2024. A year of change?

The 9th of September 2024 will see the greatest change in death certification and death review in England and Wales for 70 years. 

Medical Examiners have been put on a statutory footing. Every death in England and Wales will be scrutinized independently. Should a death be a natural death, the cause of death will be scrutinized by a medical examiner before it is referred to the Registrar of Deaths for registration. If a Medical Examiner considers a death unnatural or the cause unknown the case will be referred to a Coroner. 

 Unnatural deaths will be considered by Coroners; some deaths will require more investigation than others. Coroners will provide Registrars of deaths with their findings.

 The manner of dealing with the incident is likely influenced by location and the nature of the death. It is the way a body is dealt with immediately after the death, and then the extent of the following investigation, which most exercises the bereaved family. Most families seek fairness and proportionality from a process.  There will be four practical routes to death, certification, investigation and registration: natural deaths in a hospital setting; unnatural deaths in a hospital setting; natural deaths in the community; unnatural deaths in the community. 

The experience of the bereaved will be variable, with each having their own tale to tell.

Medical Examiners are appointed by health authorities and work within health authorities. They are centrally funded. Coroners are appointed by local authorities and are funded by those local authorities. There is likely to be a variable quality of service from both Medical Examiners and Coroners across the country.

There is likely to be a wish for a consistent national service sensitive to the wishes of the bereaved. There will be challenges in achieving that outcome, there will be different regional expectations.

An ameliorating effect will come from national training of Coroners and Medical Examiners, and national service provision such as the Coroners Court Support Service.

 As we enter a period in which there will be a new government formed, we shall await with interest the political interest taken in timely and robust death investigation.