Medical Examiner Process

Medical Examiner Process

Overview/Purpose

This article covers the new Medical Examiner Referral process.  We explain:

  1. Background information about the process
  2. Important changes to be aware of
  3. How to find resources within the PCIT toolset to make the process as smooth as possible

Background information about the process

A new statutory medical examiner system is being rolled out across England and Wales to provide independent scrutiny of deaths.  From 9th September 2024 all deaths in any health setting that are not investigated by a coroner will be reviewed by NHS Medical Examiners.
Information from NHS England about these changes can be seen in more detail here.
The Department of Health and Social Care give guidance on "An overview of the death certification reforms" which can be found here.

Important changes to be aware of

Changes to the requirement to see a patient pre mortem

The new process represents a simplification of the current rules, in that medical practitioners will be able to complete a Medical Certificate of Cause of Death (MCCD) if they have attended the deceased in their lifetime, so there is no need to have seen the patient pre mortem as exists prior to rollout.

All patients who die will need referring to a Medical Examiner

This new process will require all deaths to be reported to the Medical Examiner.  The only exception are those who are referred to the coroner.  The GP must complete the ME-1A form and send this to the Medical Examiner. The Medical Examiner will complete this form and send it back to the GP.  When the GP receives the completed ME-1A form from the Medical Examiners office they can complete the new Death Certificate adn submit this to the Register office.

What do I need to tell the next of kin?

It is wise to inform them of this new process and let them know that they will be contacted by the Medical Examiners office.  The practice will need to inform them when the MCCD has been passed to the Register Office.

Death registration

Deaths will not be registered until the registrar receives notification of the cause of death from the GP or the coroner.  This notification will also start the 5 day statutory time frame to register a death.
Finding out how to register a death can be obtained here.
Patients can find out the details of their nearest register office here.
Useful guidance on what to do when someone dies can be found here.

Where can I find out more?

There are some useful podcasts:
  1. GPs and Medical Examiners working together
  2. Changes to the death certification process adn introduction of the statutory medical examiner system

How to find resources within the PCIT toolset

The process for recording patients dying within the practice would usually be as shown by the flow below. The suggested PCIT resources are highlighted in colours and explained in the key:

OneTemplate Admin

The OneTemplate Admin can be used to collect structured information when the practice is notified that a patient has died.  This includes word scripts for your team to use when collecting this sensitive information.  To enter this information open the OneTemplate Admin (we suggest by using the OneLauncher Admin) and navigate to the "Death" page:


Users can see all the required information to record to aid with the process:


Once this information has been completed and the status of the patients registration has been updated, the clinician who will be completing the MCCD can be tasked to complete this

OneTemplate Prescriber

When opening the OneTemplate Prescriber in a deceased patient, the "Registration Admin" page will be available:

This will show the following information:

                             
                            

Here the user can record all information about the cause of death as well as either seeing the previous information or updating it if required.

Referral Tree

The Medical Examiner ME-1A document is provided within the Referral Tree for Premium Customers. This takes data that has been entered in Admin and Prescriber templates and merges it into your local document for referral to the Medical Examiner using the MCCD form.  Depending on your local Referral Tree solution this will be found in differing locations which should have been communicated to you by your local team.

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