 2 metres to reduce the risk of the healthcare worker removing PPE and inadvertently contaminating themselves while doffing.

The FFP3 respirator should be removed in the anteroom or lobby. In the absence of an anteroom or lobby, remove FFP3 respirator in a safe area (for example, outside the isolation room).

All PPE must be disposed of as healthcare (including clinical) waste.

The order of removal of PPE is as follows:

Gloves: the outsides of the gloves are contaminated

  • grasp the outside of the glove with the opposite gloved hand; peel off
  • hold the removed glove in gloved hand
  • slide the fingers of the un-gloved hand under the remaining glove at the wrist
  • peel the remaining glove off over the first glove and discard
  • clean hands with alcohol hand rub

Gown: the front of the gown and sleeves will be contaminated

  • unfasten neck then waist ties
  • pull gown away from the neck and shoulders, touching the inside of the gown only using a peeling motion as the outside of the gown will be contaminated
  • turn the gown inside out, fold or roll into a bundle and discard into a lined waste bin

Eye protection (preferably a full-face visor): the outside will be contaminated

  • to remove, use both hands to handle the retraining straps by pulling away from behind and discard
  • clean hands with alcohol hand rub

Respirator: in the absence of an anteroom/lobby remove FFP3 respirators in a safe area (such as outside the isolation room)

  • do not touch the front of the respirator as it will be contaminated
  • lean forward slightly
  • reach to the back of the head with both hands to find the bottom retaining strap and bring it up to the top strap
  • lift straps over the top of the head
  • let the respirator fall away from your face and place in bin
  • wash hands with soap and water

ENDS

Fran Hall

The Competition and Markets Authority’s investigation into the funeral market is steadily progressing, with 22 working papers published since the end of January.

It is clear that the 25-strong team working on the Market Investigation are doing a detailed and thorough job as they forensically analyse the huge amount of information they have obtained and publish their findings.

This is a once in a generation opportunity to re-shape the funeral market, and we strongly recommend that all readers of this blog find the time to share their views with the CMA as the emerging thoughts on potential remedies are published.

The problem is finding the time to do so – it’s dense reading and there are understandably deadlines by which the CMA is asking for responses.

The deadline for comment on the first batch of 13 working papers is this Thursday, 27th February, and to help anyone who feels that they should be offering their views but who just doesn’t have time to read through the almost 600 pages in the first set of working papers, we thought we’d share the most important points on which comment is invited.

Bear with us – this is a long post as we’ve copied and pasted directly from the Quality Regulation Remedies and the Information and Transparency Remedies papers so that readers can access the salient points and questions easily – we recommend reading through these two papers before responding to the questions.

Just copy and paste all the words in italics below and then add your thoughts on each point – once complete, please send to funerals@cma.gov.uk 

This is your opportunity to have your voice heard.

The Quality Regulation Remedies document poses some potential options that the CMA is considering:

Possible quality regulation remedies

(a)  Clear requirements for funeral directors in the form of, for example, statutory minimum standards.

(b)  Effective monitoring and enforcement of standards through, for example, a statutory licensing and inspection regime.

(c)  An appropriate body to monitor and enforce standards.

(d)  The collection and dissemination of information to customers on the quality of services provided by funeral directors.

The paper goes on to explain the reasons for the suggested remedies, and poses a number of questions:

Our initial assessment of the quality of services provided by funeral directors to customers suggests that:

(a)  During the purchase process and delivery of the funeral, customers can observe a range of quality aspects but care of the deceased, which is of considerable importance to customers, is largely unobservable, and customers vary rarely compare quality across providers;

(b)  together, this is likely to weaken the incentive for funeral directors to offer high quality in relation to those services that customers cannot easily observe and assess (ie back of house standards);

(c)  whilst funeral directors may monitor and invest in the quality of some of their services, we have not seen strong evidence of back of house quality responding to customer preferences, or that good quality provision requires high costs and prices; and

(d)  in relation to back of house quality standards, the evidence available suggests that many funeral directors provide an acceptable standard. However, there is a widespread view in the industry that some funeral directors do not.

Remedy selection

Do you agree with our proposal to focus quality regulation on the services provided by funeral directors or do you think we should also regulate the quality of services provided by crematoria operators? Please explain your answer.

