Medical Examiner Service

The ME service is sensitive to the requirements of all faiths and religions. The ME works closely with faith leaders to ensure they can provide a service for all patients. The service will endeavour to complete timely scrutiny of all faith deaths, allowing, when possible, the early release of the deceased thus facilitating death registration and burial or cremation. In addition to this, the ME provides a limited out of hours service at the weekend. This allows the attending medical practitioner the opportunity to refer or take advice regarding the cause of death with the on-call ME who will support the issue of the MCCD if appropriate, and release in all non-coronial deaths.

A standard operating procedure has been developed by Dr James Adeley (Senior Coroner for Blackburn with Darwen and Lancashire) and Dr Huw Twamley (Regional Lead Medical Examiner) for hospital and community deaths, this also includes referrals to the coroner. The ME continues to work closely with the coroner along with both the regional and national medical examiner services.  

The benefits of this service for the bereaved are likely to be the most dramatic. Previously, relatives of deceased rarely got to speak to the clinical team after a patient had died. The statutory medical examiner system now allows bereaved families an opportunity to ask questions and raised concerns with someone not involved in the care of the deceased prior to their death.

The Medical examiner will fully explain specifically what has been documented on the Medical Certificate of Cause of Death (MCCD) and discuss any issues that arise. This often brings clarity, dissipates doubts, and helps to alleviate negative thoughts and experiences. Providing a voice to the bereaved at this most difficult of times is important and rewarding. The ‘Care after Death' booklet given to the bereaved following the death of their loved one in hospital or community provides information and advice ‘when someone dies’. Further information regarding the ME service can be found in this booklet.

On a clinical note, the ME service offers greater safeguarding to the public, and uses the independent scrutiny of deaths for learning, education, and improvement for the services the trust provides. The ME works closely with the foundation year doctors to improve the quality and consistency of death certification and in turn the accuracy of mortality data. The ME service has designed guidance packages for both the hospital trust and community medical practitioners regarding the completion of the MCCD, and assists with terminology, structure, and sequence. This educates the medical practitioner and improves the quality of death certification.

The ME service is not accountable to the hospital trust but is accountable to their professional regulatory body and the regional and national ME service. Complaints regarding the East Lancashire Medical Examiner service will be initially directed to the East Lancashire Teaching hospital trust (ELHT) at  Complaints@ELHT.nhs.uk

The host trust will deal with the complaint if it does not compromise the services independence. Complaints will be escalated to the regional / national medical examiner service if independence is challenged.  All-information governance procedures including data protection, sharing information, patient confidentiality and safety, freedom of Information act are maintained and governed by the medical examiners host trust at East Lancashire Teaching Hospital. Both the medical examiners and medical examiner officers undergo yearly mandatory e–learning training in line with hospital trust policy. The training is based on the seven Caldicott principles surrounding information governance.  

Further information and a full overview of death certification reforms, including legislation links, can be found on the Government website.