Medical Examiners (UK)

Huge congratulations to Dame @ilovepathology.bsky.social and past NME Professor Alan Fletcher OBE for their well-deserved recognition in the #NYHonours list
👏👏👏 #MedicalExaminers

Medical Examiner stats for NW Surrey

Tuesday marks 1 year since the Medical Examiner Service became statutory. Since 9th Sept 2024 we have endeavoured to ensure deaths in NW #Surrey are explained with care, compassion & transparency—supporting families & improving patient safety every day. Here’s our year in numbers #MedicalExaminers

London funeral costs highest in UK, report finds - BBC News The average price in 2024 was £5,449, which is a 5.4% increase on the year before, the report says.

Financial services company SunLife found that the average funeral cost in 2024 was £4,285. In London, it was £5,449 - a 5.4% increase from the year before and 58% higher than in the least expensive region, Northern Ireland.

www.bbc.co.uk/news/article...

Position Statement on Terminally Ill Adult (End Of Life) Bill @rcpath.bsky.social

www.rcpath.org/discover-pat...

Doctor guilty of misconduct over case of girl, 13, whose death led to Martha’s rule — The Guardian Panel found Prof Richard Thompson failed to escalate Martha Mills’s treatment to intensive care or to review her condition directly in person

apple.news/A2uZxgP8zST2...

Police launch investigation into heart operation deaths at NHS hospital - BBC News Patients who died at Castle Hill Hospital near Hull may have suffered avoidable harm, documents suggest.

Pre-dates the statutory roll-out of the #MedicalExaminers service: TAVI mortality rate at the time (2020) was three times higher than the UK average

www.bbc.co.uk/news/article...

Senior doctor accused of failures in case that gave rise to Martha’s rule Prof Richard Thompson accused of wrongly failing to escalate care of Martha Mills, 13, before she died of sepsis

www.theguardian.com/society/2025...

@rcpsych.bsky.social cannot support the Terminally Ill Adults (End of Life) Bill for England and Wales in its current form and is once again urging MPs to look at our concerns ahead of the pivotal Commons Report stage debate and Third Reading. More here: www.rcpsych.ac.uk/news-and-fea...

Coroner's call for older driver eye tests after fatal crashes - BBC News Visual legal standards for motorists is "ineffective and unsafe", a coroner says.

Visual legal standards for motorists is "ineffective and unsafe" #coroner says.

www.bbc.co.uk/news/article...

East London GPs slammed over unnecessary autopsies of 'white Christian' patients Dead people in east London are undergoing unnecessary autopsies as GPs aren't handling their deaths properly, particularly if they are white, a…

Strong words from the Senior Coroner for East London
#MedicalExaminers www.romfordrecorder.co.uk/news/2509405...

Family say dad's body unburied after nine months - as they call for an inquest into his death www.itv.com/news/border/...

Lives at risk due to medical scan mistakes, says ombudsman - BBC News The most common issues include clinicians not spotting abnormalities, and scans being delayed.

Lives at risk due to medical scan mistakes
#NHS
www.bbc.co.uk/news/article...

Lancaster baby's death due to midwives' gross failures, coroner rules - BBC News The coroner at newborn baby Ida Lock's inquest highlights eight opportunities that were missed.

Newborn's death 'due to gross failures of midwives'

www.bbc.com/news/article...

'Reasonable precautions' could have stopped baby deaths - BBC News Leo Lamont, Ellie McCormick and Mira-Belle Bosch died within hours of their births in two Lanarkshire hospitals.

“Reasonable precautions” could have stopped baby deaths - BBC Scotland
www.bbc.co.uk/news/article...

Assisted dying debate: The UK’s real problem with palliative care - BBC News The UK was once ranked the best country for end-of-life care - but, say experts, that has all changed

The NHS is spending a fortune giving people a death they don't want

www.bbc.co.uk/news/article...

Human Rights and the proposals for Hillsborough Law: Govt response

committees.parliament.uk/publications...

Death sparks concern over non-medically qualified hospital staff - BBC News A coroner says the public is being misled over what an NHS physician associate does.

www.bbc.co.uk/news/article...

My brother, the NHS and the inquest into a needless death My brother spent the last hours of his life trying in vain to get basic help from the NHS. Why?

Really important and moving account of state failure in this weekend's @financialtimes.com that is free to read for all here:

Nottingham University Hospitals Trust pleaded guilty earlier today to charges related to 3 baby deaths in 2021. It will be sentenced next week and will likely face a substantial fine.

In 2023, it was fined £800,000 in a prosecution by the CQC following the death of baby Wynter Andrews in 2019.

Thank you - ‘expected death’ is a good topic to tackle as what may be expected by family may be unexpected in terms of notifications, and police may be called which mandates coroner involvement

More threads to come…

Also perhaps helpful to compare with where and how people resource care approaching EoL?

Deaths in hospital: seeking reversible causes, not expected to die = resource-intense
Deaths in community: Respect & ACP, recognised as approaching EoL, expected deaths = supportive care-intense

So from death to “Death Certificate” may take between 5-10 days and involves
• Doctors
• Medical Examiners
• Registration Service
… or a longer, unpredictable period of time if it is required to involve
• Doctors
• coroners
• pathologists
• inquests
• Registration services

End/

Copy of the Death Certificate issued for HM Queen

An in-person appt to register a death may be offered 2-5 days from the online booking

A death must be registered within 5 days of #MedicalExaminers releasing the MCCD to the Registrars

At the in-person appointment, families register and receive the Death Certificate

THIS IS THE DEATH CERTIFICATE

On line booking for registration

The completed MCCD is scanned and sent to Registration Services

At this point, the family are advised they can book an appointment online to register in person and go ahead and book a funeral date

NOT BEFORE

(Until the ME has reviewed it is not certain if the coroner will need to be involved) 8/

Reverse side of MCCD

NOW #MedicalExaminers are involved

ME reviews MCCD & compares with hospital + GP records to make sure all tracks AND checks for missed opportunities for care AND ensures coroner referral not indicated AND checks with family for concerns
THEN countersigns MCCD (which is NOT a death certificate) 7/

Medical Certificate of Cause of Death (MCCD)

Let’s say all goes smoothly and an AP is available and happy to offer a Cause of Death ‘to the best of their knowledge and belief’
They then complete the Medical Certificate of Cause of Death (MCCD)

The MCCD is NOT the Death Certificate 6/

Sign saying Coroners Court

If an AP cannot be sourced in a “reasonable time” (~72hrs) the death must be referred to the coroner under the Notification of Deaths Regulations 2019

This is the law

If the coroner is also unable to source an AP, they open an investigation which may include a post-mortem examination 5/

NHS App for hospital appointments

*NB* routine check-ups and care home visits do not need to be undertaken by a GP. Health professionals such as paramedics and district nurses may have far more contact with people approaching end of life which means an eligible AP may not be quickly available and hospitals may be asked to assist 4/

Healthcare worker holds hand of patient

News of the death is communicated to the Attending Practitioner (AP).

In hospitals this is via a daily report

In GP practice this is via a number of varied ways and may take 1-2 days

The AP is any doctor who has treated the deceased in life AND is able to offer a cause of death 3/

Verification of Death legal tests

When a person dies, the death needs to be Verified.
This is a precise medical assessment following set rules to provide legal confirmation of life extinct
(Time of death is recorded as the time of these tests, usually within hours)

The Verification of Death is NOT the Death Certificate 2/