Do you agree with our proposal to focus quality regulation on back of house standards? Please explain your answer.

What are your views on the likely effectiveness and proportionality of the remedies outlined in this working paper in addressing our initial concerns?

Are there any other potential remedies that we have not considered in this working paper that may address our initial concerns (as set out in our working paper on the quality of back of house funeral director services)? Please explain what those remedies are and why they would be more effective than, or suitable in addition to, our proposed remedies.

Would a predominantly outcomes-based or a rules-based regulatory model (see paragraphs 39 to 40) be more appropriate for monitoring and upholding the back of house standards of funeral directors? Please explain your answer.

Which of the services provided by funeral directors should be included under the scope of any quality regulatory regime, including statutory minimum standards, and why? We are particularly interested in your views on the regulatory standards set out in Table 1 and the following specific issues:

(a)  Is refrigeration necessary for the appropriate care of the deceased?

 (b)  Is the ratio of one refrigeration space for every 50 deceased persons taken into the care of the funeral director on average per year (as proposed in the draft Code of Practice for Funeral Directors in Scotland) an appropriate ratio? If not, what is?

(c)  Is it appropriate to require that each deceased must be stored individually in separate compartments within the unit (as proposed in the draft Code of Practice for Funeral Directors in Scotland)?

 (d)  Should training and/or education be mandatory? Please explain your answer. In the event that training and/or education was made mandatory, please comment on:

(i) Which members of staff require formal education and to what level (ie A Levels (or equivalent) or a degree or professional qualification) and to what extent can formal education be substituted by experience or other forms of training?

ii) Is it necessary to create a nationally accredited professional education programme or allow funeral directors to choose from the currently available qualifications?

 (iii) Should there be a number of specified hours of training, and any other form of CPD, that staff should be required to complete each year, or should staff or their employers self-assess their professional development needs?

 (iv) Are there any other requirements that should be imposed on staff, owners and controllers of funeral directors to ensure their technical and professional competence (eg age, conduct or experience restrictions)?

 (e) Is there a need to establish an independent ADR scheme and/or complaints adjudicator in addition to the funeral directors’ own complaint handling and customer redress?

Who is best placed to monitor and enforce compliance with quality regulation?

 (a)  Is a single UK-wide body or a different body in each part of the UK more appropriate, and how should either arrangement take account of the emerging regulatory regime in Scotland? Please explain your answer.

 (b)  What role, if any, should the existing trade associations (ie NAFD and SAIF) and other relevant organisations, such as the Good Funeral Guide, play in relation to the quality regulatory regime? Please explain your answer.

Should a licensing and inspection regime (see paragraphs 52 to 73) apply to individuals or businesses or both, and why? If both, what should be the respective obligations of individuals and businesses?

What considerations should be taken into account when designing any quality regulatory regime to enable providers of all sizes to comply with that regime, and without deterring innovation, entry and expansion?

 (a)  What would be the likely costs of quality regulation to funeral directors? This includes the costs of implementing any changes necessary to comply with the regulation and the costs of demonstrating ongoing compliance with the regime.

(b)  What would be the likely costs of implementing and running the regime and how should this be funded?

Are there any elements of quality that require immediate attention prior to the establishment of a quality regulatory regime?

Do you think we should tailor any aspects of quality regulation to reflect any differences in funeral service provision (and the current statutory regimes) across England, Wales, Northern Ireland and Scotland?

What information on the quality of services provided by funeral directors should be collected and disseminated to customers to enable them to assess and compare funeral directors?

 

The Information and Transparency Remedies paper identifies seven possible remedies and poses questions on each of them:

Possible information and transparency remedies

Invitation to comment

Our emerging thinking on remedies is without prejudice to the final outcome of our assessment on whether there are any AECs (adverse effects on competition) in relation to the services provided by funeral directors and crematoria operators and any detrimental effects on customers resulting from those AECs.

We welcome views from parties on the remedies described below, and the relative attractiveness of the different approaches to achieving their aims. We invite parties’ views on the following:

(a)  What are the expected costs to funeral directors and/or crematoria of implementing the remedy and reporting compliance?

(b)  How should compliance with the remedy be demonstrated and how should this be supervised by the relevant bodies?

(c)  Should any remedies be time-limited? If so, why?

