Preparing for the statutory rollout of the medical examiner system
The statutory implementation of medical examiner system will be coming to all NW London GP practices on 9 September 2024
(under legislation in the 2022 Health and Care Act).
The legislation will mean that independent scrutiny by a medical examiner will become a statutory requirement prior to the registration of all non-coronial deaths in England and Wales from this date. Information from the Department of Health and Social Care is here.
The new process requires practices being set-up on SystemOne and EMIS
Many of our practices are now set up with the new IT system and referring deaths through the medical examiner’s office. We will continue to support practices with this new IT system ahead the national rollout on 9 September 2024.
On this page (in the drop downs below) you will find:
- Training guides to get your practice setup on SystmOne/EMIS
- Frequently asked questions for practice staff
- Guidance for completing the Medical Certificate of Cause of Death MCCD
- Information for the public
- Contact details
Quick overview - What does this mean for GP practices?
- The change means that all deaths in the community (except clear coroner referrals) will need to be referred to the medical examiner office before a death certificate can be provided. Referral to the medical examiner will be through SystemOne/EMIS.
- From the date of statute, the MCCD must be sent to the Registrar office by the Medical Examiner’s office. The completed MCCD must therefore be sent to the ME office by the GP, and not direct to the Registrar office
- The MCCD will be signed by the Medical Examiner before it is then sent to the Registrar.
- As part of the process the medical examiner will speak to the bereaved and talk through any questions they have.
- The process should not cause undue delays for the bereaved and they will not need to do anything differently.
The statutory implementation of medical examiner system will be coming to all NW London GP practices (under legislation in the 2022 Health and Care Act).
To be compliant practices must be ready to use the new process on EMIS/SystemOne to refer deaths to the Medical Examiner’s Office - before a medical certificate for cause of death (MCCD) can be issued, for non-coronial deaths.
User guides to set your practice up:
All practices should attend a training session to support set-up on these systems - please see the NW London primary care bulletin for dates and times.
If you have IT set-up questions and cannot attend one of these training days please contact: tsmith8@nhs.net
What is the change to the death certificate process and why is it happening?
The statutory implementation of medical examiner system is coming to all GP practices on 9 September (under legislation in the 2022 Health and Care Act).
The medical examiner system has been successfully running in our acute trusts for the last two years and the rollout to primary care completes the final stages of the nationwide process. A medical examiner will review the clinical notes to agree the cause of death with you or suggest a referral to the coroner. As part of the process the medical examiner will speak to the bereaved and talk through any questions they have.
The service so far has received positive feedback.
What does this mean?
The change means that all non-coronial deaths (non-acute sector) need to be referred to the local medical examiner’s office before a death certificate can be provided.
This will be done using a new pathway set up on EMIS/SystmOne TPP.
User guides can be found on the tab above.
What does a medical examiner do?
Medical examiners (ME) are senior clinicians who act in a supportive role:
- agree the proposed cause of death with the doctor completing death certificate
- discuss the cause of death with the next of kin/informant and establish if they have questions or any concerns with care before death
- identify potential learning and compliments to contribute to clinical governance procedures.
Will the new process cause delays to the bereaved?
There are additional steps in the process but they should not cause undue delays for the bereaved. Medical examiner review should happen within 24 hours. The GP will need to respond to the medical examiner review and together agree a cause of death. The final certificates will continue to be sent electronically to the registrar by the Medical Examiner.
The practice will need to inform bereaved relatives that they will receive a call from the Medical Examiner's office. Other than this call bereaved relatives/next of kin should not notice a difference in process.
Why is the medical examiner calling the family?
The medical examiner or medical examiner officer has the responsibility to ask the family if they had any concerns about the care of the deceased. This is the case even if the regular GP has been present in the home or visited afterwards as the medical examiner service is independent.
It also provides an opportunity for the bereaved to speak to someone independent of the deceased's care about their treatment.
