Medical Examiner and Medical Certification of Cause of Death [MCCD]
Written: 24th January 2024
Medical Examiner and Medical Certificate of Cause of Death [MCCD]
I am writing to all colleagues to highlight the impending intended statutory implementation of Medical Examiner scrutiny of non-coronial deaths in the Community. This process was supposed to be implemented in April 2023, but was postponed because the service was not ready. It is now scheduled for implementation from April 2024* [*further delays noted below].
Download guide in full here: Medical Examiner and MCCD Update
Written: 16 April 2024
Update: Medical Examiner Arrangements
As colleagues will recall, the original date for implementing these arrangements was April 2023, after many concerns were raised, this was ultimately postponed until April 2024, but as this date approached it became clear, without any official announcements from the National Medical Examiner or the Ministry of Justice, that reliable arrangements to ensure all community deaths were covered by local Medical Examiner Units were not in place. The Health Minister has now announced that the statutory introduction of these changes will now be delayed until 9th September, to allow “time to prepare for implementation”. This presumably represents a euphemism for “still not ready”.
This means the use of the Medical Examiner system by GP practices will not be universal, and the current unsatisfactory hybrid process will continue. If your practice has been “on-boarded” by local ME Units, you can continue to refer draft MCCDs and accompanying information about the deceased to the Unit. However, you are not obliged to do so, although if the process is operating smoothly, the LMC recommends colleagues continue. GP practices should give feedback on any concerns, including advising patients to contact MEs directly, in order to ensure this facilitates learning and improvements to the service.
If your practice continues to refer all, or a proportion, of deaths to local Medical Referees, then colleagues can continue to do so over the coming months. ME units should be contacting practices not linked to their service to set up arrangements for GP referral of deaths for ME scrutiny.
I last wrote to all colleagues about this issue about the Medical Examiner and MCCD Update on 24th January 2024 and I know colleagues will forgive me if I say on rereading this, the LMC seems to have been prescient: the LMC did not feel, at that time, that “the Medical Examiner Process will work” on its then intended implementation on 1st April 2024. The linked letter dated 24th of January confirms details of how the Medical Examiner led process will operate and what it is seeking to achieve. The LMC cannot feel assured it will work in September 2024, although it is possible the promised digital MCCD may be available by then.
Although I appreciate there are GP practices where this process is working well, at present it would seem premature to guarantee all will be well for everyone by September 2024.
Dr Julius Parker Chief Executive
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Updated on Wednesday, 17 April 2024
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