(d)  Should we consider a firm size threshold for any of the remedies discussed here? And if so, what should that threshold be, and why?

(e)  Are there any relevant customer benefits in either market that may be lost or reduced by the implementation of these measures and that we should consider as part of our assessment of any remedy package?

(f)  Are there any other remedies that may equally or more effectively improve the availability and transparency of information to consumers?

 

Remedy 1 – Price transparency and comparability

There are several options (or combinations of options) that could achieve the objectives listed above that we think are worth exploring in more detail. We could, for example, require funeral directors and crematoria operators to:

(a)  make their prices available online, over the telephone, or in branch (ie before the arrangement meeting with a potential customer).

(b)  provide prices to potential customers at their first point of contact (whether in branch, over the telephone or online) rather than upon request by the customer.

(c)  adopt the same price reporting template whether they sell directly to customers (whether in branch, over the telephone or online) or through a third-party platform.

(d)  provide disaggregated pricing and service information, such as:

(i)  specific component prices (eg car, collection, transport and storage of the deceased, coffin, embalming, etc) or a package of specific components (eg those components that could be mandatory); and

(ii)  disbursement costs (eg celebrant, flowers, etc), in order to convey typical total costs (even when these disbursements are nil, such as for ministers belonging to the Church of Scotland), including information and general advice on a typical range of disbursements.

(e)  offer the same price across all of their sales channels; and

(f)  facilitating all of the above by, for instance, establishing an independent platform that could allow customers to compare providers and build their own funeral package by selecting individual elements. We discuss this part of the remedy in more detail below.

Invitation to comment on Remedy 1

We invite views on the following questions:

(a)  How can we best facilitate shopping around and increase customer awareness of total funeral costs and local price differentials?

(b)  How can we enable better comparison of funeral directors’ prices and quality of services?

(c)  How can we better prepare the customer for the arrangement meeting and make them aware of all the options offered by the funeral director, including low-cost options?

(d)  How can we give customers a clearer idea of the final cost (early on in the process of choosing a funeral director and before the arrangement meeting)?

(e)  How can we make the platform most useful for customers how can we ensure that it is used by as many customers as possible?

(f)  Should funeral directors and crematoria operators be required to adopt a standardised methodology for presenting pricing and service data as an alternative to the platform?

(g)  Should crematoria availability be incorporated into the platform?

(h)  What will be the likely costs of this remedy?

(i)  Will this remedy give rise to any potential unintended consequences?

  

Remedy 2 – Intermediaries to (more effectively) inform customers of their options and encourage shopping around

The CMA could develop guidance or ask a third party, such as the Care Quality Commission (CQC), to develop guidance to support intermediaries in their discussions with the bereaved about funeral planning. These discussions could take place when an individual enters a care home or hospice, or when death is anticipated or has just occurred. The guidance could include the following information:

(a) Explaining to the bereaved that they can change funeral director after the deceased has been collected from the place of death and that they are not obliged to remain with the funeral director that collected the deceased.

(b)  A checklist of questions that customers may wish to ask the funeral director.

(c)  Funeral directors and crematoria in the local area (and possibly their prices).

(d)  Information on the platform.

Invitation to comment on this remedy

We invite views on the following questions:

(a) Are there intermediaries other than the CQC who provide, or are well placed to provide, information on funeral planning to those close to death or to the bereaved?

(b) Are other ways in which funeral directors and crematoria operators can raise awareness of the platform other than providing information on their websites and promotional material and discussing the platform at the arrangement meeting?

(c) Are there alternatives to raising awareness of the platform to general advertising and the use of intermediaries?

(d) What are the likely costs of this remedy?

(e) Will this remedy give rise to any potential unintended consequences?

 

Remedy 3 – Funeral planning awareness before the point of need

The CMA could recommend to Government to invest in and run media campaigns and produce literature about funeral planning, as well as raising awareness of the platform described under Remedy 1.

The CMA could also recommend that local authorities, specifically those individuals or teams responsible for bereavement services, raise awareness about funeral planning on their website and through wider outreach work in their local areas.

The CMA could also work with the Citizens’ Advice Bureau and other similar organisations to develop information and guidance on funeral planning.

Invitation to comment on this remedy

We invite views on the following questions:

(a)  Are there particular circumstances prior to the point of need at which consumers are likely to be receptive to the idea of preparing for their funeral or that of a loved one?

