‘New approach will give bereaved relatives an opportunity to have a voice’ says United Lincolnshire Hospitals NHS Trust, which runs Grantham Hospital

A medical examiners service is the focus of a column by Philippa Williams, the lead medical examiner officer for the United Lincolnshire Hospital NHS Trust. She writes:

As part of the NHS Long Term Plan, Medical Examiner (ME) services are being extended across Lincolnshire.

United Lincolnshire Hospitals NHS Trust have hosted this independent service since 2019 and has been undergoing a recruitment drive for additional medical examiners and medical examiner officers, which has enabled the trust to implement the extension of their ME service.

The service provides help to bereaved people across Lincolnshire with a more extensive offering in communities as well as a hospital setting.

Medical examiners are responsible for reviewing deaths that occur naturally and therefore would not go to a coroner, for example those who have died with an existing illness. Medical examiners already undertake this role in acute trusts and the new service expands that in particular to working with local GPs.

An ME works closely with doctors within a hospital and will now be working closely with doctors in communities with the primary goal of agreeing the proposed cause of death with the attending doctor, ensuring the accuracy of the medical certificate of cause of death (MCCD) and sharing any learning that may have been identified as part of the review.

The appointment of medical examiners and medical examiner officers has been a key component for the improvements to the death certification process in England and Wales. The need for change was highlighted by a number of public enquiry reports; including the Shipman Inquiry report and later by reports about Mid-Staffs and Morecambe Bay.

A priority of this new approach is to give bereaved relatives an opportunity to have a voice, ask questions and, if necessary, raise concerns. Medical examiners will call the next of kin to discuss the cause of death and answer any questions or respond to any concerns.

The expansion of this service into communities is based on the success and excellent patient feedback that the provision of medical examiners and medical examiner officers within hospitals has provided. The expansion of the service not only provides bereaved people with opportunities to ask questions and raise concerns, but also acts to enhance safeguards for the public and healthcare providers through improved and consistent scrutiny of all non-coronial deaths.

The roll out of the service to the community is undertaken incrementally so does not currently encompass all community deaths, however the service is expected to be made statutory in law as of April 2024 by which time the Medical Examiner Service will review all deaths that are not referred to the coroner.