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The vital role of medical examiners

Minister for Patient Safety, Suicide Prevention and Mental Health Nadine Dorries yesterday spoke at the Royal College of Pathologists' Medical Examiner Annual Conference.

I’m so glad I can join you today – and I’m so grateful to the Royal College of Pathologists for bringing us all together for these important conversations.

We’ve spent much time reflecting on the extraordinary life of His Royal Highness, the Duke of Edinburgh, and the dignity of his life was matched only by the dignity he was shown in death.

Like so many families across our great country, the Royal Family has lost someone that they love.

And every one of us, no matter who we are, deserves dignity – whether that’s at the end of our life or when we’ve lost someone who is close to us.

That’s what our new medical examiner system does so well, by establishing a vital point of contact for bereaved families, by providing greater safeguards for the public and for being that trusted professional voice at a time of such sensitivity.

Pandemic challenges

Tragically, this past year, many lives have been lost through the pandemic.

The measures we’ve had to put in place have made it more difficult for people to say goodbye to the people that they love or are close to them.

Funerals and rituals have been disrupted, and it’s been much harder to grieve.

Since last March, we’ve increased our support for mental health charities, including bereavement support helplines, counselling and signposting services – who are playing such an important role.

I’ve also been struck by the incredible way in which you’ve all played your part too, as processes like death certification, registration and managing the deceased have never been more important.

You have done a tremendous job, in the most challenging of circumstances.

But it’s your empathy – in supporting those when they are at their most vulnerable – that we all really cherish.

In my opinion, medical examiners are some of the unsung heroes of the pandemic.

And I know it hasn’t always been easy.

It has often meant additional work – and I understand that, for a lot of people, it’s taken its emotional toll, not least, when charged with looking after the deaths of colleagues working in the NHS and in adult social care.

But you’ve risen to this challenge, and I’m truly – truly – grateful for that.

So it’s right that we have a system that reflects both your compassion and equally your capabilities.

So I just want to reflect on that for a moment on what comes next – and what the medical examiner system might look like in the future.

Learning from the pandemic

First, we have to learn from the lessons of the pandemic.

And the past year has tested every part of our system in unprecedented ways.

It has magnified the importance of the tools and processes at our disposal in ways we might never have expected.

That you’ve not only coped, but risen to the challenges with such professionalism, is a real credit to you.

But there is always more we can all do and much of the blueprint for how we can improve the system sits within our proposals for the future of the health and care system – in our health and care white paper.

1. Integration

At the heart of that paper is the idea that health professionals can operate seamlessly across health and care without being split into artificial silos that keep them apart.

Medical examiners are no exception to that.

Although hosted by NHS trusts, crucially, medical examiners will be able to provide scrutiny to neighbouring providers – from community hospitals to general practice.

Medical examiners will scrutinise all non-coronial deaths – providing an equal system for all, irrespective of the decision to either bury or cremate.

And that ability to scrutinise is vital.

The public’s expectations are, rightly, changing. There’s a much greater desire for transparency.

So we’re now working across Whitehall to address the whole journey of the deceased, focusing on every part of the system that needs changing as well as introducing a statutory medical examiner process.

2. Technology

Another key theme of our health and care white paper is the use of technology.

Aspects of the death certification process have not changed for decades.

But throughout the pandemic, it has forced us to consider new ways of working.

For example, in the absence of face-to-face appointments, we’ve transmitted information digitally.

That’s a change that was certainly coming – but the pandemic has sped that up.

Another use of technology we’re determined to embrace is our plan to digitise the medical certificate of cause of death, the form where the doctor proposes the cause of death.

This change opens up the new possibility to review the content and update or introduce new fields.

A specific requirement from the pandemic was the ability to identify ethnicity, and that’s one of the new fields which will be included so that self-declared ethnicity on patient records can be directly transferred at death certification.

I’m so grateful to the Royal College of Pathologists for their tremendous support for the delivery in these reforms, which will not only be vital for our colleagues at the Office of National Statistics, but can ultimately inform and shape health policy for the better.


And I just want to say again, thank you all so much. We really do value the work that you have put in during the pandemic and the way that you have risen to the challenges that you have been presented with.

Thank you.


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