Independent Inquiry into the issues raised by the David Fuller case

All NHS trusts with mortuaries and/or body stores should commission a specialist strategic review of the systems in place to protect deceased people, which should include a detailed risk assessment of the potential breaches of security that could occur. The review should include an assessment of: the systems in place to identify any unauthorised access to the facility; the strength and effectiveness of barriers to prevent unauthorised access to the facilities; the systems in place to identify any access to deceased people for unauthorised purposes; and how CCTV is used, including its monitoring and any audits undertaken.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter setting out the actions expected of trusts to ensure improvements are delivered consistently (Preet Kaur Gill, Jul 2026). In June 2026, it had confirmed that new self-assessment questions reflecting inquiry recommendations were incorporated into the Premises Assurance Model, with submissions open until September 2026 (NHS England, Jun 2026). Earlier, in December 2025, the Department of Health and Social Care accepted the recommendation in principle subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

All NHS trusts should install CCTV inside the mortuary, with cameras facing all doors and access points, the reception area and the doors of body fridges, while maintaining the security and dignity of deceased people by implementing the appropriate safeguards. Where double-ended fridges also open into the post-mortem room, NHS trusts should install CCTV cameras inside the post-mortem room that focus on the doors to the fridges.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter setting out expected actions for providers (Preet Kaur Gill, Jul 2026). In an annex to that letter issued in June 2026, it noted that mortuary building standards were updated in 2023 to improve security and CCTV, but stated it "will be providing further update during 2026 to provide additional guidance to NHS trusts" (NHS England, Jun 2026). Previously, the Department of Health and Social Care confirmed in December 2025 that the government had accepted the recommendation in principle subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

All NHS trusts should routinely audit the access data of all facilities used to store deceased people.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter detailing actions expected of trusts to ensure consistent improvements (Preet Kaur Gill, Jul 2026). In its June 2026 letter, it mapped the recommendation to supporting guidance, including the Premises Assurance Model and relevant standards for mortuary facilities (NHS England, Jun 2026). Previously, the Department of Health and Social Care accepted the recommendation in principle in December 2025 "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

The practice of using shared electronic swipe cards for specific staff groups should cease immediately.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter setting out the actions expected of trusts and providers to ensure consistent improvements (Preet Kaur Gill, Jul 2026). In its June 2026 letter, it mapped this recommendation to supporting guidance, including the NHS Premises Assurance Model and mortuary facilities guidance (NHS England, Jun 2026). Earlier, in December 2025, the Department of Health and Social Care accepted the recommendation in principle, "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

All NHS trusts should consider putting in place systemic operational barriers that prevent the security and dignity of deceased people being compromised. An example of this would be implementation of a rule that prevents electronic devices such as phones or cameras being taken into a mortuary, other than for approved reasons.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter setting out the actions expected of trusts and providers to ensure improvements are delivered consistently (Preet Kaur Gill, Jul 2026). In its June 2026 letter, it mapped this recommendation alongside others on mortuary security, access, and audit to supporting materials, including the Premises Assurance Model and Health Building Note 16-01 (NHS England, Jun 2026). The Department of Health and Social Care had earlier accepted the recommendation in principle in December 2025, "subject to further work to determine the full impact of these recommendations" (Department of Health and Social Care response, Dec 2025).

All NHS trusts should take every breach of security in a mortuary or body store extremely seriously. Each security incident should be reviewed by a security expert who is able to identify any systemic security issues associated with the incident. A detailed action plan should be developed for each security breach, no matter how minor trusts regard such breaches to be. All security breaches occurring in mortuaries should be incorporated into security reports provided to trust boards or relevant subcommittees, in line with security breaches in other vulnerable areas.

In July 2026, the Department of Health and Social Care's Parliamentary Under-Secretary of State, Preet Kaur Gill, reported that NHS England had issued a national system letter setting out actions expected of trusts to ensure consistent improvements (Preet Kaur Gill, Jul 2026). In its June 2026 letter, it mapped this recommendation to supporting guidance, including the NHS Premises Assurance Model, Health Building Note 16-01, and Human Tissue Authority guidance (NHS England, Jun 2026). Previously, the department stated in December 2025 that the government had agreed to accept the recommendation in principle "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

The NHS should ensure that the security standards required for body stores are the same as those required for facilities licensed by the Human Tissue Authority.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that a national system letter had been issued setting out expected actions for NHS trusts to deliver improvements consistently (Preet Kaur Gill, Jul 2026). NHS England had previously mapped this recommendation in June 2026 to supporting guidance, including its Premises Assurance Model and Human Tissue Authority standards (NHS England, Jun 2026). In December 2025, the Department of Health and Social Care accepted the recommendation in principle "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025). Earlier, in July 2025, Dr Colin Sullivan of the regulator stated that it had piloted an assessment model for unlicensed body stores and set clear expectations on security measures (Dr Colin Sullivan, Jul 2025).

