GPAtlas🧭 When to engage with the service
The medical examiner (ME) system provides independent scrutiny of every death in England and Wales that is not investigated by a coroner. Since 9 September 2024 this scrutiny is a statutory requirement: a death cannot be registered until it has been reviewed by either a coroner or a medical examiner. The system arose from the Shipman, Mid-Staffordshire and Morecambe Bay inquiries.
Its three aims are to improve the accuracy of certification, to give the bereaved a voice (a conversation with a doctor not involved in the care), and to identify patient-safety and governance concerns. The medical examiner is an independent senior doctor; the day-to-day contact is often a medical examiner officer (MEO).
The clinical task in primary care is twofold: decide the correct route (coroner versus medical examiner), and, where the ME route applies, propose an accurate cause of death to the best of your knowledge and belief. Every non-coronial death now passes through the ME before the registrar.
| Route | Which deaths |
|---|---|
| Coroner (statutory notification) | Deaths that are unnatural or violent, of unknown cause, in custody or state detention, or that otherwise meet the Notification of Deaths Regulations 2019 (see Red Flags). |
| Medical examiner (all other deaths) | Every other (natural-cause) death where an attending practitioner can propose a cause of death; the ME scrutinises before registration and sends the certificate to the registrar. |
Source: DHSC MCCD guidance · National Medical Examiner (NHS England) · Coroners and Justice Act 2009
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