When will the Medical Examiner System be Rolled Out?
A Ministerial Statement in April 2023 set out the pathways towards implementing the full Medical Examiner Service from April 2024.
What is Changing?
From April 2024, it is now a legal requirement that before the GP has completed the MCCD, it is reviewed by a ME. If the death is reportable to the Coroner the GP will report it to the Coroner and inform the ME.
The ME will liaise with the GP and review the deceased’s medical records so they can answer three questions; what caused the death, does the coroner need to be notified, and was the care before death appropriate? They will liaise with the family of the deceased giving them a chance to ask questions about the cause of death and discuss if they have any care concerns.
What do Medical Examiners do?
Medical examiners are senior medical doctors, who are trained in the legal and clinical elements of death certification processes. Their role includes:
- Speaking to the doctor who treated the patient on their final illness
- Reviewing the medical records and any supporting diagnostic information
- Agreeing the proposed cause of death and the overall accuracy of the medical certificate cause of death
- Discussing the cause of death with the next of kin/informant and establishing if they have any concerns with care that could have impacted/led to death
- Acting as a medical advice resource for the local coroner
- Informing clinical governance systems to highlight deceased patients who require a mortality case record review so any formal learning can be gained by the provider organisation
- Ensuring that patterns and concerns about care are raised appropriately
- Enabling a medical examiner officer to conduct component parts of the role under delegated authority
Where will the Medical Examiners be based?
This may vary from town to town. In most cases the ME’s will be based at the Hospital as much of their work will be dealing with deaths in Hospitals.
How will this Work Out of Hours?
The Medical Examiner has issued guidance to ensure that areas make suitable provision to cater for their communities needs in particular for timely burials.
NBC regional leads have been working with the local ME teams to ensure the systems put in place meet our communities needs for the provision of an out of hours service. However, there is still a major stumbling block in accessing GP’s out of hours. This may require local solutions to be developed.
Urgent Release
Many bereaved families and FD’s fear that the additional requirement of a ME reviewing a death may cause anxiety for family members as they fear that the process will impact how quickly their loved one can be laid to rest.
The Medical Examiner has published guidance to plan for requirement for an urgent release based on faith or other priorities. It clearly emphasises that ME’s should make every effort to facilitate such circumstances, and where possible, to prioritise the scrutiny of these cases to avoid any delays.
They will try to be flexible, especially where relatives need access to the deceased, or release of the deceased quickly for cultural, religious, or other reasons.
New and digitised Medical Certificate of Cause of Death
When medical examiners become part of the statutory death certification process, Medical Certificates of Cause of Death (MCCDs) will need to be countersigned by a medical examiner before the death can be registered. This means a new MCCD form may be required, and DHSC are preparing to provide an online version of the new form.