All NHS trusts should consider the installation of 'swipe to exit' for mortuary facilities. This would allow trusts to monitor and audit entry and exit, as well as time spent in the mortuary.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported that NHS England had issued a national system letter detailing actions expected of trusts to deliver improvements consistently (Preet Kaur Gill, Jul 2026). In that June 2026 letter, it mapped this mortuary access recommendation to supporting guidance, including the Premises Assurance Model, Health Building Note 16-01, and Human Tissue Authority guidance (NHS England, Jun 2026). Previously, the Department of Health and Social Care accepted the recommendation in principle in December 2025, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

All NHS trusts should monitor the number of staff with access to the mortuary or body store and keep this under routine review.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter setting out actions expected of trusts to ensure improvements are delivered consistently (Preet Kaur Gill, Jul 2026). In that June 2026 letter, it mapped the recommendation to supporting guidance, including the NHS Premises Assurance Model and Health Building Note 16-01 (NHS England, Jun 2026). Previously, in December 2025, the Department of Health and Social Care accepted the recommendation in principle "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

NHS trusts should ensure that Designated Individuals have enough time and resource to fulfil their responsibilities, including time for learning and development.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill stated that NHS England had issued a national system letter setting out actions expected of trusts to ensure improvements are delivered consistently (Preet Kaur Gill, Jul 2026). In June 2026, it mapped this recommendation to third-party Human Tissue Authority guidance on the role of the Designated Individual (NHS England, Jun 2026). The Department of Health and Social Care had accepted the recommendation in principle in December 2025, "subject to further work to determine the full impact of these recommendations" (Department of Health and Social Care response, Dec 2025).

NHS trusts should ensure that senior managers, including the Chief Executive, have a clear understanding of the role of the Designated Individual, their lines of accountability, and the individual legal responsibility associated with being a Designated Individual.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter setting out the actions expected of trusts to ensure consistent improvements (Preet Kaur Gill, Jul 2026). In an annex to that letter in June 2026, it mapped this recommendation to Human Tissue Authority guidance covering the role of the Designated Individual (NHS England, Jun 2026). Previously, the Department of Health and Social Care agreed in December 2025 to accept the recommendation in principle "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

NHS trusts should ensure that Designated Individuals attend the correct governance forums. This would allow them to escalate issues and risks, as well as reporting upwards when required.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill reported that NHS England had issued a national system letter setting out actions expected of trusts (Preet Kaur Gill, Jul 2026). In its June 2026 letter, it mapped the recommendation to Human Tissue Authority guidance regarding the role of the Designated Individual (NHS England, Jun 2026). The Department of Health and Social Care had earlier accepted the recommendation in principle in December 2025, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

A professional background in the field of mortuary services should be made a prerequisite for the post of Mortuary Manager.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that NHS England had issued a national system letter setting out actions expected of trusts to ensure consistent improvements (Preet Kaur Gill, Jul 2026). In its June 2026 letter, it mapped this recommendation on the mortuary manager role to supporting guidance covering local HR policies and resource allocations (NHS England, Jun 2026). Earlier, in December 2025, the Department of Health and Social Care recorded that the government had agreed to accept the recommendation in principle, "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

NHS trusts should assure themselves that the Mortuary Manager has adequate resources and support to perform their role effectively, including meeting any reporting requirements.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported that NHS England had issued a national system letter setting out expected actions for trusts to ensure consistent improvements (Preet Kaur Gill, Jul 2026). In June 2026, it had mapped this recommendation to supporting guidance on local human resources policies and resource allocations (NHS England, Jun 2026). Previously, the Department of Health and Social Care agreed in December 2025 to accept the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