(b)  What interventions (if any) are likely to encourage funeral planning and how might they be delivered?

(c)  Should this remedy target particular types of consumers?

(d)  What are the likely costs of the remedy?

(e)  Will this remedy give rise to any potential unintended consequences?

 

Remedy 4 – Mandatory ‘reflection period’

We could require funeral directors to allow customers a ‘reflection period’, which could take place either before or after the customer signs the contract with their chosen funeral director. We could also require funeral directors to allow customers to choose a different provider or different services from the same provider at minimal or no additional cost.

Customers do not currently have the same statutory cancellation rights for an ‘on-premises contract’, such as when a contract is concluded in the funeral directors’ office.

The potential ‘reflection’ period remedy could take one of the following forms:

(a)  impose a mandatory pause or ‘reflection’ period between an arrangement meeting on-premises and before signing any contract; or

(b)  have cancellation rights for on-premise contracts in line with the cancellation rights for off-premise and distance contracts described above.

Invitation to comment on this remedy

We invite views on the following questions:

(a)  Is a ‘reflection period’ an effective mechanism for encouraging customers to ensure that they choose a funeral director that best meets their needs?

 (b)  If so, when should this ‘’reflection period take place?

(i)  After getting information on funeral options from a funeral director on its premises and before signing the contract?

(ii)  after signing the contract in an arrangement meeting but having cancellation rights for a certain period of time afterwards? or

(iii)  another suitable time?

(c) What are the likely costs of this remedy?

(d) Will this remedy give rise to any potential unintended consequences?

 

Remedy 5 – Potential cap on the level of charges incurred for the collection, transportation and storage of the deceased

Invitation to comment on this remedy

To reduce this potential barrier to switching, we could set a cap on the level of charges that a funeral director can levy for the collection, transportation and storage of the deceased to recover the costs that the funeral director has incurred prior to the customer switching to an alternative funeral director (or the costs incurred if the customer chooses not to switch). We envisage that such a cap could apply to all funeral directors (and not a subset of funeral directors) to ensure that this possible barrier to switching is addressed across the whole sector.

We invite views on the following questions:

(a)  Will the imposition of a cap on the collection, transportation and storage of the deceased encourage more customers to switch funeral directors after having reflected on their original choice of funeral director?

 (b)  How should the cap be calculated?

(i)  Should the charge for collection and transport reflect the distance covered by the funeral director or represent an average cost?

 (ii)  Should there a daily charge for the storage of the deceased or an average charge for storage, which reflects the average length of time that the deceased is typically stored?

 (c)  Are there other approaches to setting a potential cap on charges levied by funeral directors for the collection, transportation and storage of the deceased (other than cost-based approaches) that the CMA should consider?

(d)  What are the likely costs of this remedy?

(e)  Could this remedy give rise to any unintended consequences?

 

Remedy 6 – Managing conflicts of interest

We could impose prohibition of certain forms of payment, such as:

(a) partnership agreements with hospices or care homes which involve direct referral payments when the hospice or care home facilitates an introduction to a funeral director business; and

(b) commissions to employees for upselling funeral packages

Invitation to comment on this remedy

We invite views on the following questions:

(a)  Are there any other ways to eliminate conflicts of interest that may adversely impact the quality of service provided by funeral director to customers?

(b)  Are there any other types of inducements or payments that should be captured by this remedy?

(c)  What are the likely costs of this remedy?

Remedy 7 – Disclosure of business ownership and other commercial relationships

The CMA could require funeral directors and crematoria operators to disclose their business ownership structure. This remedy could apply to branches that form part of a larger funeral director business, so that customers are aware of whether the funeral director is part of a larger business or is, instead, an independent business. This information could be disclosed on premises and websites and any other promotional material.

The CMA could also require funeral directors and crematoria to inform customers of any changes in ownership, such as when an independent funeral director is acquired by a larger multi-site operator, so that customers are aware of the current ownership structure.

The CMA could also require funeral directors to disclose when they recommend a crematorium that is owned by the same company as the funeral director business, in order to address the presence of vertical integration in the funerals sector.

Invitation to comment on this remedy

We invite views on the following questions:

(a)  What potential harm could the non-disclosure of business interests and other commercial relationship cause customers?

