Trusts and GPs told to scrutinise all deaths from next year

A letter signed by NHS leaders published today states the national medical examiner system will apply to deaths in all settings by the end of March next year.

Medical examiners — initially a recommendation of the Shipman inquiry — were first introduced to acute trusts in 2019 to independently scrutinise the cause of death in cases that are not referred to the coroner. Trusts were supported to set up medical examiner offices on site.

NHSE’ letter, published today, states medical examiners should now be rolled out for deaths in all settings “as early as possible in 2021-22” and all deaths are expected to be scrutinised by April 2022.

A large share of all deaths take place in people’s homes and in care homes.

The letter says: “The progress made at local and national levels mean we are now in a position to begin work on the next phase of implementation, which will extend medical examiner scrutiny to non-acute settings.”

Medical examiners are based in acute trusts and they will be responsible for deaths in other settings in their areas.

However, GP practices, mental health and community trusts will now have to decide how to apply the system and work closely with the medical examiners to refer deaths and share details about them.

The letter says: “Established medical examiner offices will need to work with GP practices and chief executives and medical directors at specialist, mental health and community trusts to plan how they will facilitate medical examiner scrutiny of deaths of their patients.

“Each organisation will need to work with one established medical examiner office. Regional medical examiners will help guide medical examiner offices and health providers through implementation.”

The national medical examiners office says there is now a legal basis for providers to share records of deceased patients for medical scrutiny, according to the letter.

The Royal College of Pathologists has so far trained 1,200 medical examiners, it adds.

The letter has been signed by national medical examiner Alan Fletcher, national director of patient safety Aidan Fowler, deputy chief medical officer prof Steve Powis and national medical director for primary care Nikita Kanani.