Between March and June 2016 the Government consulted on a package of reforms to the death certification process and the introduction of medical examiners. The reforms aim to improve engagement with the bereaved in the process of death certification and offer them an opportunity to raise any concerns, as well as improving the quality and accuracy of Medical Certificates of Cause of Death. Safeguards will be enhanced in the process to enable medical examiners to report matters of a clinical governance nature to support local learning and changes to practice and procedures.
As part of the drive to further improve patient safety, I have today published the Government’s response to consultation on the introduction of medical examiners and the reforms of death certification in England and Wales and a copy is attached. This sets out the Government’s intention to introduce a system of medical examiners in England. The Welsh Government consulted separately in Wales.
Medical examiners are a key element of the death certification reforms, which, once in place, will deliver a more comprehensive system of assurances for all non-coronial deaths regardless of whether the deceased is buried or cremated. Medical examiners will be employed in the NHS system, ensuring lines of accountability are separate from NHS acute trusts but allowing for access to information in the sensitive and urgent timescales to register a death.
The response to the consultation demonstrates that there is widespread support for the aims of the reforms and for the introduction of medical examiners, but there were concerns about some aspects of the proposals. In particular concerns were raised about how the proposed model, based in local authorities, would work in practice and about the timeframes for implementing the system. Feedback on a proposed funding model was also received.
Since the Government consulted on the package of Death Certification Reforms, events have moved on. New information about how a medical examiner system could be introduced has been generated by the Department of Health and Social Care’s (DHSC) medical examiner pilot sites, early adopters of the medical examiner system, as well as from the Learning from Deaths initiative.
There will be two stages to funding the ME system to enable its introduction while legislation is in progress. Initially, medical examiners will be funded through the existing fee for completing medical cremation forms, in combination with central government funding for medical examiner work not covered by those fees. Following this interim period and when Parliamentary time allows for the system to move to a statutory footing, the funding of the system will need to be revisited. The existing medical cremation forms and fees payable associated with those forms will continue to apply for the interim period.
The Government has proposed that all child deaths (up to age 18) be exempt from the cost associated with the Medical Examiner system. This aligns with the broader purpose of the Government’s recent announcement about steps to ensure that no bereaved family will have to pay for the essential costs of burying or cremating their child.
This statement has also been made in the House of Commons: