After a patient dies, the practice arrange for a Doctor to complete relevant after death paperwork, including the Medical Certificate of Cause of Death (MCCD), unless a death is required to be notified to a Coroner.
A Medical Examiner from Epsom and St. Helier University Hospitals NHS Trust checks MCCDs before they are passed to the Sutton Register Offices.
A nominated representative, normally the person who will be registering the death, can expect to receive a call from the medical examiner office before the death can be registered.
Who are medical examiners and medical examiner officers, and what do they do?
Medical examiners are senior NHS doctors who, after completing specialist training work part time in this role. Their job is to give an independent view on causes of death and the care provided (except for deaths which have to be investigated by a coroner).
Medical examiners and their staff (usually called medical examiner officers) offer families and carers of the person who died an opportunity to ask questions or raise concerns about the causes of death, or about the care the person received before their death. This will usually be through a telephone call. They can explain what medical language means, and make it easier to understand what happened. Medical examiners also look at relevant medical records, and discuss the causes of death with the doctor who is completing the MCCD.
You can be confident medical examiners and medical examiner officers will provide an independent view. They will never look into the causes of death of a person they provided care for.
Coroners
Under certain circumstances, for example if the death was sudden or unexpected or the cause of death has not been determined, a doctor will not be able to issue a Medical Certificate of Cause of Death. In such cases, the doctor must legally inform the Coroner.
The Coroner may decide to carry out their own independent investigation. This link explains more about coroners and the types of deaths they investigate.
https://www.gov.uk/government/publications/notification-of-deaths-regulations-2019-guidance
You can also request information in other formats by emailing the Ministry of Justice at [email protected].
The medical examiner may sometimes give the coroner medical advice in these cases, but coroners lead these investigations.
Why am I being asked if I have any concerns?
You are being asked if you would like to have a conversation with an independent, specially trained person – the medical examiner or a medical examiner officer – about anything that may be worrying you about how the person who died was cared for. You may simply want to better understand why the person died, including by having medical terminology explained, or you may want to raise something about the care which did not feel right or ideal. This is your opportunity to ask questions and raise concerns.
Medical examiners and medical examiner officers will discuss your feedback, questions and concerns. If they consider any issues with care need further investigation, they will refer these to someone who can do this work.
As well as answering your questions, talking to a medical examiner helps the NHS provide better care for other patients and carers in future; for example, by identifying ways in which patient and family care could be improved.
Can I ask the medical examiner to talk to someone else if it’s too difficult for me to talk to them?
Yes, of course. The medical examiner or medical examiner officer may contact you to ask who you would like them to talk to instead, or you can let the medical team know if you would like someone other than you to be the first point of contact. The medical examiner or their office will usually phone you before the Medical Certificate of Cause of Death is completed – but we can arrange another way of contacting you if you let us know what you prefer.
What questions will I be asked?
The medical examiner or medical examiner officer will explain what is written on the Medical Certificate of Cause of Death and why, and check if you have any questions or concerns. They will also discuss the medical examiner’s review and ask if you have any concerns or questions about the care the person received before their death. This is the best time for you to ask any questions and raise anything that concerns you.
What if I don’t want to talk to the medical examiner or medical examiner officer, or I don’t want to tell them about my concerns?
We understand this is likely to be a difficult time for you and it is your choice whether you talk to a medical examiner or not. If you are not sure, you can contact the medical examiner or medical examiner officer on 0208 296 2492 and ask for more information before deciding if you want to go ahead – they are trained to help bereaved people and will be very understanding.
Medical examiners and medical examiner officers provide an independent view, so if you can, we encourage you to talk to them. They can explain things to you and are specially trained to answer your questions. If medical examiners find any potential issues, they will be able to raise these with the people who were responsible for the care of the person who died, or refer the issues to someone who can investigate further. Talking to the medical examiner and medical examiner officer can help improve the care the NHS provides to other patients and carers in future.
What will happen if something was not right?
