The Royal College of Pathologists (RCPath) welcomes Lord O’Shaughnessy’s announcement today that a national system of independent medical examiners will be introduced from April 2019. The College has long campaigned for the implementation of this important patient safety initiative, which was recommended by the Shipman, Mid Staffs and Morecambe Bay inquiries.
While rapid wholesale implementation would be ideal, the proposed phased approach will allow the many agencies involved to prepare and is a pragmatic solution to a complex scheme. It is important that the second phase follows quickly to ensure that the benefits of the medical examiner system are applied in all healthcare settings.
Pilot studies have demonstrated that medical examiners ensure that death certificates are accurate, cases are referred appropriately to the coroner and most importantly, that bereaved relatives have the opportunity to ask questions and raise any concerns they may have. Medical examiners are also ideally placed to identify trends relating to deaths and highlight areas for further investigation, giving relatives the answers they deserve and improving care for future patients.
As well as two continuing pilot sites, several hospitals have already taken steps towards implementing a limited medical examiner system. While typically only looking at deaths in hospital, this is a step in the right direction and can only make implementation of the full programme easier. The RCPath is sharing experience and lessons from the pilots and early implementer sites to support more hospitals to introduce a similar system.
The initiative is also being aligned with the ‘Learning from deaths’ work, which is already being undertaken in all trusts. The combination of this important project with the imminent introduction of medical examiners will help healthcare professionals to learn lessons from mistakes and improve the care they provide for future patients. The Royal College of Pathologists strongly backs this process and is committed to providing medical examiners, of whatever specialty, with the training and support they need.
18 October 2017