• Alan Fletcher is currently lead medical examiner in Sheffield
  • Will report to national patient safety director Aidan Fowler
  • Has reviewed more than 20,000 deaths in his Sheffield role

NHS Improvement and the Department of Health and Social Care have appointed a national medical examiner to oversee the introduction of the new death review service.

Emergency medicine consultant and current lead medical examiner in Sheffield Alan Fletcher will take on the national role reporting to the national patient safety director Aidan Fowler.

Dr Fletcher has run a pilot medical examiner service in Sheffield since 2008 as part of wider reforms to the death certification system following Dame Janet Smith’s inquiry into serial killer GP Harold Shipman.

In his role in Sheffield, Dr Fletcher has personally reviewed more than 20,000 deaths.

The government had intended to bring in a full national medical examiner service that would examine all deaths but this has since been watered down to focus only on deaths in acute trusts amid Treasury concerns over funding.

The current plans will mean deaths in the community, under primary care or among mental health or learning disability patients will not be examined.

Sir Robert Francis recommended the role of medical examiners be implemented in line with the Shipman inquiry in 2013. This was underlined with recommendations from Bill Kirkup following the Morecambe Bay Inquiry in 2015 and again in the recent Gosport Inquiry published last year.

Medical examiners will be required to speak with relatives of patients who have died to hear any concerns they may have. They will also review medical notes and cause of death forms. Where they have concerns, they will be able to refer deaths for full investigation by a coroner at an inquest.

Evidence from the pilots, including the Sheffield pilot led by Dr Fletcher, has shown medical examiners can expose problems with patient safety in hospitals, and can uncover governance failings and wider systemic problems not spotted by trusts themselves.

Dr Fletcher said: “Having worked on the system’s first pilot for the last decade, I have seen first-hand the crucial role that independent medical examiners can play in giving those bereaved a voice, while ensuring that the necessary steps after their loss are as problem free as possible.

“I look forward to working with stakeholders, current and future medical examiners to ensure that the service is able to deliver for patients and families.”

Care minister Caroline Dinenage said: “Independent medical examiners will improve the way NHS investigations are carried out to provide bereaved families with the full and honest answers they deserve and enabling the NHS to continually improve.”

Dr Fletcher will undertake his new role on a part-time basis and will continue serving as medical examiner for Sheffield and consultant emergency physician at Sheffield Teaching Hospitals Foundation Trust.