Medical Examiner Service

About the Medical Examiner Service

The Medical Examiner Service has been developed following a number of recommendations from key inquiries to provide greater scrutiny of all non-coronial deaths in England and Wales.

The Medical Examiner system is designed to:

• Provide bereaved families with greater transparency and opportunities to raise concerns

• Improve the quality/accuracy of medical certification of cause of death (Death Certificate)

• Ensure referrals to coroners are appropriate

• Provide the public with greater safeguards through improved and consistent scrutiny of all non-coronial deaths, and support healthcare providers to improve care through better learning

Who are Medical Examiners?

Medical Examiners are senior independent doctors who have received specialist training in the legal and clinical elements of the death certification process. Their role includes:

• Advise on whether or not the law requires the coroner to be informed about a death

• Advise doctors on how best to certify the cause of death

• Identify situations where some aspect of healthcare could have been improved, and feedback suggestions for possible improvements in the future.

Medical Examiners are assisted by the Medical Examiners Officers, who are not doctors but have experience of the healthcare system and have had training for their role. They manage cases from initial notification through to completion and are essential for the effective and efficient working of the service.

Medical Examiners and Medical Examiner Officers offer next of kin’s a chance to ask questions or raise concerns about the cause of death or about the care their loved one received before their death.

The Medical Examiner Office, although located within all 3 sites of East Kent Hospitals, is independent and impartial in its work of reviewing patient deaths.

The Coroner

Some deaths must be notified to the Coroner. When the Coroner starts an investigation, they will investigate the death independently – although the Medical Examiner may still provide expert medical advice to the Coroner.

Further information in relation to Coroners can be found on the Ministry of Justice website: www.gov.uk/government/publications/guide-to-coroner-servicesand-coroner-investigations-a-short-guide

Death Certification Reforms September 2024

After 9 September 2024 it is a statutory requirement for all deaths to be reviewed by either the medical examiner or coronial service.

The death certificates can still only be signed by a registered doctor, but recognising the changes to how medicine is practiced, the 28-day rule is changing.

From September 9th, a doctor will be able to issue the death certificate, provided they have seen the patient in their lifetime, and from the records (which may be allied professional records), they can establish a cause of death to the best of their knowledge and belief.

From this date, the need to have seen the patient in last 28 days of life or after death ends. Instead, a medical practitioner can complete the MCCD if they have attended to the deceased in their lifetime and can propose a cause of death to the best of their knowledge and belief. The case then needs to be reviewed by a Medical Examiner 

There will be three new MCCDs: ‘Attending Practitioner MCCD’, ‘Attending Practitioner child death within the first 28 days of life MCCD’, and ‘Medical Examiner MCCD’, which the Medical Examiner will be required to sign to confirm their agreement with the cause of death. Without this signature, the death cannot be registered.

The cremation form 4 will no longer be required. The recording of medical devices and implants will be included on the new MCCD and in the certificate for burial or cremation (green form).

Contact details

The East Kent Medical Examiner Service can be contacted on ekhuft.medicalexaminerofficers@nhs.net