HTA Progress Update on advice to the Secretary of State for Health and Social Care in connection with offending by Fuller in a hospital mortuary

The judicial process relating to David Fuller’s crimes, which included offences involving bodies of deceased people in a hospital mortuary at Maidstone and Tunbridge Wells NHS Hospital Trust, concluded in mid-December 2021.

The Human Tissue Act (2004), which established the Human Tissue Authority (HTA), prescribes general functions to the organisation. These include advising the Secretary of State for Health and Social Care on issues relating to activities within its remit as he or the Department may require (S15 (f) of the Human Tissue Act 2004).

In response to a request from the Secretary of State, we sent advice setting out our remit, specifically focusing on our role in licensing and providing regulatory oversight of premises where post-mortem examinations take place. This advice also identified actions that we would take as part of a system-wide response to the identified offending.

Today, we have published the advice from December 2021, alongside a high-level progress update, given below.

We are conscious of the need not to pre-empt the findings and recommendations of the two phases of the Independent Inquiry led by Sir Jonathan Michael, with the first phase expected to be completed during 2022.

However, we remain committed to taking all the action that we can, within our remit, to reinforce the importance of maintaining the dignity of the deceased. Our initial focus has therefore been on three areas, set out as follows:

1. Preparing for the Independent Inquiry
   Our preparations for the Fuller Independent Inquiry are ongoing.
2. Working with other stakeholders
   We have been engaging with stakeholders involved in mortuary oversight across the wider health sector to coordinate and join up our approach. In relation to England, we have provided advice and support to their initiatives, such as NHS England / Improvement’s (NHSEI) work to reinforce security requirements for hospital mortuaries in England. We have also contributed to NHSEI’s review of hospital mortuary standards through revisions to Health Building Note 16 (HBN-16), in particular in relation to mortuary security.
3. Review of HTA guidance
   We have carefully considered the 72 licensing Standards for our Post Mortem sector to identify those that appear particularly pertinent to the issues identified by this case. One of our guiding principles is the vital importance of dignity and therefore maintaining the dignity of the deceased is a significant factor in how our Standards and guidance should be applied.
   We have completed a thorough internal review of the wording of, and guidance associated with, 7 specific licensing standards. These Standards are broadly concerned with effective control and monitoring of access, storage arrangements that maintain the dignity of the deceased, and oversight of visitors and contractors.
   As part of our internal review, we have updated sections of the guidance to make some of them clearer and to reinforce the importance of establishments considering all risks to the dignity of the deceased, including, for example, when looking at the installation of CCTV. We will shortly begin external engagement with relevant stakeholders, with a view to finalising and publishing the updated guidance for implementation later this year.