Death certification reform and the introduction of Medical Examiners on 09/09/2024

NHS England has been working with 126 NHS trusts since 2020 to implement the medical examiner system on a non-statutory basis.

Key Points

Implementation Date: The new system will come into effect on 9 September 2024.

Scope: All deaths in any health setting not investigated by a coroner will be reviewed by NHS medical examiners.

Medical Certificate of Cause of Death (MCCD): From 9 September 2024, any medical practitioner who attended to the deceased during their lifetime will be able to complete an MCCD, streamlining the previous process.

NHS bodies: the regulations require NHS bodies employing medical examiners to incorporate certain terms of appointment.

Background

The national medical examiner system was initially rolled out on a non-statutory basis, with acute trusts in England and local health boards in Wales establishing medical examiner offices to certify deaths within their organisations. In June 2021, medical examiner offices in NHS trusts started to extend their scrutiny to all non-coronial deaths. Draft regulations setting out the forthcoming statutory changes were published by the Department of Health and Social Care in December 2023.

Objectives

The primary goals of the medical examiner system are to:

• Ensure independent scrutiny of all non-coronial deaths.
• Provide greater safeguards for the public.
• Improve the quality of death certification and mortality data.
• Offer bereaved families an opportunity to raise concerns about the care provided to the deceased.

Resources and Support

Good Practice Guidelines: These guidelines ensure consistency in the operation of medical examiner offices. The guidelines will be updated for use from 9 September 2024.

Funding: Allocations are made annually through ICBs for the costs associated with medical examiner offices.

Regional Support: Each NHS region has a regional medical examiner and officer to provide support and oversight.

Terms of appointment: The Medical Examiners (England) Regulations 2024 set out the required terms of appointment for employers of medical examiners.

Contact Information

For further details, including national and regional contact information, as well as the requirements of the role, you can contact either the NHS England’s national team or the regional Medical Examiner and Officer. Please visit the NHSE webpage for the Medical Examiner Offices contact details.

Action Required

NHS trusts with medical examiner offices are required to ensure that terms of appointment for medical examiners are in place before 9 September. The list of 126 medical examiner offices can be found here. Please ensure that all relevant staff members and teams are aware of these changes and understand the new requirements. Please direct them to the provided resources for additional information and support.

For any questions or further assistance, please contact the National Medical Examiner’s team at nme@nhs.net.

Thank you for your continuous support.

Debi Reilly 

Regional Director of Workforce, Training and Education

NHS England