All NHS trusts should establish a routine reporting system for matters relating to mortuaries and body stores. This reporting system should include the presentation of a formal report, by the accountable executive director, to the trust board on a routine basis. The accountable executive director should prepare and present to the trust board a formal annual report, similar to the annual safeguarding report. The report should include: staffing matters; security incidents; all serious incidents; Human Tissue Authority reports (where applicable); and all security audits, including audits of access and any access breaches.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill of the Department of Health and Social Care stated that NHS England had issued a national system letter setting out expected actions for trusts (Preet Kaur Gill, Jul 2026). In that June 2026 letter, its Chief Nursing Officer Duncan Burton and Chief Operating Officer Sarah-Jane Marsh asked provider trusts managing mortuaries or post-death care to return a Board Assurance Statement by 31 July 2026 (Duncan Burton, Jun 2026). Previously, in December 2025, the department agreed to accept the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Trust boards should assure themselves that the recommendations in this Report have been implemented.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill stated that NHS England had issued a national system letter setting out actions expected of trusts to ensure consistent delivery of improvements (Preet Kaur Gill, Jul 2026). In its June 2026 letter, it mapped the recommendation to supporting guidance, including the Insightful provider board guide (NHS England, Jun 2026). Previously, the Department of Health and Social Care accepted the recommendation in principle in December 2025, "subject to further work to determine the full impact of these recommendations" (Department of Health and Social Care response, Dec 2025).

Trust boards should ensure that these recommendations and governance arrangements are applied to any temporary facilities used by trusts for the storage and care of deceased people.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported that NHS England had issued a national system letter outlining actions expected of trusts, noting that the Department of Health and Social Care remained committed to providing a full response (Preet Kaur Gill, Jul 2026). In an annex to that June 2026 letter, it mapped recommendation 17 alongside related board assurance recommendations to supporting guidance on board capability and reporting (NHS England, Jun 2026). Previously, in December 2025, the department accepted the recommendation in principle "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

Trust boards should take note of the fact that mortuary services are subject to statutory regulation and should be treated with equivalent regard to other regulated activities within trust governance arrangements.

Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, reported in July 2026 that NHS England had issued a national system letter setting out actions expected of trusts to ensure improvements are delivered consistently (Preet Kaur Gill, Jul 2026). In June 2026, it had mapped this recommendation to supporting board guidance, including "The Insightful provider board guide" and provider capability guidance (NHS England, Jun 2026). The Department of Health and Social Care had previously accepted the recommendation in principle in December 2025, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

NHS trust boards should ensure that the security and dignity of deceased people are included in safeguarding training, policies and assurance.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that NHS England had issued a national system letter setting out actions expected of trusts to ensure improvements are delivered consistently (Preet Kaur Gill, Jul 2026). In that June 2026 letter, it mapped the recommendation to supporting guidance in the NHS Safeguarding Accountability and Assurance Framework (NHS England, Jun 2026). Previously, in December 2025, the Department of Health and Social Care accepted the recommendation in principle subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

The remit of the Chief Nurse in NHS trusts should explicitly include executive responsibility for safeguarding the security and dignity of deceased people in NHS mortuaries and body stores.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported that NHS England had issued a national system letter detailing actions expected of trusts to deliver improvements consistently (Preet Kaur Gill, Jul 2026). In that June 2026 letter, it mapped this recommendation to its Safeguarding Accountability and Assurance Framework as supporting guidance (NHS England, Jun 2026). The Department of Health and Social Care had previously accepted the recommendation in principle in December 2025, stating that acceptance was "subject to further work to determine the full impact of these recommendations" (Department of Health and Social Care response, Dec 2025).

NHS England should formally incorporate the safeguarding of deceased people into its safeguarding framework for NHS trusts.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill stated that NHS England had issued a national system letter setting out actions expected of trusts and providers (Preet Kaur Gill, Jul 2026). It reported in June 2026 that its safeguarding framework "was updated to include reference to the deceased" in April 2026 (NHS England, Jun 2026). Earlier, in December 2025, the Department of Health and Social Care accepted the recommendation in principle, noting that further work was required to determine the full impact (Department of Health and Social Care response, Dec 2025).

There should be a process to routinely review who is permitted to access the mortuary unsupervised.

Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated in July 2026 that ongoing work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Earlier, in December 2025, the Department of Health and Social Care reported that the government had accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Where unsupervised access is permitted for a legitimate and unavoidable purpose, there should be individualised electronic access controls to enter the mortuary and restrict access to specific areas of the mortuary, such as the post-mortem room. There should be a requirement to 'swipe to exit' to ensure that all activity is auditable. There should be no shared electronic access controls.

In a July 2026 written statement, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, reported that the government was "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care had previously stated in December 2025 that the recommendation was accepted in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Where people other than mortuary staff are visiting the mortuary during working hours, for example contractors, cleaners and other visitors: Access must be limited to specific areas required for the purposes of their work or visit. They must be supervised when working in areas where there is access to deceased people, for example in the fridge or post-mortem rooms. Their attendance must be recorded and audited.

