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Frequently Asked Questions

What is the Medical Examiner Service?

Why is the Medical Examiner Service being implemented?

Who are the Medical Examiners?

Who are the Medical Examiner Officers?

What do the Medical Examiners do?

What do the Medical Examiner Officers do?

Will the Medical Examiner tell the attending Doctor what to write on the MCCD?

Will the Medical Examiner write the MCCD?

Will this create delay in the after death process?

How does this differ to the current process?

Who can I speak to if I have concerns following a patients death?

Can I approach the Medical Examiner office if I need advice on Coroner’s referrals?

How do I access the PTL?

How do I access the Coroner’s Portal?

What are some tips with filling out MCCD?

How do I know what is acceptable for the cause of death on MCCD?

What is the 2020 list of acceptable cause of death list?


What is the Medical Examiner Service?

It is a new national service, covering all NHS Trusts, that will be a statutory function in the near future. The medical examiner service will provide independent scrutiny of all deaths not referred to the Coroner. To begin the ME service will be concerned only with hospital deaths but will eventually also cover deaths in the community.


Why is the Medical Examiner Service being implemented?

Following recommendation in the Shipman Enquiry and new legislation The Coroners and Justice Act 2009 the Medical Examiner Service is intended to improve the after death experience for the bereaved.


Who are the Medical Examiners?

Doctors of appropriate experience with five years service or above, can be from any speciality and can be retired but do need to registered with the GMC.

MEs for EKHUFT are currently:

Dr Paul Stevens

Dr Michelle Webb


Who are the Medical Examiner Officers?

Stacey Brown – William Harvey Hospital

Stephen Mumford – Kent and Canterbury Hospital

Rosalind Andrews – Queen Elizabeth the Queen Mother Hospital


What do the Medical Examiners do?

Following the death of a patient, the ME will conduct an independent review of the medical notes in order to form an opinion of what has caused the patient to die and whether there are any issues for patient safety review teams. The ME will also be on hand to offer advice on cases that need to be referred to the Coroner and wording of MCCDs. ME will complete the part 5 of the cremation form.


What do the Medical Examiner Officers do?

Support the ME’s in their role. Will be a point of contact for the Doctor and the ME. If and whendelegated by the ME, the MEO will speak to the families, explain the cause of death and discuss any concerns raised.


Will the Medical Examiner tell the attending Doctor what to write on the MCCD?

No, the ME will review the notes and discuss the proposed Cause of Death with the attending Doctor. The clinical decision of the parent team will always be respected.


Will the Medical Examiner write the MCCD?

No, this responsibility will stay with the attending Doctor.


Will this create delay in the after death process?

No, This service has been implemented to streamline the after death process.


How does this differ to the current process?

The ME will be independently scrutinising the notes of the deceased and will be giving an impartial view on the cause of death. The service will also be giving a voice to the bereaved to express any concerns to an independent department.


Who can I speak to if I have concerns following a patients death?

The ME office will be an open forum for clinicians who have had any involvement with care and the bereaved.


Can I approach the Medical Examiner office if I need advice on Coroner’s referrals?

Yes. The ME and MEOs will be able to offer the link between you and the Coroner’s Office.


How do I access the PTL?

There is a widget on the application launcher ‘Mortality PTL’. All trust Doctors have access to the PTL and it can also be found on the home page under the banner Information Portal. All relevant databases are found under ‘Quality’ and then ‘Mortality’


How do I access the Coroner’s Portal?

There is a widget on the application launcher ‘Coroner Referral Portal’ and a link on the intranet page. Both the ME office and the BSO will be able to offer any practical assistance.


What are some tips with filling out MCCD?

  • Clear handwriting and check spelling
  • No abbreviations
  • Important to state cause rather than mode (cachexia, heart failure, asphyxia) of dying

How do I know what is acceptable for the cause of death on MCCD?

  • The cause has to reflect content of medical records.
  • Cause should reflect balance of probabilities based on a conscientious appraisal of the available facts. You don’t have to be certain!
  • 1a is the immediate cause of death. There can be more than one cause.
  • Where necessary, 1b and 1c outline the sequence of events leading to the immediate cause. E.g. 1a Sepsis, 1b aspiration pneumonia, 1c end stage Parkinsons disease.
  • 2 Indicates significant other co-morbidities that may have made the individual more likely to die

Please check the 2020 list of acceptable cause of death list, this is not an exhaustive list but rather a guide

https://www.rcpath.org/uploads/assets/c16ae453-6c63-47ff-8c45fd2c56521ab9/G199-Cause-of-death-list.pdf


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