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A faulty production line

Medical examiners to review all deaths from 2018

Health secretary Jeremy Hunt has announced the introduction of medical examiners from April 2018 to independently ‘review and confirm the cause of all deaths.’

Mr Hunt said that independent medical examiners - which were first recommended at the 2005 inquiry into the murders by GP Dr Harold Shipman - would bring a ‘profound change in our ability to learn from unexpected or avoidable deaths’.

The GPC said that GPs will still have to sign the medical certificate of the cause of death, and this may even require further information, such as that required by the cremation certificate.

Medical defence organisations said that there was a lack of detail around the announcement, including how they will be funded.

In a statement to the Commons, Mr Hunt said: ‘Grieving relatives will be at the heart of the process and will have the chance to flag any concerns about the quality of care and the cause of death to an independent clinician, meaning we get to the bottom of any systemic failings much more quickly.’

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

Heidi Alexander, Labour’s shadow health secretary said: ‘The implementation of independent medical examiners is long overdue and it is unclear why it is being further delayed until 2018, given that the previous Labour Government first legislated for these important reforms in 2009’.

But GPs and medical defence organisations said there was a lack of clarity around the announcements.

Dr Robert Morley, chair of the GPC’s contracts and regulation subcommittee, said GPs ‘will still have to sign the medical certificate of the cause of death as now’.

However, he added, ’this may require further information, possibly including details that are currently on the cremation certificate. I believe GPs will no longer be required to sign a separate cremation certificate - for which they are currently paid a fee - as this responsibility will pass to the new medical examiners.’

The MDU said: ‘There is no detail about who the medical examiners will be, how they will be trained and funded and what their independent review process will consist of. Until such further detail is available it isn’t possible to determine the future contribution medical examiners could make to patient safety.’

Mr Hunt also announced other measures including the introduction of a Healthcare Safety Investigation Branch to make it easier for healthcare staff to report wrongdoing.

He also introduced a national ‘learning from mistakes league’, which ranks NHS trusts in terms of transparency, and has rated 32 as having a ‘poor reporting culture’, 78 with ‘significant concerns’ and 120 as outstanding or good.

Readers' comments (11)

  • Anything introduced by this man is likely to have been corrupted from that which was originally intended, imposed without consultation and designed principally to save money and boost political control ....I have nothing but suspicion for anything Hunt is involved in.

    If this process ends up turning signing a death certificate into a professional indemnity nightmare, with some kind of underlying suspicion when anyone in the UK dies that their Dr may have killed them unless proved otherwise, I won't be signing any or working with anyone who might die...and if that means quiting practice, so be it.

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  • When I hear of a death in our practice I often scrutinise the notes and can see the path of decline. With the rectoscope I can often see that things could have been handled differently. I use this to inform my future practice, to do things better for the next patient. This is all that can be done, going forward.

    What will the purpose be, of this formal scrutiny ?

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  • Back of a fag packet management at its finest once again.

    Who are these people?
    What happens to coroners?
    How will grieving families feel if I have to interrogate them?
    What if the medical examiner thinks I am wrong? Or mendacious?

    And above all....

    What will I do without Ash Cash? I have an Audi to pay for.

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  • Hello Mrs Brown, I'm Quincy ME. Sorry for your loss. Now, I see Mr Brown lived to 104 and died in bed yesterday. Your GP has listed his cause of death as 1a) Old Age. Are you happy with that? No, I wouldn't be either. Refused a late had visit once in 1987, you say? Shocking, truly shocking. And despite all these medicines for blood pressure and angina I can see, you say you never saw the same doctor twice? Dear me. Sounds like a shocking bit of malpractice to me. Now, if you'll just sign here, here and here, we can arrange for a postmortem, launch a formal complaint to the GMC and a medical negligence case all in one handy form. No, you aren't causing a fuss. Well, we better see to it that Dr Rabbit-Headlight isn't able to butcher other Centenarians in their pyjamas by filling them full of Ramipril, hadn't we? It's about protecting other people like your husband, who was so badly let down. Sign here. And here. Have a tissue. There there.

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  • Funny enough, just completed an audit of patients died in last 5 years to analyse what our patients were dying of.
    Interesting finding was that in some cases no reason was listed and no information received as to reason of death from hospital.

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  • Perhaps we should look upon it as an opportunity! They will need an army of Medical Examiners, not to mention the administration that will be required to run the whole show. We can all leave General Practice and see all our patients only after they are all dead. I am not sure who will be left to look after the living patients though. Perhaps the junior doctors that Jeremy Hunt has treated so kindly could be induced to do the job. Mind you, with the constraints and micromanagement of the CQC, NICE, GMC, CCGs, etc. Maybe they will become just as demoralised in that job too.

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  • There won't be an army of independent GPs - this will be a CQC role, with a few antiquated GPs and a host of "other experts" whose sole remit will be to find problems and concerns in every case

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  • This is unlikely to be a GP issue. But it has been estimated that between 100 and 200 avoidable deaths occur in NHS hospitals PER DAY!

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  • Yet another GP witch hunt.Another knee in the groin for GP morale. Grieving relatives don't want the CQC at their door. When the Health Maintenance Organisations take over these matters will be commercial secrets -no need for Mr H to worry then.

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  • Great! -
    If this meant that the real prevalence of SSRI / SNRI - Akathisia induced suicides were correctly identified as resulting from academic misconduct and deliberately falsified "clinical trials" - plus the published failure of regulatory bodies to validly address prescription drug safety :- then it would be invaluable.
    Anything from this administration is likely to support, never to address, the (alleged) global marketing fraud in psychopharmacolgy.

    Hence those numerous and ever growing number of families bereaved by iatrogenic death will continue to blame themselves for the rest of their tormented lives.

    All ages. The CYP 450 genetic variants which lead to disadvantaged, delayed and ineffective metabolism of SSRI / SNRI's and resulting in unrecognised akathisia, and it's catastrophic sequalae, are not self correcting at age 24 years.

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