What is the process - how will practices be informed of a death?
There is no change to the way that the practice will hear about a death in the community. Most are communicated from the relatives or friends of the bereaved, others from the out of hours GP service or community nurses, or the practice may receive a notification of deduction.
How will I know when the change has come into effect?
The process is required by law - we are still waiting for a confirmed national date. Practices will be contacted to confirm this date.
How do we get the practice ready for the change?
Information will be shared with practices, but if you would like to talk to someone about getting your practice set-up. Please email: tsmith8@nhs.net
Who is my medical examiner– how do I contact them?
If you have any questions, please contact your local medical examiner office.
|
Borough of patient death |
Medical examiner service base |
Medical examiner office email |
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Hillingdon |
Hillingdon Hospital |
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Harrow |
London NW University Healthcare (Northwick Park) |
LNWH-tr.medicalexaminerharrow@nhs.net
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Hounslow |
West Middlesex Hospital |
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Brent |
London NW University Healthcare (Northwick Park) |
LNWH-tr.medicalexaminerbrent@nhs.net
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Ealing |
London NW University Healthcare (Northwick Park) |
LNWH-tr.medicalexaminerealing@nhs.net
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Royal Borough of Kensington and Chelsea |
Chelsea and Westminster Hospital |
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Hammersmith and Fulham |
Imperial College Healthcare |
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Westminster |
Imperial College Healthcare |
What resources will be available to help train staff?
Information for practice staff, IT training support and information for the public can all be found on these pages.
Information is regularly shared with practices, therough the bulletin and email to ensure they are set up correctly on SystmOne/EMIS.
You can also listen to this national podcast.
This page will be updated shortly - the process to cover the new legislation needs to be incorporated.
What happens after a loved one dies and how do you go about registering the death?
This information has been provided to introduce you to the role of the medical examiner and explain why they will call the next of kin following a bereavement.
Watch our video or read more below.
Losing a loved one is never easy and it can be difficult and confusing having to think about what you need to do to register the death when you are grieving.
To help you understand the process we’ve put together a simple guide of what happens next and what you will need to do.
1. Phone call from the medical examiner’s office
As soon as possible after the death (on average within 24 hours) the next of kin will receive a phone call from the medical examiner’s service. This service provides an independent review of the cause of death and gives the next of kin time to ask questions.
(Medical examiners are senior medical doctors who provide independent scrutiny of the causes of death. They are trained in the legal and clinical elements of death certification processes. The medical examiner’s service was rolled out nationally in September 2024 to all community and GP services. You can find out more here).
The medical examiner’s office will be able to:
- confirm your loved one’s cause of death
- discuss the care they received
- answer your questions, and concerns
- explain the wording on the death certificate agreed by the doctor and medical examiner.
If the cause of death is unknown, they will also be able to talk you through the referral process to the coroner (if required).
Following your call with the medical examiner’s office the medical certificate of cause of death will then be electronically sent straight to the registrar in the borough the death was recorded. You will then be able to book an appointment to register the death.
You do not need to visit the GP surgery to collect the medical certificate of cause of death.
2. Registering the death
A death must be registered within five days.
To register you will need to book an appointment with the registrar in the borough that the death occurred in. The registrar will need the medical certificate of cause of death to do this.
Please use the links below to register in the borough you need;
- Brent: Deaths and funeral arrangements | Brent Council
- Harrow: Register a death – Register a death – Harrow Council
- Ealing: Register a death | Register a death | Ealing Council
- Hillingdon: Register a death - Hillingdon Council
- Hounslow: Register a death | Register a death | London Borough of Hounslow
- Hammersmith and Fulham: How to register a death | LBHF
- Kensington and Chelsea: Deaths | Royal Borough of Kensington and Chelsea (rbkc.gov.uk)
- Westminster: Register a death | Westminster City Council
3. Arranging a funeral
A funeral can usually only take place after the death is registered.