 (b)  What business relationships and other commercial relationships should be disclosed to customers?

(c)  How should such interests and relationship be disclosed to customers?

(d)  What are the likely costs of this remedy?

 (e)  Will this remedy give rise to any potential unintended consequences?

Fran Hall

Those additional observations on the FSCSR consultation we mentioned in our previous post this week:

1. At the GFG, while we welcome any improvements in the funeral industry Codes of Practice, we despair at the length of time it has taken NAFD and SAIF to come up with revisions to existing industry codes to make them remotely fit for purpose.

Ten years ago, on 14 June 2010, Charles wrote a blog post ‘Chasing the money’: 

Here’s an excerpt:

“In 2002 Helen Parker, editor of Which, commented: “We want to see all funeral directors in the UK signed up to a standard code of practice. The code should be monitored and enforced by an independent body.” 

In response, Alan Slater, CEO of the NAFD gave this assurance: “We are currently mid-way through the process of improving our code … Once finalised, the new code will be sent to the OFT.” 

The NAFD’s Slater said this in 2002. 

But as of February 2009, the NAFD code of practice has not been approved by OFT. In fact, none of the funeral trades associations’ codes of practice have been approved by OFT. Approval would mean that the codes of practice would be blessed by the Consumer Codes Approval Scheme, offering a much greater degree of assurance to consumers.”

So, in 2002, in response to public criticism, the NAFD showed willing to improve their code of practice. 18 years later, they are still working on it.

NB It’s not clear if the quote from Helen Parker was made before or after the role of Funeral Ombudsman was axed by the funeral trade bodies – that happened in 2002 too.

2. The FSCSR appears to be recommending that the two funeral trade associations should be an integral part of a proposed interim regulator before a statutory body is set up. (Details on page 10 of the FSCSR consultation document. It’s entitled ‘Recommendation that government should work with the industry to establish an interim regulatory body’.)

In brief, having recommended that a regulatory body be appointed to regulate the funeral sector, recognising that there would likely be a significant delay in bringing forward the necessary legislative work, the FSCSR is ‘minded to recommend’ that the two funeral trade associations, NAFD & SAIF work with the Chartered Institute of Trading Standards to create an ‘independent’ interim regulator. Albeit one without a mandatory remit or statutory powers.

Um, that will be a big NO from us.

The role of a trade association is to represent their members’ interests.

We believe that this role is incompatible with the role of a regulator, interim or not. 

And we’re not the only ones. Remember the Funeral Ombudsman, whose role was axed by the funeral industry almost twenty years ago?

The late, highly respected consumer academic lawyer, lecturer and author Professor Geoffrey Woodroffe was appointed Funeral Ombudsman in 1994. His tenure lasted until 2002, during which time there were two critical reports about the funeral industry by the Office of Fair Trading and a third damning report by the Consumers Association.

Let’s hear what Professor Woodroffe thought about the involvement of trade associations:

Ombudsmen are impartial. How on earth can anyone expect regulation processes set up by trade bodies to be impartial and fair? People are extremely vulnerable when they are arranging funerals for relatives or partners. Independent regulation is vital.”

Fran Hall

It’s a busy time in funeralworld.

Last week, the Competition and Markets Authority uploaded a whole suite of working papers and other documents (21 in total) to the website providing information about their ongoing Market Investigation into funerals, seeking comment on their findings so far by 27thFebruary.

On the same day, with impeccable timing, the Funeral Service Consumer Standards Review* published the first of their own consultation papers and requested feedback within a similar timeframe to the CMA, with a deadline of midnight on March 1st.

This is a surprising coincidence, given that the original FSCSR indicative timetable last July indicated that their documents would have been drafted, approved and signed off by October / November last year, with recommendations made to government bodies, industry bodies and policy makers at the same time. All out there in the public domain, months before the CMA published their working papers.

Instead, the timetable for publication of the FSCSR draft documents has slipped by several months, resulting in a confusing juxtaposition of two sets of publications on standards in the funeral industry, both seeking comment from any interested parties within the next four weeks.

