The law in England and Wales is changing and from September 2024 all deaths will need to be reviewed by a Medical Examiner if not by a Coroner.
Who are Medical Examiners and Medical Examiner Officers, and what do they do?
Medical Examiners are independent senior medical doctors who come from a variety of medical specialities. They review all hospital deaths and also those occurring at home, in care home, hospices and other community settings. They are supported in this role by Medical Examiner Officers. Both Medical Examiner and Medical Examiner Officer have undertaken specialist training for this role from the Royal College of Pathology.
Their job is to review the patient’s last care episode and ensure that their cause of death is recorded accurately. They do this by reviewing their medical records and also discussing with the doctors who looked after them. Medical Examiners also review the quality of care and make sure that it was satisfactory. Where there are concerns about the quality of care, or the death needs investigating further, the Medical Examiner Office will refer the case to an appropriate person to undertake this work, such as a Coroner.
A Medical Examiner or Medical Examiner Officer will contact the relative or representative of the person who died. This will usually be through a telephone call, or sometimes a meeting. This is quite routine and there is no cause for concern. They will discuss the Medical Examiner’s review and explain what is written on the Medical Certificate of Cause of Death and why, and check if you have any questions or concerns about the care the person received before their death. They can explain what medical language means and make it easier to understand what happened.
You can be confident that Medical Examiners and Medical Examiner Officers will provide an independent view. They will never look into the causes of death of a person they personally provided care for. The Medical Examiner Office reports themes and concerns and provides information on public health surveillance. Any feedback that you can provide is incredibly important and will help the NHS provide better care for other patients and carers in future; for example, by identifying ways in which patient and family care could be improved.
Coroners
Some deaths, for example unexpected deaths, are notified to a Coroner who may decide to carry out their own independent investigation. This link explains more about Coroners and the types of deaths they investigate.
https://www.gov.uk/government/publications/notification-of-deaths-regulations-2019-guidance
The Medical Examiner may sometimes give the Coroner medical advice in these cases, but Coroners lead these investigations and Medical Examiners will not be directly involved. We can help answer questions about the steps and procedures involved when a case is referred to the Coroner.
Frequently Asked Questions about the Medical Examiner Process
What happens upon the death of a family member?
The Doctor that last attended to the deceased will complete a Medical Certificate of Cause of Death (MCCD). This document will be sent to the Medical Examiner electronically. The Medical Examiner will review the patient’s medical records, speak to family members, and make the decision to approve or contest the Cause of Death cited by the Doctor on the Certificate. Once the Medical Examiner has approved the MCCD, the certificate will be forwarded, again electronically, to the local Register Office.
When can I start the process of arranging a funeral?
Funeral plans should not be confirmed until the Medical Examiner has conducted their review. All deaths must be registered at the Register Office by an informant – usually a relative. You can only book an appointment at the Register Office once the approved Medical Certificate of Cause of Death (MCCD) has been sent to the Register Office. Further information on the registration of deaths in the Rotherham area, including how to book an appointment, can be found at the Register Office – Rotherham Metropolitan Borough Council website. Only once both the Medical Examiner and Register Office processes have been completed, can the body be released
Will funeral plans or release of the body take longer?
We will be unable to issue Death Certificates or Cremation Certificates to family members, the Register Office or Funeral Directors, until the Medical Examiner has confirmed to us that their process is complete and that we are able to issue these documents. Medical Examiner offices make every effort to avoid any delays and work with families and carers of the person who died to meet the legal requirements for registering deaths. There will usually not be any additional delays incurred by this process and they will try to be flexible, for example where relatives would like the body to be released quickly for religious requirements. Please let the Doctor know if you wish for the process to be treated as Urgent.
Can I ask the Medical Examiner to talk to someone else if it’s too difficult for me to talk to them?
Yes, of course. Please let the Doctor who cared for the person know if you would like someone other than you to be the first point of contact. The Medical Examiner office will usually phone you around the time that the Medical Certificate of Cause of Death is being completed – but they can arrange another way of contacting you if you let us know what you prefer.
What if I don’t want to talk to the Medical Examiner office, or I don’t want to tell them about my concerns?
We understand this is likely to be a difficult time for you and it is your choice whether you talk to the Medical Examiner office or not. If you are not sure, you can contact the Medical Examiner office by calling the Rotherham Medical Examiner Service (details below) and request more information before deciding if you want to go ahead – they are trained to help bereaved people and will be very understanding.
Medical Examiner offices provide an independent view, so if you can, we encourage you to talk to them. They can explain things to you and are specially trained to answer your questions and act upon any concerns that you may have. If you don’t wish to talk to the Medical Examiner, please tell the patient’s doctor or the Medical Examiner when they call.
What can I do if I have concerns about the Medical Examiner process?
If you are not satisfied with the Medical Examiner office’s advice, please first discuss this with staff in the Medical Examiner Office, and if you are still not satisfied, you can also contact the Rotherham Hospital Patient Advice and Liaison Service on 01709 424461 or by emailing your.experience@nhs.net
How can I contact the Medical Examiner office?
The Medical Examiner office will contact you in the first instance. However, if your query is urgent, you can contact the Medical Examiner office:
01709 424465
rgh-tr.medicalexaminerservice@nhs.net