The Royal College of Pathologists has long campaigned for an independent system of medical examiners to investigate all deaths that are not reported to the coroner. Extensive pilot schemes have shown that medical examiners improve patient safety and increase the accuracy of death certification.

A national system of medical examiners was also recommend by three separate public inquiries: into GP Harold Shipman’s murders, neglect at Mid Staffordshire NHS Foundation Trust, and failings in the Morecambe Bay maternity unit.

In March 2016 the Secretary of State announced a consultation on medical examiners and other death certification reforms prior to their implementation in England and Wales in 2018.

The introduction of medical examiners will have a major impact on the way the NHS reviews how people die. It will affect anyone who completes a death certificate as well as those who teach about the accurate completion of death certificates and the process around death investigation.

Members are encouraged to respond to the consultation directly. You do not have to answer all the questions. We would be grateful if you would copy your response to the College at [email protected]. Members’ responses will be incorporated into the official College response but  we understand that the number of responses often determines how seriously an issue is taken so the more responses the Department of Health receive, the better.

All the documents that relate to the consultation are available here government  consultation 

To save time it is suggested respondents focus on the main consultation document - Introduction of Medical Examiners and Reforms to Death Certification in England and Wales: Policy and Draft Regulations. 

The College has also prepared a Medical examiners pamphlet with key information to help respondents: 

 

Also available are lessons from seven pilot schemes in Sheffield, Gloucester, Powys, Leciester, north London, Brighton and Hover, and Mid Essex which scutinised over 23,000 deaths. 

There are 26 questions in the consultation, not all of which will be relevant to pathologists so we have drawn attention to the ones that are likely to be of most interest:

• Question 11: Are the proposed certificates and medical examiner forms fit for purpose? There are new proposed death certificates and forms to be completed by the medical examiner to allow burial or cremation to go ahead.
• Questions 14-23: These ask about understanding of terms such as ‘unnatural’ and ‘neglect’ and ask about examples given under each category of death.
• Question 25: Do you agree that this proposal will provide a sufficient level of scrutiny in stillbirth cases? There is a possibility to extend the role of the medical examiner to include investigation of stillbirths – is this appropriate?

It would also be helpful if members could indicate that they support the College’s position of backing the introduction of a national medical examiner system. It is suggested that respondents do this in the section: ‘Do you have any other comments about the draft Regulations?’

I encourage all members to take part in the consultation and copy any response or questions you may have to [email protected]