In a July 2026 written statement, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated that work included "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care had previously reported in an interim update in December 2025 that the government accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Where mortuary staff are permitted to work alone in the mortuary, there should be a review of lone working policies, including consideration of activities involving direct handling of the deceased, alongside mitigations that can be put in place to safeguard the security and dignity of the deceased, such as CCTV.

In July 2026, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated in a written statement to the House of Commons that work included working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit (Preet Kaur Gill, Jul 2026). This followed an interim update in December 2025 by the Department of Health and Social Care, which recorded that the government had accepted the recommendation in principle "subject to further work to determine the full impact of these recommendations" (Department of Health and Social Care response, Dec 2025).

Routine and regular audits of security must be conducted, encompassing both access to and exit from the mortuary and movement within it, including the post-mortem room. Access data must be reconciled against CCTV footage. Audits must be reported to the Designated Individual and head of service or equivalent.

In July 2026, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated that work was under way with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care previously noted in December 2025 that the government accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Immediate steps must be taken to commission a specialist strategic review of the systems in place to protect the deceased, which should include a detailed risk assessment of the potential breaches of security that could occur. The review should include an assessment of: the systems in place to identify unauthorised access to the facility; the strength and effectiveness of barriers to prevent unauthorised access to the facility; the systems in place to identify any inappropriate access to the deceased; and how CCTV is used, including its monitoring and any audits undertaken.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care had previously accepted the recommendation in principle in December 2025, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

There must be no reliance on keys and keypad codes alone to secure access to the mortuary.

In a July 2026 written statement, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated that work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Previously, the Department of Health and Social Care reported in December 2025 that the government had agreed to accept the recommendation in principle subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Fridges and freezers containing deceased people must be locked at all times, with appropriate key security in place.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported in a written statement that the government was "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care previously stated in December 2025 that the government had accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

CCTV must be installed inside the mortuary facing all doors and access points, the reception area and the doors of all fridges containing deceased people, including where these are accessible from within the post-mortem room. Local authorities must put appropriate safeguards in place to maintain the security and dignity of the deceased in relation to the monitoring of CCTV. CCTV footage should be regularly reviewed. This should be done by mortuary staff where it is of a sensitive nature.

In a July 2026 written statement to the House of Commons, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated that ongoing work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Previously, the Department of Health and Social Care reported in December 2025 that the government had accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Arrangements for responding to incidents of unauthorised access must be reviewed and incorporated into Standard Operating Procedures.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Earlier, in December 2025, the Department of Health and Social Care reported that the government had accepted the recommendation in principle subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

All policies and procedures in relation to the security of the mortuary must be accurately and comprehensively reflected in a single security Standard Operating Procedure.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported in a written statement that ongoing work included "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Previously, the Department of Health and Social Care stated in December 2025 that the government had accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

There must be a process to ensure that, where there is a requirement for funding to strengthen mortuary security, it is expedited and considered at the highest levels within the local authority.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit", while noting that a full response remains committed once the leadership period for Prime Minister has concluded (Preet Kaur Gill, Jul 2026). Earlier, in December 2025, the Department of Health and Social Care reported that the government had accepted the recommendation in principle subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

There must be an investigation into the root cause of each security breach. Each incident, the investigation and action plan must be reported to director level within the local authority as a minimum. Serious security breaches must also be reported to the relevant cabinet member and/or committee of elected members.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported that ongoing work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Previously, in December 2025, the Department of Health and Social Care stated that the government accepted the recommendation in principle subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

There must be audits of the mortuary Standard Operating Procedures and compliance with Human Tissue Authority requirements, undertaken annually as a minimum, with a clear record of authorisation by the Designated Individual, head of service or equivalent. Audits of staff compliance with the Standard Operating Procedures must be undertaken at least annually, with the results of the audits reported to the Designated Individual and head of service or equivalent.

In July 2026, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated in a written statement to the House of Commons that work includes supporting local authorities towards closer alignment with Human Tissue Authority standards on security, governance and audit (Preet Kaur Gill, Jul 2026). Earlier, in December 2025, the Department of Health and Social Care recorded that the government had agreed to accept the recommendation in principle "subject to further work to determine the full impact" (Department of Health and Social Care response, Dec 2025).