Here at the GFG we have limited time to read and digest reams of information, and we presume that busy funeral directors and others with interest in the subject will feel the same. There is a huge amount of essential reading in the 20+ CMA working papers and providing considered comment will take significant commitment on our part. Without question, our priority for all of our free reading time is the once-in-a-generation opportunity offered by the CMA investigation into funerals.

The CMA has the authority to recommend remedies to issues they may identify, and have already set out a range of possible remedies that may be effective in addressing possible competition issues they may find in the provision of funeral director services at the point of need:

(a) The introduction of a quality regulation regime;(b) measures to promote greater information transparency;
(c) price controls; and
(d) local authority procurement of funeral director services.

One can almost hear the collective sharp intake of breath as the implications of these potential remedies sink in across funeralworld.

If you’re someone interested in the potential changes that are on the horizon, then we urge you to find the time to read through the CMA papers, and send your thoughts by e-mail to funerals@cma.gov.uk

As for the FSCSR consultation? Well, if you’d like to help the trade associations get their house in order, then they’d very much like to hear your thoughts. We will be focusing on responding to the CMA and don’t have capacity to give comprehensive feedback to the FSCSR as well.

Although we may have a couple of observations.

Fran Hall

There’s a tremendously interesting publication from the University of Dundee by researcher Ruth Bickerton and Dr. Carlo Morelli which we’ve been reading over the last few days.  It came out earlier this year, and is called Funeral Poverty in Dundee – Funeral Link Evaluation. It’s about Funeral Link, a charity set up to address the problem of funeral poverty in Dundee.

The report is a comprehensive evaluation of the project in its initial phase of existence, which makes fascinating reading. It is a thorough analysis of the need for such an independent, informed advocacy service with a specific goal of helping people who are struggling with funeral costs. Other local authorities might like to make this required reading for their decision makers.

In analysis of the impact of Funeral Link, one of the stakeholders quoted the need for this funeral advice as being ‘essential’. They went on to say ‘There’s a stigma about saying you don’t have the money for a funeral. With Funeral Link you can go anonymously for advice and sign-posting, and get an idea of what your options are, and what they might cost.’

Along with analysing the effects of the existence of Funeral Link, the report also offers an analysis of the process and the current funeral market.

It’s worth a read even if you’re not responsible for the purse strings of a local authority budget. Some extracts below:

2.3i Need Recognition

“One level of uncertainty comes in the form of information asymmetry between the next of kin and the funeral director. This takes a number of forms: first the consumer is making decisions at a time of significant stress and cognitive dissonance. Grief and emotional distress limit the ability to process and evaluate information. Next of kin are thus uncertain as to the exact nature of the funeral director’s role and the funeral director’s role itself can be multi-faceted and ambiguous in three distinct areas.

First, in ensuring statutory requirements are followed by the next of kin, involving complying with the legal requirement that is to dispose of a deceased’s remains. Second, they also have a sales role. A funeral director is a direct service provider, involving the provision of services on behalf of the next of kin in the maintenance, care and movement of the deceased. In this sales role they additionally act as an intermediary sales organisation supplying services of third party providers such as booking slots at crematoria or burial grounds, ordering flowers, organising post-funeral receptions or placing notices in newspapers. A funeral director’s third and final act is to provide counselling, advisory and even advocacy activities. Funeral directors provide counselling and comfort, listening to the next of kin and guiding them in decision making, through a one-to-one meeting to make the arrangements. Funeral directors also provide advisory information and signposting to next of kin for their bereavement journey and, finally, they provide advocacy functions with regulatory bodies such as the NHS, police or the Department for Work and Pensions, via the completion of formal applications for means-tested Social Fund Funeral Expenses Payments SF200.

The ambiguity within the funeral director/next of kin relationship facilitates both the development of information asymmetry in the contracting between parties but also the prospect of moral hazard in the potential abuse of the power relationship arising from these information asymmetries. Moral hazard can be understood as consumers making decisions detrimental to their wellbeing due to an inability to distinguish between the elements of the funeral director’s counselling, advisory and advocacy functions. There is the potential for what economists regard as opportunism in the contracting and price setting environment, as consumers’ preferences are revealed in advance to funeral directors revealing their price elasticities, allowing for the potential emergence of price discrimination and individualised pricing.” 

