Appropriate and sensitive contact with bereaved families

Accepted.
The Royal College of Pathologists and e-Learning for Healthcare have produced an online learning module to help those involved in the certification of death. The training is open to all NHS staff along with all prospective medical examiners.
This training consists of 91 sessions within 11 modules that fully trained Medical Examiners will be expected to complete. This training includes a module on interacting with the bereaved and covers topics on the bereavement office; the psychology of bereavement and loss and the medical examiner’s role; and supporting the bereaved.
Prior to application, all candidates are required to complete a core component of the 91 sessions and present the local appointing panel with a certification of its completion as part of the application process.
Where an application is successful, the medical examiner will receive face-to-face training organised by the Royal College of Pathologists and must complete the remaining e-Learning within a year.
The e-Learning is currently being reviewed and Royal College of Pathologists and e-Learning for Healthcare will consider recommendations 277, 278, 280 in taking that forward.

Medical examiners have now been introduced as set out in recommendation 45.

A core objective of the medical examiner system is to support bereaved people, and all operational and strategic decisions should be considered from this perspective. Medical examiners and officers need to interact compassionately and sensitively with bereaved people and be aware that heightened emotions in those who are grieving may affect how they behave and respond. They need to communicate sensitive information with tact and sensitivity, appreciating its potential impact, avoiding jargon and explaining technical or clinical terms in ways non-clinicians will understand.

The Medical Examiners (England) Regulations 2024 and The Medical Examiners (Wales) Regulations 2024 require that medical examiners undertake training from time to time to ensure that they have the experience and skills necessary to carry out their relevant functions.

All medical examiners should complete 24 core e-learning modules before starting medical examiner work; and face to face training within 6 months of starting work. Training is provided by the Royal College of Pathologists

In addition to the 24 core modules, there are 61 other e-learning modules. Their completion is not a mandatory requirement but will help medical examiners in performing their role. Once appointed, medical examiners should undertake continuing professional development (CPD) activities relevant to their role. Examples are completing further or updated e-learning modules, attending regional and national update meetings or further training sessions such as with local coroners. The National Medical Examiner’s good practice series published by the Royal College of Pathologists provides further insight. Reflective practice is also encouraged.

A number of the recommendations in Sir Robert’s Mid Staffordshire Inquiry report refer to our planned reform of the death certification system and the introduction of the role of medical examiner in England and Wales. A new system of medical examiners has been trialled successfully in a number of areas across the country. The work of the two flagship sites in Gloucestershire and Sheffield has been continued and extended to operate a medical examiner service on a city and countywide basis at a scale that will be required for implementation by local authorities when legislation is introduced. We will publish shortly a report from the interim National Medical Examiner setting out the lessons learned from the pilot sites.

The government remains totally committed to the principle of these reforms. Further progress will be informed by a reconsideration of the detail of the new system in the light of other positive developments on patient safety since 2010 and by a subsequent public consultation exercise.

The medical examiner e-learning module will be refreshed following any future consultation to ensure it reflects the relevant Francis recommendations.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government referred to the Royal College of Pathologists and e-Learning for Healthcare producing an online learning course, including a module on interacting with the bereaved.

In April 2023, the Government announced it intended to introduce a statutory medical examiner system from April 2024. Primary legislation by way of amendment of the Coroners and Justice Act 2009 to provide the framework for this came into force in October 2023.