The medical examiner and medical examiner officer are here to listen to your concerns and answer your questions and, if necessary, contact someone who can investigate further. Medical examiners will not investigate further themselves, as they must complete their work in the time before the death has to be registered by law.
Will funeral plans or release of the body take longer?
Medical examiners make every effort to avoid any delays and work with families and carers of the person who died to meet the legal requirements for registering deaths. Medical examiners and medical examiner officers will try to be flexible, for example where relatives would like the body to be released quickly.
What can I do if I have questions or concerns about the medical examiner process?
If you are still not satisfied, you can also contact Epsom and St. Helier Hospitals NHS Trust Patient Advice and Liaison Service (PALS) on 0208 296 2508 or [email protected]
How can I contact the medical examiner office?
0208 296 2492
The medical examiner office is open 9am-4pm Monday – Friday.
Medical Examiner Office
Ground Floor B Block,
St. Helier Hospital
Wrythe Lane
Carshalton
Surrey
SM5 1AA
If you require assistance accessing services please contact the practice in the first instance who will notify the Medical Examiner Office.
Bereavement Support Services
You may find the following organisations helpful in support following your bereavement:
Bereavement Advice Centre
0800 634 9494
https://www.bereavementadvice.org
Bereavement Advice Centre is a free helpline and web-based information service provided by Co-op Legal Services.
Sutton Uplift
0800 032 1411 / 0203 513 4044
https://www.suttonuplift.co.uk/psychological-therapies/what-do-we-offer/bereavement-counselling
Sutton Uplift can take self referrals for Bereavement Counselling
CRUSE
Cruse Bereavement Care, PO Box 800, Richmond, Surrey TW9 1RG
Bereavement helpline: 0808 808 1677
The Good Grief Trust
Private counselling services
Names and addresses of private counselling services or individual counsellors can be found in public libraries, your local Citizen Advice Bureau or by contacting:
The British Association for Counselling and Psychotherapy
15 St John’s Business Park, Lutterworth, Leicestershire, LE17 4HB
Telephone: 01455 883300
Email: [email protected] www.bacp.co.uk
Religious and cultural groups
Care for bereaved people is also offered by local religious or cultural communities. Help can be obtained by contacting the bereaved person’s local church, minister, religious or cultural representatives.
Road Peace
Unit F6, Shakespeare Business Centre, 245 Coldharbour Lane, London SW9 8RR
Telephone: 0845 450 0355 www.roadpeace.org
Support for those bereaved or injured as a result of a road crash.
Samaritans
The Upper Mill, Kingston Road, Ewell KT17 2AF 7 Church Street, Leatherhead, Surrey KT22 8AT 4b High Street, Reigate RH2 9AY
Offers emotional support, befriending and a sympathetic ear for lonely, suicidal or despairing
people of all ages.
Telephone: 116 123
Terrence Higgins Trust
314-320 Gray’s Inn Road, London WC1X 8DP
Helpline: 0808 802 1221
Offers individual bereavement counselling for anyone bereaved by HIV or AIDS.
The Compassionate Friends
Kilburn Grange, Priory Park Road, London NW6 7UJ
Helpline: 0345 123 2304
Offers, emotional support and a befriending service for parents whose child of any age has died from any cause. Telephone number of the nearest representative is given on the helpline number.
The Silver Line
Tavis House, 1-6 Tavistock Square, London WC1H 9NA
Support for the over 55’s.
Helpline: 0800 4 70 80 90
Thrive LDN
Support after sudden bereavement www.thriveldn.co.uk/bereavement/
The Lullaby Trust
Support after a sudden, unexpected death of a baby or young child
Bereavement support: 0808 802 6868 www.lullabytrust,org.uk
Child Bereavement UK
Support when a child dies or when a child grieves
Helpline: 0800 02 888 40 www.childbereavementuk.org
Winston’s Wish
Charity for bereaved children
Helpline: 08088 020 021 www.winstonswish.org
Jigsaw4u
Grief support for children and young people
Telephone: 020 8687 1384
SANDS – stillbirth and neonatal death society
Helpline: 0808 164 3332
Email: helpline @sands.org.uk