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.
• Every non-coronial death now passes through the ME before the registrar.
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)
• 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).
When a patient dies:
• Decide the correct route (coroner versus medical examiner)
• Where the ME route applies, propose an accurate cause of death to the best of your knowledge and belief
| 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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