SAIF Golden Charter

Death certification reforms

Following a pilot scheme in Sheffield and Gloucester, Medical Examiners could be introduced in England from April 2019, but clarification is still required on the finer details

Lord O’Shaunessy, the Parliamentary Under-Secretary of State for Health, released a statement on 11 June regarding the reforms to the death certification process and the introduction of Medical Examiners. The statement indicates that from April 2019, Medical Examiners will be introduced across England. The Welsh Government consulted separately on this and will issue its own guidance in due course.

Medical Examiners will be employed within the NHS system and based initially in hospitals. This will be the case in all areas apart from Sheffield and Gloucester, where the pilots for the Medical Examiner were held. In these two areas, the intention is for the Medical Examiners to start to work in the community too with their ongoing work being reviewed prior to this happening in other areas of the country.

It was initially thought that the Medical Examiners would be funded through local authorities, but it became evident that this was going to cause complications. There will apparently be two stages to the funding of the system to enable it to be introduced while Government legislation is in progress.

Quoting Lord O’Shaunessy’s statement: “Initially, Medical Examiners will be funded through the existing fee for completing medical cremation forms, in combination with central government funding for medical examiner work not covered by those fees. Following this interim period and when Parliamentary time allows for the system to move to a statutory footing, the funding of the system will need to be revisited. The existing medical cremation forms and fees payable associated with those forms will continue to apply for the interim period.”

It is therefore clear that the current documentation will initially remain in place, but what is still unknown at this stage is who will ultimately be responsible for paying the Medical Examiner’s fee in the short and longer term, what that fee will be, and who it will be payable to. It would appear that funding the system using the existing payment for the Part 5 certificate is being seen as an easy way to use the current practice of payment, thus avoiding too much confusion and, indeed, conflict in the early stages. Once I have detail on how this is to be paid, I will advise members accordingly.

The new system will be non-statutory to begin with and it is likely to be 18 months to two years before it becomes statutory practice. During this time, there will be firstly a national Medical Examiner appointed, followed by local Medical Examiners based in hospitals. It is also proposed that digital documentation will be introduced at some point.

It is going to be a very interesting period from April 2019 for all concerned both directly and indirectly with these new procedures. There are still many questions to be answered and lessons to be learned.

I hope and pray that the system works smoothly and benefits everyone, from the doctors and funeral directors to, most importantly, the general public.