 

2.4 The Funeral Market

“The funeral market has distinct and related properties which distinguish it from other markets for services and explain why it is difficult for the market to operate as other markets would be expected to operate. The fixed nature of demand and the oligopolistic nature of competition together increase the potential for market failure leading to consumers paying higher costs than might otherwise occur.

In most consumer markets a reduction in price would be expected to increase the consumption of the service. This is not the case for funerals. Demand for funeral services is what economists would understand as inelastic and changes in price therefore do not impact on the quantity demanded within a market. The consequence for the supply of funerals and competition is thus that, for entry of new producers into the market to occur (or alternatively for existing firms to cut prices) the only change would be for existing demand to be redistributed among the producers of funeral services. Market competition in this environment is what many would understand to be a zero sum game.

Attempts to influence the timing of purchases for funeral services occurs through pre-payment and funeral plans, in order to bring forward income to firms, but this cannot alter the absolute market size for funerals. Market size is influenced, and predictable, by the demographics and life expectancy of the population as a whole and therefore of a relatively fixed size with the consequence that entry into the market by new producers has historically been discouraged.”

 

“The funeral director’s role has remained relatively static for many years. Whilst the funeral directors’ origins can be found in the associated activities of carpenters and woodworking companies or garage owners, many of today’s funeral directors are specialist organisations with greater or lesser degrees of investment in specific assets. While buildings can be changed in function, the backroom facilities in cold rooms and refrigeration, funeral limousines and hearses are not easily adapted for alternative uses. Thus the industry itself has been relatively static for many years with little innovation. From the established funeral directors’ perspective, while the dominant duopolistic firms of Dignity and the Co-Op set high prices, smaller firms can adjust their prices at a small discount to those set by these two firms. Smaller firms’ concerns lie not with the actions of the larger dominant firms but with the potential for entry by smaller, and less well-equipped firms. Thus, the low-cost unregulated sector provides a threat to the continued success of established firms and therefore the dominant view presented by the smaller chains and independent firms was to favour regulation conditionally on the basis that the levels were neither set too high nor that the regulatory minima were applied selectively and low cost entrants could avoid regulation.”

There’s lots more, but we felt that the thorough understanding of the funeral process and sector outlined in the report was worth highlighting. 

Conclusion? We need more Funeral Links. Lots of them. Advocates for bereaved people acting as intermediaries and advisors would make a massive difference to people around the UK struggling to afford a funeral.

Well done Linda and team, and the board of Funeral Link trustees overseeing this venture. 

Fran Hall

We are privileged to be able to publish a guest blog from Tracy Douthwaite today.

Tracy works providing training and talks about mental health awareness and wellbeing. Her husband Steve is pictured above, in his garden last summer.

Steve died earlier this year, and Tracy found finding a funeral director a very painful experience. She wrote about it originally on her blog here.

In her e-mail today Tracy comments – ‘I feel passionately that there needs to be huge change with the whole industry and also the way as a society we deal with death and the bereaved.’

Read Tracy’s blog post below. You’ll find it difficult to argue.

What is it about funeral directors that makes them fit into two equally awful categories that means an already overwhelming task feel almost impossible?

When my husband, Steve died this year, I was determined to do a funeral I wanted, nothing too out of the ordinary, although you would have thought I was asking for the earth. Instead of just using the first funeral directors I found, (why are they even called funeral directors the whole thing makes me feel I have gone back to Victorian times.) Anyway, as I was saying I decided to visit a few places to find somewhere that I felt listened to me and I felt comfortable to carry out this important task alongside the family and I. 

The first types of FD are full of sycophantic whispering tones which feel so insincere – you can speak to me like a “normal” person as I am not 5 years old and actually if I was 5 it would still be offensive. Why do they feel you can’t have an adult conversation and mostly they can hardly look at you as if bereavement were catching and to be avoided, surely you are in the wrong job if you feel this is the case?

On one occasion I took my brother with me and the funeral director just completely ignored him, didn’t say hello, shake his hand, look at him, you would think basic social skills were a necessity to do this job. He just whispered “their” way of doing things to me and looked aghast when I suggested anything different. Somehow the fact I wanted less put the price up as it was not in their usual package.

