Medical examiner service

The medical examiner service was rolled out across the NHS in England from 2019 with the aim of improving death certification and ensuring that the bereaved are kept at the centre of the process.

From 9 September 2024 all deaths that are not investigated by a coroner will be reviewed by NHS medical examiners.

By introducing this new service, the NHS aims to provide an opportunity for the bereaved to ask questions about the cause of death and discuss the care that their relative or friend received.

Who are medical examiners and medical examiner officers?

Medical examiners are senior NHS doctors who have not been involved in the care of the deceased. Medical examiner officers are there to support the work of medical examiners. They have had specialist training to undertake their roles and help support families during these difficult times.

What does the medical examiner do?

Medical examiners and medical examiner officers review the relevant medical records and discuss the care with the medical team who were looking after the deceased. This is to ensure that when completing the Medical Certificate of Cause of Death (MCCD), the document accurately reflects the cause of death.

Medical examiners or medical examiner officers will discuss the cause of death with the bereaved. This gives you the opportunity to ask questions, give any feedback or raise concerns, if you have any, in relation to your loved one’s death.

You will receive a telephone call a few days after the death. The medical examiner can make it easier for you to understand some of the medical language in the MCCD. In some situations, the death is discussed with the coroner’s office.

By law, some deaths must be reported and then investigated by the coroner. The medical examiner’s office is guided by the coroner’s decisions, but that may mean they cannot issue the MCCD. The medical examiner’s office will be able to support you if coroner involvement is required.

Further information: Notification of Deaths Regulations (Gov.uk)

What is the coroner’s service?

The coroner’s service investigate deaths where a doctor cannot issue a Medical Certificate of Cause of Death. This is an investigation independent from the medical examiner, although they may still provide expert medical advice to the coroner.

Some deaths must be reported to the coroner:

You can also receive guidance in other formats by emailing the Ministry of Justice: [email protected]

Why am I being asked to speak to the medical examiner?

A discussion with the medical examiner or their team will provide you with an opportunity to have an open and honest conversation with someone who was not involved in providing care to your loved one.

It could be as simple as helping you to understand more about the treatment and causes of death or to understand the medical language used.

There may be some aspect about their care which you would like to discuss, and this is your opportunity to have a conversation about your thoughts and feelings.

If the medical examiners find any issues with care in hospital that need further inquiry, they will refer these cases to someone within the trust who can arrange this. For community deaths any issues can be raised with the practice manager.

As well as answering your questions, this can help the NHS provide better care for other patients and carers in the future. It may provide ways in which patient and family care could be improved.

Can I ask the medical examiner to talk to someone else if it is too difficult for me to speak with them?

Yes, this can be discussed when the team contact you, or you can let the bereavement team or medical examiner’s office know if you would rather they spoke to someone else on your behalf.

If you change your mind and feel able to talk to the team about the death of your relative or friend, you can let the team know at any point.

What happens if I do not want to speak to the medical examiner or their team?

We understand this is likely to be a difficult time for you. Speaking to someone is completely your choice. If you are not sure, you can contact the medical examiner or a member of their team on 01642 835905 and ask for more information before deciding if you want to go ahead.

Will this mean funeral plans or release of the body take longer?

Medical examiners make every effort to avoid delays and work with the bereaved to allow registering of deaths.

Medical examiners and their team will try to be flexible, especially where relatives need access to the deceased, or release of the deceased quickly for cultural or religious reasons.

What will happen if there a post-mortem or the coroner is involved?

If it has been decided that the deceased will require a post-mortem, they will then be under the care of the coroner’s service.

Post-mortems are usually performed at The James Cook University Hospital, which means that the deceased will be transferred there.

Post-mortems are usually carried out within two to three working days following death and the information shared directly with the coroner.

You will be kept fully informed, by the coroner’s office, throughout to help you with your plans.

What can I do if I have questions or concerns about the medical examiner process?

If you are unhappy with the medical examiner’s advice, we recommend that you discuss this with staff from the medical examiner’s office in the first instance.