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A faulty production line

New death certificate system delayed until April 2019

The launch of an independent medical examiner service has been pushed back to April 2019, a year later than the Government had planned.

The medical examiner service, which was proposed at the 2005 inquiry into the murders by serial killer GP Dr Harold Shipman, will review and confirm the cause of all deaths.

Medical examiners were piloted several years ago, but plans to roll them out nationwide were put on hold.

A Department of Health and Social Care spokesperson said: ‘We are fully committed to the introduction of medical examiners by April 2019.’

The reformed system for certifying non-coronial deaths is expected to improve the quality and accuracy of the medical certificate of cause of death, the national data on avoidable mortality and contribute to improved patient safety.

However, GPs are expected to still have to sign the certificate giving the medical reason for the cause of death, according to previous comments from the BMA's GP committee.

Readers' comments (11)

  • Who is going to be doing this work? If its a role which GPs can do then we are suddenly going to loose a load more GPs from the coalface.

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  • Cobblers

    It might suit those who have recently retired.


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  • This was a service that was originally supposed to be funded by local authorities. They have bleated that can't do it due to their own funding restrictions. The expectation now is that hospitals will fund and commision the service to examine hospital deaths only and it is unlikely ever roll out to primary care.

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  • What could possibly go wrong? Currently 2 separate doctors doing Crem forms followed by overall review by an independent medical referee to be replaced for all 3 stages by a single clinician so let’s remove the safety nets. I assume the money for all 3 separate stages will also not be continued so it’s being introduced as a financial cut and do they have any idea how long doing all 3 stages will take and how much work will be involved plus how many forms will be needed to be done each day? Who by?

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  • 525000 deaths England and Wales in 2016
    Proposal is for 1000 IMEs
    So that’s 525 deaths each/year if all things were even. In my retirement town we had 1200 deaths in 2016 so we would need at least 2 IMEs who would deal with up to 60 deaths in a flu week. This is currently a job that GPs do for free as a ‘statutory duty’

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  • Healthy Cynic

    In your town is the medical referee a GP who works for nothing? And do all the other GPs fill in cremation certificates gratis?
    The reforms are essentially aboutauthorisation of disposal of the deceased. The MCCD certification process will continue much as before, with a little oversight by the ME.

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  • I don't think this is anything to do with cremation. It's a reform to the death certification process

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  • To my knowledge, the 'Medical Referee' service was Dame Janet Smith's primary proposal in avoiding another Shipman scenario and she suggested that it be promptly 'rolled out'. This was never done. It's reported that she is appalled that her secondary proposal of 'annual appraisal with associated revalidation' which she never had much belief in, was so 'rolled out', that it rolled over and crushed the medical profession?

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  • As inferred in other comments above - this will only work if:

    1. These posts are filled by experienced docs.

    2. Medical Examiners have the communication skills to give colleagues a steer occasionally and to deal with coroners and the press when the inevitable criticisms are made.

    Just as well then that we are absolutely awash with spare senior GP capacity.

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  • AlanAlmond

    Prediction - this will be an absolute bloody disaster. It will be under funded and rely disproportionately on flawed IT.

    ‘Customer’ facing responsibility will remain with the GP but there will be some faceless beurocracy contactable only by via an online form that will be actually producing the certificates. Computer glitches/teething problems and ‘lessons to be learned’ will all follow.

    The undertakers better invest in a few more fridges, there will be long backlogs waiting for their cremation papers

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