The time surrounding the death of a loved one can be difficult, and there are lots of practical tasks to complete and people who may contact you. This leaflet will explain the role of the Medical Examiner and Medical Examiner’s Officers (MEO) following the death.
Introduction
Medical Examiners are required to review the last episode of care (either the final admission, or the care in community prior to death) for all patients who die in England and Wales where a Coroner’s referral is not needed.
Sometimes, when a person dies, their last episode of care can be complicated, with lots of medical terminology or an unclear sequence of events. Some families experience difficulties getting answers to their questions.
The Medical Examiner, or Medical Examiner’s Officer, by reviewing the notes, will be able to explain the events leading up to the death. They will also give an opinion about the Cause of Death as written on the Medical Certificate of Cause of Death.
A discussion with a Medical Examiner or their team provides you with an opportunity to have a conversation with someone who was not involved in providing care to the person who died, and to ask any questions.
The Medical Examiner system was set up by Government and has been established within hospitals for some time. It is now also reviewing deaths outside of hospital, for example deaths in care homes, the patient’s own home, community hospitals, and hospices.
Who are Medical Examiners?
Medical Examiners are senior doctors (for example consultants or experienced General Practitioners) who have received extra training and usually perform this role alongside their normal clinical role. They will not have looked after your loved one during their final illness, so they are independent. They will have access to your loved one’s record or a summary of their care and will be able to speak to the team who were looking after them.
They will scrutinise the notes about the final episode of care. If there are issues raised by the Medical Examiner’s review or through discussion with you, this will be highlighted to the treating team or organisation. This will not normally delay the issuing of the Medical Certificate of Cause of Death.
Who are Medical Examiner’s Officers (MEOs)?
MEOs are not doctors but are NHS professionals who are trained and experienced in issues surrounding bereavement and causes of death. Calls from the Medical Examiner’s office may come from these Officers rather than the Medical Examiner and they are able to explain cause of death and answer your questions. If your question is more complex, they may refer you to the Medical Examiner.
Why am I being asked if I have any concerns?
A discussion with a Medical Examiner or their Officers provides you with an opportunity to have an open and honest conversation with someone who was not involved in providing care to your loved one and answer any questions you may have. It could be as simple as helping you to understand more about the treatment and causes of death or to understand the medical language used, or there may be something about the care which you did not understand.
This is an opportunity to ask questions and raise concerns. The Medical Examiner will provide an independent view of causes of death and the care provided. Medical Examiners and MEOs will discuss your thoughts, questions and concerns, and if they find issues with care that need further investigation, Medical Examiners will refer these to someone who can do this.
As well as answering your questions, this can help the NHS provide better care for other patients and carers in the future, for example by identifying ways in which patient and family care could be improved.
How does this work practically?
If your loved one died in hospital, you will be asked to contact the Bereavement Office. They will explain whether it is likely that the death will be referred to the Coroner or reviewed by the Medical Examiner’s team. The Medical Examiner’s Officer or Medical Examiner will call you once the notes have been reviewed and they will be able to explain the cause of death and will ask you whether you have any unanswered questions or any concerns and will address these.
If your loved one died in a community hospital or hospice, the clinical team there will refer to the Medical Examiner’s Office and will coordinate the sending of patient records to that team. They will also send your contact details to the Medical Examiner’s office and the Medical Examiner’s office will contact you once this information is received to explain the cause of death and answer any questions you have.
If your loved one died in the community (i.e. their own home or a care home), the GP practice will contact the Medical Examiner’s office and will coordinate the sending of patient records to that team. They will also send your contact details to the Medical Examiner’s office and the Medical Examiner’s office will contact you once this information is received to explain the cause of death and answer any questions.
The conversation with the Medical Examiner’s office will be expected to take 5-10 minutes and you should hear from the team within the first couple of days after the death.
How does this link in with the Coroner?
Your loved one’s death will be reviewed in more detail by either the Coroner or the Medical Examiner’s office, not both. The team caring for your loved one prior to death, or the Bereavement office, will be able to tell you which route is likely. If your loved one is being referred to the coroner’s team, you will hear from them instead of the Medical Examiner’s team and they will be able to explain the next steps.
What if I need a rapid burial for faith or other reasons?
It is a requirement that all deaths are reviewed by either the coroner’s office or the Medical Examiner’s team. However, teams are aware of the necessity to ensure this review is proportionate and occurs as quickly as possible, particularly where there are requirements for a rapid funeral.
Please highlight this to the team looking after your loved one as early as possible. It may be possible to seek advice from the Medical Examiner’s office in advance of a death where this is the case, so you should mention it to the team caring for your loved one either before or as soon as possible after death.
Can I ask the Medical Examiner to talk to someone else if it’s too difficult for me to speak with them?
Yes of course. The Medical Examiner or their staff may contact you to ask who you would like us to talk to instead, or you can let the team know if you would rather have someone else as a first point of contact.
Who can I contact?
This information is intended to summarise the role of the independent Medical Examiner Service. If you have any queries about the legal processes required prior to registration of the death, please contact the organisation that is dealing with the paperwork, e.g., GP practice, Hospice, or Hospital.