Greater scrutiny of causes of death to help protect the public

New measures to help protect the public and support bereaved families will be introduced in a revamp of how deaths are certified

  • Medical examiners will look at causes of all deaths not investigated by the coroner to help prevent criminal activity and poor practice
  • Reforms to improve death certification welcomed by medical practitioners, coroners and registrars
  • Bereaved families to receive greater transparency and be given the opportunity to raise concerns

New measures to help protect the public and support bereaved families will be introduced in a revamp of how deaths are certified.

Medical examiners will strengthen safeguards by scrutinising how people have died prior to registration and make sure the right deaths are referred to coroners.

The reforms to certification have widespread support from medical practitioners, coroners and registrars and have been agreed in partnership with them.

Medical examiners are senior medical practitioners and will:

  • Seek to confirm the proposed cause of death by the medical doctor and the overall accuracy of the medical certificate of cause of death;
  • Discuss the proposed cause of death with those bereaved and establish if they have questions or any concerns relating to their loved one;
  • Support appropriate referrals to senior coroners;
  • Identify cases for further review to ensure best practice.

Minister Maria Caulfield said:

"It has taken time to get this right, but it was vital we had the backing of all involved in the process in order to make sure it protects people and supports bereaved families in the way they deserve.

"Although abuse of the system is rare, what we are announcing today will be a significant step in preventing failures in the future.

"I want to thank all those involved in the process – from medical professionals, to coroners, to registrars – for helping this government fulfil its promise of introducing a safer system of death certification."

These reforms to death certification will include changes to practices for multiple professions such as medical practitioners, coroners and registrars, as well as all those involved in the process of officially certifying the deceased.

As of September 2023, medical examiners have already reviewed 640,000 deaths in hospital trusts since 2019.

These reforms will apply to all deaths not investigated by a coroner in other locations and put this on a statutory footing.

NHS trusts will host medical examiners with 126 offices in England.

Draft regulations and communications have been published to help medical practitioners, local registration services, coroners and the public, understand how the new legal requirements will work, and will help ensure frontline services are ready.

Legislation will be laid in early 2024 and from April 2024 the new statutory regulations will come into force in England and Wales.

National Medical Examiner Dr Alan Fletcher said:

"The NHS is pleased the government is putting the work of medical examiners delivering independent scrutiny of all non-coronial deaths in England and Wales on a statutory footing in April 2024.

"As the medical examiner system lead, I have witnessed the care medical examiners take to support bereaved people, increase safeguards, and identify opportunities to improve care.

"Medical examiners ensure that if bereaved people have concerns after their loss, these can be raised as easily as possible, which is why it is great to see this progress towards a comprehensive system."

Dr Suzy Lishman, Senior Medical Advisor on Medical Examiners for the Royal College of Pathologists, said:

"As the lead college for medical examiners, the Royal College of Pathologists welcomes the publication of the draft regulations on the long-awaited death certification reforms.

"Medical examiners are already scrutinising the majority of deaths in England and Wales, identifying concerns and helping improve care for patients and support for bereaved people.

"The move to a statutory system in 2024 will further strengthen those safeguards, ensuring that all deaths are reviewed and the voices of all bereaved people are heard."

Department of Health and Social Care
Maria Caulfield MP