New medical examiner system increases GP admin burden, warns BMA

The new medical examiner system will be ‘administratively burdensome’ for GP practices, the BMA has warned.

Beginning in April, the new system will require GPs in England and Wales to engage with local medical examiners for all non-coronial deaths and therefore implement processes to share patient records.

England’s GP Committee also expressed concerns that some medical examiners may not have capacity to provide scrutiny of community deaths within ‘reasonable timescales’, particularly for certain faith groups with specific ‘expectations’.

Draft regulations for the new system were published in December and are expected to be laid before Parliament in ‘early 2024’.

The Government failed to meet its original deadline for bringing in this legislation, but many regions are already using the system.

It will mean GPs, as an attending practitioner, are legally required to agree death certificates with the medical examiner at a local hospital trust. 

In a recent update to BMA members, the GPCE said it has written to the national medical examiner outlining concerns with the new system, based on feedback from GPs. 

The committee criticised the lack of consistency in the implementation of medical examiners (MEs). 

‘Regrettably there is no consistency within the England-wide rollout; instead, ME units have been asked to form geographically appropriate links with local GP practices; this then means each practice should know where the deceased’s details, including medical records and the proposed MCCD (medical certificate of cause of death), should be sent,’ the updated said. 

Other GPCE concerns:

• The provision of information to ME Units from practices may be administratively burdensome;
• In some cases ME units may not have sufficient capacity to undertake the scrutiny of community deaths within reasonable timescales and be unable to adapt these timescales to faith groups with particular expectations;
• ME units may not appreciate the level of patient concerns and distress about delays in this process, as these concerns are currently being directed to practices. 

Last year, the BMA highlighted that the GP contract for 2023/24 does not stipulate that GPs must agree death certificates with a medical examiner, and Pulse reported that the ME system was included in the union’s list of ‘bureaucratic items’ that should be completed elsewhere to reduce GP workload.

However, from April and pending the necessary legislation being laid in Parliament, GPs will have a statutory responsibility to comply with the new system.