Medical Examiner Review Process (2024 Changes)
What is the Medical Examiner System?
Since April 2024, all deaths in England and Wales must be reviewed by a Medical Examiner (ME) before a death certificate can be issued. This new system provides independent scrutiny of death certification.
October 2025 Update:
The ME system is now fully established across all NHS trusts and local authorities. Most reviews are completed within 2-3 working days, though complex cases may take longer.
💡 What this means for you: Expect a phone call from a Medical Examiner Officer before you can register the death. This is now a standard part of the process.
Why Was This System Introduced?
The Medical Examiner system aims to:
- Improve the accuracy of death certification
- Provide an opportunity for families to raise concerns
- Identify deaths that may require coroner referral
- Offer better support to bereaved families
- Ensure consistency in death certification across England and Wales
The Review Process
Step 1: Doctor Proposes Cause of Death
The doctor treating the deceased completes a Medical Certificate of Cause of Death (MCCD) and sends it to the Medical Examiner for review.
Step 2: ME Reviews Medical Records
A qualified Medical Examiner (a senior doctor) reviews the death and medical records to ensure the proposed cause of death is accurate.
Step 3: Family Contact
A Medical Examiner Officer will call the next of kin or informant to discuss the death, answer questions, and check if there are any concerns.
Step 4: ME Makes Decision
The ME either approves the MCCD, discusses amendments with the certifying doctor, or refers the death to the coroner if needed.
Step 5: Registration Can Proceed
Once approved, the MCCD is sent to the register office and you can book your registration appointment.
What to Expect from the ME Call
The Medical Examiner Officer will typically:
- Confirm your relationship to the deceased
- Explain the proposed cause of death in plain English
- Ask if you have any questions or concerns about the care received
- Check if you agree with the proposed cause of death
- Explain next steps for death registration
- Provide contact details if you have further questions
⏱️ The call usually takes 15-30 minutes. You don't need to prepare anything, but it helps to have quiet time to talk.
Common Questions and Concerns
Does this mean there's a problem?
No. The ME review is now mandatory for ALL deaths, not just suspicious ones. It's a quality check, not an investigation.
Will this delay the funeral?
Usually no. Most ME reviews are completed within 2-3 working days. Funeral arrangements can be discussed with your funeral director during this time.
What if I disagree with the cause of death?
Tell the ME Officer. They can discuss your concerns with the Medical Examiner and certifying doctor. The ME may request additional information or refer to the coroner.
Can I raise concerns about care?
Yes. The ME Officer will listen to any concerns and can advise on formal complaints procedures if appropriate.
Timeline Expectations
Day 1: Doctor completes MCCD and sends to ME
Days 1-2: ME reviews records and ME Officer contacts family
Days 2-3: ME approves MCCD and sends to register office
Days 3-5: You book and attend registration appointment
Total typical timeline: 3-5 days from death to registration, assuming no complications.
When Deaths Are Referred to the Coroner
The ME may refer a death to the coroner if:
- The cause of death is uncertain
- The death was sudden or unexpected
- The death may have been caused by violence, neglect, or suspicious circumstances
- The death occurred during surgery or before recovery from anesthetic
- The death may be linked to medical treatment or care issues
- The deceased was not seen by a doctor within 28 days before death
If referred to the coroner, the ME process pauses and the coroner takes over. You'll be contacted by the coroner's office with next steps.
Your Rights During the ME Process
- You have the right to speak with the Medical Examiner directly if needed
- You can request a meeting instead of a phone call
- You can have a family member or support person present during calls
- You can request written information about the cause of death
- You can raise concerns about care at any stage
- You can request the ME review findings in writing
Scotland and Northern Ireland
Scotland
Scotland has a different system. The "medical reviewer" role is handled differently and integrated with existing processes. The system is less formal than in England and Wales.
Northern Ireland
Northern Ireland is planning to introduce a similar ME system but has not yet implemented it as of October 2025. Current processes remain unchanged.
Useful Information
- • Is there a fee? No, the ME service is free
- • Can I refuse the ME review? No, it's mandatory for all deaths
- • What if I miss the ME call? They'll try again or leave a message with callback details
- • Can I request a specific ME? No, MEs are assigned based on workload
Related Guides
You might also find these guides helpful
How to Register a Death in Scotland
Complete guide to death registration in Scotland, including 8-day deadline, National Records procedures, and key differences from England/Wales.
How to Register a Death in Northern Ireland
Essential guide to GRONI death registration procedures, required documents, 5-day timeline, and how Northern Ireland differs from GB.
Registering a Death Over Christmas – Complete Guide 2025
How to register a death during Christmas and New Year. Registrar office closures, emergency registration, calculating deadlines with bank holidays.