There must be a review of the management and oversight arrangements for the mortuary service, taking into consideration who is appointed as the Designated Individual, their direct contact with the mortuary, level of influence within the local authority, and attendance at governance forums. In particular: Local authorities must ensure that the Designated Individual has enough time and resource to fulfil their statutory responsibilities, including time for learning and development. The Designated Individual must have access to director-level officers in the local authority. The Designated Individual must also be able to directly raise issues in relation to the mortuary at the highest level within the local authority if they deem it is necessary. Where the Designated Individual is non-technically trained, a senior anatomical pathology technologist must fulfil the Mortuary Manager role to ensure that there is sufficient technical experience within the mortuary. The Designated Individual must attend regular, documented meetings at mortuary level. The Designated Individual must also attend governance forums where the mortuary is discussed and scrutinised. In line with Human Tissue Authority guidance, the named Licence Holder must be at a more senior level than the Designated Individual (e.g. director level or higher) and have a clear understanding of the Human Tissue Authority's statutory requirements and the role of the Designated Individual.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that government action includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Previously, in December 2025, the Department of Health and Social Care reported that the government had accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

The mortuary service must be treated in the same way as other regulatory services within local authority reporting structures: The mortuary must be visible to scrutiny at the relevant statutory committee, with regular reporting. Key performance indicators must be identified and must include the results of audits of compliance with Human Tissue Authority requirements. Inspections by the Human Tissue Authority and Human Tissue Authority Reportable Incidents (HTARIs) must be reported to the relevant statutory committee, and actions to achieve compliance monitored.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill reported that government action includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). Earlier, in December 2025, the Department of Health and Social Care recorded that the government had accepted the recommendation in principle, noting that further work was required to determine the full impact of the measure (Department of Health and Social Care response, Dec 2025).

The mortuary service must be reviewed by professional auditors at least biennially, with the results of the audit reported to a formal committee regardless of the level of assurance. Local authorities must arrange a peer review of the mortuary service at least every three years.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that ongoing work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care had previously reported in December 2025 that the government accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

All relevant reports and incidents concerning the mortuary must be made known to the lead local authority manager for the coroner service (and the Senior Coroner if they wish to see these reports). Local authorities that are not the lead authority for the coroner service must also share these reports and incidents with the coroner service lead in that coroner area.

In July 2026, Preet Kaur Gill, Parliamentary Under-Secretary of State for Health Innovation and Safety, stated in a written statement to the House of Commons that ongoing work included "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care had previously reported in December 2025 that the government accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

The implementation of these recommendations must be reported to the relevant statutory committee.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that work includes "working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit" (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care previously reported in December 2025 that the government accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025).

Local authorities providing a coroner service must review plans for the provision and operation of contingent body storage, in collaboration with local organisations providing mortuary services.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated in a written statement to Parliament that work was in progress, including working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit (Preet Kaur Gill, Jul 2026). Previously, the Department of Health and Social Care recorded in December 2025 that the government accepted the recommendation in principle, "subject to further work to determine the full impact of these recommendations" (Department of Health and Social Care response, Dec 2025).

Local authorities providing an unlicensed body store must be prepared to comply with the Human Tissue Authority's standards and guidance where applicable, in the event that a Human Tissue Authority licence is required to enable activities outside Human Tissue Authority licensing exemptions.

In July 2026, Parliamentary Under-Secretary of State for Health Innovation and Safety Preet Kaur Gill stated that the government was working with local authorities to support closer alignment with Human Tissue Authority standards on security, governance and audit (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care had previously confirmed in December 2025 that the government accepted the recommendation in principle, subject to further work to determine its full impact (Department of Health and Social Care response, Dec 2025). Earlier, in July 2025, Dr Colin Sullivan, Chief Executive Officer of the authority, stated that it had piloted an assessment model for unlicensed settings such as body stores and stood ready to offer its expertise (Dr Colin Sullivan, Jul 2025).

Where local authorities provide an unlicensed body store, they should do so in line with this Report's recommendations to local authority providers of licensed mortuaries.

In July 2026, Parliamentary Under-Secretary of State Preet Kaur Gill stated that the government was "working with local authorities to support closer alignment with Human Tissue Authority standards" on security, governance, and audit (Preet Kaur Gill, Jul 2026). The Department of Health and Social Care had previously accepted the recommendation in principle in December 2025, noting that further work was required to determine its full impact (Department of Health and Social Care response, Dec 2025). Prior to this, in July 2025, Human Tissue Authority Chief Executive Officer Dr Colin Sullivan reported that the regulator had piloted an assessment model for unlicensed settings and stood ready to offer its expertise (Dr Colin Sullivan, Jul 2025).