Guidance for those responsible for the dignity and care of the deceased

Ensuring the dignity of deceased people is a sensitive and important matter for families, communities and wider society, across all cultures, faiths and for those with no faith background. 

How deceased people are cared for reflects our shared responsibility to treat them with dignity and respect. It also supports those who are grieving. 

All settings where deceased people are cared for should consider how their practices uphold dignity and respect diverse cultural and religious observances. 

This guidance draws on the HTA's Codes of Practice and Standards and is intended to help organisations outside the Human Tissue Authority's (HTA) regulatory remit. 

The HTA regulates organisations that remove, store and use human tissue for purposes set out in the Human Tissue Act 2004, including post-mortem examination, education and training, and research. Organisations licensed by the HTA are required to meet its standards and are subject to regulatory oversight. A key expectation within the HTA's regulatory framework is that the dignity of deceased people should be paramount. 

We have developed this guidance based on our regulatory experience. It sets out principles that may help organisations outside the HTA's regulatory remit in reviewing, developing and strengthening their own arrangements and practices. 

In applying the following principles, organisations should consider, for example, relevant legal requirements, professional standards, sector-specific guidance and training when determining appropriate practices.

Arrangements should be in place to ensure that practices relating to the care and management of deceased people and their tissue align with legal, ethical and professional expectations. This includes: 

• Regular review of practices through audits, quality reviews or other assurance activities, including considerations of arrangements which support security and dignity. 

• Regular governance meetings or other arrangements are in place to ensure relevant issues and risks are discussed, monitored and acted upon. 

• Ensuring that incidents or concerns are appropriately investigated and acted upon, with clear routes for escalation, where appropriate.

Governance arrangements should be in place to support the dignified care and management of deceased people through effective oversight, accountability and risk management. This includes: 

• Maintaining clear, accurate and up-to-date documentation, policies and procedures.  This can involve using standardised forms.  

• Undertaking audits to provide assurance that processes and procedures are being followed, identify areas for improvement and support continual learning. Audits to include security arrangements and facility access records. 

• Having an effective system of risk management with protocols in place for managing adverse events, including clear processes for reporting, monitoring, investigating and escalating concerns where appropriate.   

• Ensuring there are accessible and clearly communicated complaints procedures, enabling families and other stakeholders to raise concerns about the care and dignity of deceased people, with appropriate arrangements for investigation, response and learning. 

Staff involved in the care and management of deceased people should be appropriately recruited, trained and supported.  This includes:  

• Staff appointed to roles are properly assessed prior to appointment and found suitable against predetermined criteria relevant to their role. 

• Staff are trained and equipped to communicate clearly, honestly and sensitively, with knowledge on correct procedures, potential risks and the cultural and religious needs that may arise in the care and management of deceased people. 

• Staff receive suitable induction and training on the policies and procedures relevant to their role. 

• Continuing professional development plans are in place to maintain competence and ensure staff keep abreast of good practice. 

• Clear routes are established for staff to raise concerns about behaviours, practices or incidents that may compromise the dignity of deceased people. 

Environmental controls should be in place to maintain conditions that support the safe, respectful and dignified care of deceased people.  This includes: 

• Premises are clean and well-maintained, with regular cleaning schedules and audits in place, to prevent contamination or degradation of human tissue.  

• The environment is appropriate to undertake activities. For example, suitable ventilation and temperature controls are in place where required. 

• Appropriate monitoring systems are in place, for example, temperature monitoring, humidity control and alarms for equipment failure. 

• Environmental conditions are routinely monitored and reviewed with appropriate action taken where required.   

Access to areas where deceased people are cared for and managed should be appropriately controlled and monitored to prevent unauthorised access to areas: This includes: 

• Arrangements are in place to monitor and control access, including who can access areas where deceased people are managed to ensure authorised access for legitimate purposes only. Appropriate security considerations may include locks, alarms, access control systems and CCTV. 

• Access arrangements are underpinned by clearly documented policies and procedures to protect against unauthorised access and inappropriate behaviour. 

• Access controls and security arrangements are regularly reviewed to ensure they remain effective.