There are many things to think about and decide when arranging a funeral. The person may have left plans for the funeral they want, or you may need to arrange the funeral yourself. It can be a good idea to ask family and friends for help. Or you may want to pay for the services of a funeral director, who can take you through the whole process step-by-step.
Whilst planning a funeral, it can be useful to consider:
- waiting until you have the medical certificate of death certificate and (green certificate from the registrar for burial or cremation) before finalising any arrangements making any arrangements
- if the person has left instructions in their will or a letter about their wishes
- letting people know about the death and funeral details by organising an obituary in a newspaper or other.
More information on arranging funerals on GOV.UK
Frequantly asked questions
What happens if I miss the phone call from the medical examiner, will it delay the process of the death certificate being issued?
The medical examiner’s office wants to check if you have any concerns about the death before the death certificate is issued. If you miss a call from them they will keep trying to contact you.
How will the medical examiner know who to call?
The medical examiner’s office will contact the next of kin registered with the deceased’s GP/doctor.
Do I have to receive this phone call – can I opt out?
The medical examiner’s office will call, if you decide that you don’t need to talk to them for very long that is fine. The service is designed to support the next of kin.
What happens if I don’t speak English – will a translator be provided?
Yes, interpreting services will be available to support bereaved relatives who need them.
Can I call the medical examiner to speed up the process?
Yes, you can contact the office for your borough using the following details
|
Borough |
Medical examiner service base |
Medical examiner office email |
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Hillingdon |
Hillingdon Hospital |
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Harrow, Brent, Ealing |
Northwick Park Hospital |
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Kensington and Chelsea Hounslow |
West Middlesex Hospital |
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Hammersmith and Fulham, Westminster |
Imperial |
For religious reasons I need to register the death quickly?
The medical examiner’s office is sensitive to religious needs surrounding burial. They will make sure they call next of kin as soon as possible within 24 hours of the death.
How long will it take for the medical certificate for cause of death to be issued?
The certificate is issued by the GP after the Medical Examiner review and a discussion between them. In most cases this will be within a day of the death but in some cases may be longer. If the death needs to be referred to the coroner there will be a delay in issuing the death certificate. This will vary depending on what the coroner decides they need to do.
What happens if the death is referred to the Coroner?
Coroners investigate all deaths where the cause is unknown, where there is reason to think the death may not be due to natural causes, or which need an inquiry for some other reason. The GP has a legal duty to report any death that meets the coroner’s referral criteria. The GP or medical examiner’s officer will tell you if the death of your loved one has to be referred.
The coroner will investigate each case in an appropriate way. It may be as simple as consulting with the doctor who last treated the person who has died, or a post mortem examination may be needed.
In some cases, the coroner may open an inquest, which is a judicial inquiry into the death. Coroners have the power to have a body brought into the public mortuary and keep it there while they carry out investigations.
For further advice please visit the gov.uk website.
You can find out more about the medical examiner service here.
