Medical Examiner

at  Oxford University Hospitals NHS Foundation Trust

Medical Examiners (MEs) are senior doctors who verify clinical information on Medical Certificates of Cause of Death (MCCDs), to ensure appropriate referrals to the Coroner and accuracy and consistency of MCCD content. They are responsible for the scrutiny of the documentation and circumstances arising from non-coronial deaths in England and Wales. MEs will take a consistent approach to the formulation of MCCD content, which must be clinically accurate and reflect any discussions with the next of kin/informant. MEs must not have been involved in the care of the deceased patients for deaths they scrutinise. MEs and their Officers also are required to ensure that the bereaved have an opportunity to raise concerns about the care of the deceased so that these are recognised and passed to the clinical team or the relevant clinical governance team.
To work within the team of Medical Examiners and Medical Examiner Officers to deliver timely and appropriate scrutiny of deaths within the catchment area of the Medical Examiners’ Office.
To ensure compliance with the legal and procedural requirements associated with the reformed processes of certification, investigation by coroners and registration of deaths.
To scrutinise the certified causes of death offered by attending doctors in a way that is proportionate, consistent and compliant with the proposed changes in national guidance.
To discuss and explain the cause of death with next of kin/informants in a transparent, tactful and sympathetic manner. It is anticipated that such discussions will be predominately conducted through telephone conversations where barriers to understanding information may exist.
The Medical Examiner Service for Oxfordshire is hosted by the Oxford University Hospitals NHS Foundation Trust, but the Service is independent of the Trust and Medical Examiners report to the National Medical Examiner but are also accountable to the CMO of the Trust.
The values, standards and behaviours of the team of MEs and the team of Medical Examiner Officers are in common with those of the host Trust and other NHS organisations.
To work within the team of Medical Examiners and Medical Examiner Officers to deliver timely and appropriate scrutiny of deaths within the catchment area of the Medical Examiners’ Office.
To ensure compliance with the legal and procedural requirements associated with the reformed processes of certification, investigation by coroners, and registration of deaths.
To scrutinise the certified causes of death offered by attending doctors in a way that is proportionate, consistent and compliant with the proposed national guidance.
To discuss and explain the cause of death with next of kin/informants in a transparent, tactful and sympathetic manner. It is anticipated that such discussions will be predominately conducted through telephone conversations where barriers to understanding information may exist.
To ensure that all users of the ME system are treated with respect and are not discriminated against on the grounds of sex, race, religion, ethnicity, sexual orientation, gender reassignment or disability.
Identify deaths that could potentially be reported as clinical incidents to the treating doctor or organisation to allow the potential for learning through clinical governance processes.
To maintain comprehensive records of all deaths scrutinised on the Trust electronic ME software system.
To undertake analysis of the records to provide information to the National Medical Examiner’s (NME) office.
To participate in relevant clinical governance activities relating to death certification including audits, mortality review processes and investigations regarding formal complaints about patient care.
To support the training of junior doctors in their understanding of death certification and promote good practice in accurate completion of MCCDs.
To work with Medical Examiner Officers delegating duties as appropriate.
To adopt a collaborative working relationship with other MEs by sharing experiences and expertise to support peer learning and set uniform standards of service delivery.
Knowledge, skills and performance
As a pre-condition of practicing, you must have successfully completed the mandatory components of the national online medical examiner curriculum. Face-to-face training must be completed within the first three months of being in post.
You will be expected to comply with national protocols to ensure that in each case the cause of death is scrutinised in a way that is proportionate and consistent.
You must have up to date knowledge of medical conditions, treatments and medicines which may or may not have contributed to death, and be able to exercise judgement in where to seek specialist advice in order to determine the appropriate level of scrutiny required.
You must have detailed knowledge of the relevant legislation and processes which apply to:
The determination of whether a death is natural or unnatural
Deaths that must be reported to the coroner
Deaths abroad where bodies are returned to England and Wales for disposal
Deaths where relatives wish to transport the body abroad for disposal
You will have regard to guidance issued by the NME when carrying out your ME functions.
MEs should be aware of how their personal communication style impacts on others and be able to adapt their approach to suit a variety of situations and audiences. This will require:
Clinical and professional experience gained during a career working at a senior level in either in primary or secondary care, eg Consultant or senior General Practitioner.
Highly evolved self-awareness and empathetic skills to liaise effectively and sympathetically with bereaved families
The ability to demonstrate and combine appropriate levels of compassion with professionalism and discretion
Being open to constructive criticism, ideas and solutions
Acting as a positive role model and interacting appropriately with all stakeholders including MEOs, other MEs, the bereaved and the coroner
Having the integrity to gain trust and comply with the independent nature of the ME role in the context of other clinical specialty duties.
MEs must avoid any potential conflicts of interest as defined in the national guidance.
Clinical Governance
The postholder will participate in clinical governance activities, including clinical audit, clinical effectiveness, risk management, quality improvement activities as required by the Trust, and external accrediting bodies.
MEs may be asked to participate in any relevant governance activities relating to scrutiny and confirmation of the cause of death where concerns have been raised by the next of kin/informant of the deceased and/or clinical staff and ME scrutiny. However, the ME service is independent of the Clinical Governance process of NHS organisations providing clinical care.
MEs will facilitate routine analysis of MCCD information to identify trends, patterns and unusual features of deaths and report, as required, firstly to the Regional Lead ME and ultimately to the NME’s office.
Accountability
You will have professional independence in scrutinising deaths but will be accountable to the National Medical Examiner for achieving agreed standards or levels of performance.
For those MEs who did not have a Responsible Officer for the purpose of Medical Revalidation, the Trust’s Chief Medical Officer has offered to provide this through the Revalidation Office in the Trust.
MEs will have an immediate local line management responsibility to the Lead Medical Examiner, the Regional Lead Medical Examiner and the National Medical Examiner.
Medical Examiners enjoy the same NHS indemnity as any other Medical employee, but additional protection can be obtained from the appropriate organisation

Please refer the Job description for details