The second group are business minded if you can call it that- full of endless brochures of ridiculously priced coffins and over bearing people who are not listening to a word you say but telling you what you want. E.g what fits with what they offer, they know best as they have been doing it for years and you don’t know what you are talking about. In one place, this time with my Dad we were led past a room full of coffins (could you not have closed the door?) and then left in the sterile, unwelcoming  “Arrangement Room” for ages until a pregnant lady came to talk to us but was more interested in talking about her pregnancy than my wishes- not sure at that point that I wanted to think about new life or her concerns about bending over to hand me a brochure I didn’t want – or am I being harsh?

Not in one of the places I visited was I even offered a tea/coffee, shown any real compassion, or felt welcomed, listened too or valued. If they treated me this way how would they care for my husband if I left him with them? I felt like a commodity and the prices I was quoted were also terrifying. I’m sure most people in that weird dream like, this can’t be happening, vulnerable state just go to the first place and agree with most of what is offered so funeral directors almost feel that they have a captive market.

If more of us found the strength and courage at that most painful of times to say no, to shop around and go where we felt valued and where we felt our departed loved one would be valued than maybe, just maybe things would improve.

Steve, as we all are, was unique and I wanted a funeral in keeping with him as a man and one that would support the families differing needs in saying goodbye. So, this is what I wanted and didn’t want:

  • Motorbike sidecar and hearse- had to be a Triumph, he loved his Triumph bikes.
  • No funeral cars, we would use Taxis instead, less formal and sterile.
  • Double slot at the crematorium so we didn’t feel rushed or part of a procession of funerals (it’s only costs a little bit more, not double the price)
  • Choice of celebrant to conduct the service who would meet with family and take on board our requirements and get a feel for the man
  • Family members to speak at service, not formal eulogy but memories, poems.
  • The coffin to stay in the crematorium as we all left, placing items to go with him and saying our final goodbyes.
  • Able to use own Vessel for ashes after cremation – keeping everything personal

There is nothing that exceptional in our requests but all the little things I feel add up to make it unique. But I was told in some places I would still have to pay for cars I didn’t use, they couldn’t get double slot for a month (although I found out later that was due to them being busy not the crematorium) I checked directly price and availability for bike hearse, they quoted me but said they are usually cheaper via funeral directors. Out of those I tried only one quoted me the same price I had received and all rest much higher, so putting their mark up on it, but none of them wanted me to book it direct- in case something goes wrong!

By this time I was exhausted, frustrated and just angry at the lack of empathy and understanding, I was considering doing everything myself, but in reality I knew it may be too much for me to take on at that point.

I started searching online and found Poppy’s. I emailed my requests as I had run out of energy to speak to people and amazingly, they replied quickly, with a yes, no problem to all my wishes and clear pricing that was affordable. More importantly, even via email I could feel a warmth. Phone calls followed which were just as helpful and understanding, for the first time I felt heard.

When we met in their office, it was a calm environment with sofas, plants and pictures. I was welcomed, given a cup of tea and put at ease immediately. They talked me through want I wanted, what they could do, nothing was too much trouble. They asked me questions, to make sure they had understood everything and gave me opportunities to change my mind. They recommended celebrants based on my needs that I could meet and choose, rather than one assigned to me, I chose Andrew Bone who then came to my home, spent time getting to know the family, understand Steve’s life and crafted a wonderful eulogy.

In the week leading up to the funeral, both Andrew and Poppy’s, called and emailed several times ensuring everything was how I wanted it and checking on all the small details or just asking if there was anything else I wanted.

On the day, the whole service was perfect. I’ve no idea how Andrew got Steve’s character down to a tee but he did. The motorbike and hearse with wild flowers looked stunning- Steve would have loved his final ride (although I’m sure it didn’t go fast enough for him!) Steve’s sons and nephews carried the coffin and because I had so much trust in Poppy’s and Andrew I felt able to share my tribute to Steve, feel completely present for the whole ceremony and do the small things I wanted like place one of his favourite hats on the coffin as I left. The feedback I’ve had from those who attended has been so positive, everyone felt able to remember, celebrate and grieve for Steve in their own way as the whole service felt so supportive and personal.

I feel we must change our relationship with death and the way we say goodbye to those who mean so much to us. In order for this to happen we need people in the industries surrounding this to listen to those who are grieving, adapt and really care- is that too much to ask?

If we have the strength, we also need to share our thoughts and help others in similar situations find their voice and act as agents of change.

Tracy Douthwaite

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