London medical examiner's offices:
|
Host trust |
Lead ME |
London boroughs |
Office number |
|
Barking, Havering & Redbridge University Hospitals NHS Trust
*King George *Queen’s
|
Dr Peter Tanner
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Barking & Dagenham Havering Redbridge
|
01708 435000 ext 3307 |
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Barts Health NHS Trust
*St Bart’s *Newham *The Royal London *Whipps Cross |
Dr William White
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City of London Newham Tower Hamlets Waltham Forest
|
St Bartholomew’s 020 3465 6470
Newham 020 7363 8055
Royal London 07842 323392
Whipps Cross 020 8539 5522 ext. 4399 & 4398
|
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Chelsea & Westminster Hospital NHS Foundation Trust
*Chelsea & Westminster *West Middlesex
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Dr Sarah Cox (Chelsea)
Dr Elora Mukherjee (West Mid)
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Hounslow Kensington & Chelsea |
0203 315 8650 Chelsea
chelwest.medicalexaminer@nhs.net West Middlesex |
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Croydon Health Services NHS Trust
*Croydon
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Mr Gregory Ward
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Croydon
|
0208 401 3719 |
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Epsom & St Helier University Hospitals NHS Trust
*Epsom *St Helier
|
Dr Sally Lewis
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Sutton |
020 8296 2493 |
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Guy’s & St Thomas’ NHS Foundation Trust
*Guy’s *St Thomas’ * Royal Brompton * Harefield
|
Dr Luke Smith (GSTT)
Dr Sarah Trenfield (RB & H) |
Lambeth Southwark |
020 7185 2608 (GSTT)
Harefield 01895 828638
gst-tr.medicalexaminer@nhs.net
Royal Brompton 0207 352 8121 ext 82268
MedicalExaminerService@rbht.nhs.uk
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Homerton University Hospital NHS Foundation Trust *Homerton |
Dr Nicola Radford
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Hackney
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0208 510 7150 Huh-tr.medicalexaminer@nhs.net
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Imperial College Healthcare NHS Trust
*Charing Cross *Hammersmith *Queen Charlotte’s & Chelsea *St Mary’s *Western Eye
|
Dr Susannah Long
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Hammersmith & Fulham Westminster
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Hammersmith 0203 313 3075
Charing Cross 0203 311 1098
St Mary's Hospital 0203 312 3325
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King’s College Hospital NHS Foundation Trust
*Kings College *Princess Royal University Hospital
|
Dr Yasmin Kapadia
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Bexley Bromley
|
020 3299 34051 |
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Kingston Hospital NHS Foundation Trust
*Kingston
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Mr Andrew Pooley
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Kingston Richmond
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020 8934 3478 |
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Lewisham & Greenwich NHS Trust
*University Hospital Lewisham *Queen Elizabeth Hospital, Woolwich |
Dr Charles Mazhude
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Greenwich Lewisham |
QEH 0208 836 4626 UHL 0203 192 6045 lg.medicalexaminerofficecommunitylgt@nhs.net
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London NW University Healthcare NHS Trust
*Central Middlesex *Ealing * Northwick Park * St Mark’s
|
Dr Glynn Evans
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Brent Ealing Harrow
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Northwick Park And St Mark’s Hospitals Ealing and Central Middlesex Hospitals |
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North Middlesex University Hospital NHS Trust
*North Middlesex |
Dr Rebecca Gillibrand
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Enfield Haringey
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Royal Free London NHS Foundation Trust
*Barnet *Chase Farm *Royal Free
|
Dr Rachel Craig
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Barnet |
Royal Free Hospital: 020 7472 6393
Barnet Hospital: 020 8216 4744 |
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The Royal Marsden NHS Foundation Trust
*RMH – Chelsea *RMH - Sutton |
Mr Cyrus Kerawala (Fulham)
Mr Jonathan Handy (Sutton)
|
N/A |
Chelsea 0207 808 2012
Sutton 0208 915 6778 |
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St George’s University Hospital NHS Foundation Trust
*St George’s * Queen Mary’s Roehampton
|
Dr Nigel Kennea
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Merton Wandsworth
|
0208 725 4317 |
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The Hillington Hospitals NHS Foundation Trust
*Hillingdon * Mount Vernon |
Dr Jeremy Weinbren
|
Hillingdon |
01895 2793354 |
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University College London Hospitals NHS Foundation Trust (plus Great Ormond Street and Moorfields)
*University College Hospital
*National Hospital for Neurology and Neurosurgery
*Hospital for tropical diseases
*Royal National ENT and Dental Hospitals
|
Dr Sally Wilson
|
Camden |
0203 447 5130 0203 447 5129
|
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Whittington Health NHS Trust *Whittington |
Dr Francesca Silman
|
Islington |
020 7288 5680 whh-tr.medicalexaminer@nhs.net
|