GPs do not contractually have to engage with medical examiners, BMA confirms

The new GP contract does not stipulate that GPs must agree death certificates with a medical examiner, the BMA has told GPs.

The BMA’s GP Committee for England is currently in a dispute with the Government over the imposition of contract tweaks for 2023/24, which it says comes with extra workload and no additional funding.

However, during a webinar on Wednesday this week, GPCE acting chair Dr Kieran Sharrock told GPs that currently ‘there is nothing in the contract’ that says practices have to engage with medical examiners.

The news comes a week after Pulse exclusively revealed that the statute for the new system – which was due to come in from 1 April – has been postponed due to legal delays.

The webinar advice formed part of a section focusing on what workload GPs could consider not doing in a bid to protect themselves from burnout.

The union also said it would publish new guidance on the matter in the upcoming weeks.

The new system was meant to commence in less than two weeks, with the intention of medical examiners providing independent scrutiny of all deaths in the community which are not taken to the coroner.

The statutory system was formally introduced by the Health and Care Act last year and NHS England wrote to GP practices in England in July asking them to implement processes to facilitate the work of medical examiners by 31 March 2023. 

It means GPs would have to give access to a deceased patient’s records in order for the medical examiner to reach agreement on the accuracy of the medical certificate of cause of death (MCCD), where before this extra scrutiny was not required. 

Implementation has so far been determined locally and some GP practices have been using the system for many months already as a pilot scheme. 

However, some GPs have flagged that the legislation necessary to mandate this system is currently missing, with one LMC leader calling the implementation process a ‘car crash’.

And Pulse has heard from multiple GP leaders across the country that the commencement of the system has been postponed with no new start date confirmed.

New guidance published yesterday by NHS Digital said that as e-RS is used in all GP practices and all acute providers, extending its use to support the medical examiner system ‘should minimise the need for training and business change at either end of the process.’

Recently, the BMA included medical examiners in its list of workload which should be removed from GP practices, in order to relieve pressures.

A spokesperson from the Department of Health said: ‘The medical examiner system will introduce an additional layer of scrutiny of the cause of death by the medical practitioner, improving the quality and accuracy of the medical certificate of cause of death and thereby informing the national data on mortality and patient safety.

‘It will increase transparency and facilitate discussions with the bereaved about any concerns they may have, providing new levels of scrutiny to improve detection of criminal activity or poor practice.

‘We will set out next steps in due course.’

The webinar also updated GPs on potential options for industrial action and advised them to stick to ‘safe working guidance’ in order to prioritise patients and ‘avoid burnout’.