Medical Examiner

Job description

Job responsibilities

Dimensions of role

Medical examiners (MEs) are appropriately trained doctors who will verify clinical information on Medical Certificates of Cause of Death (MCCDs) and ensure that the correct referrals are made to the coroner for further investigation. A practising medical practitioner who has been on the General Medical Council register for a minimum of five years post registration can apply to be an ME. It is recommended that medical examiners are consultants or experienced GPs. 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. It is expected that ME sessions will be undertaken on the St Georges site and work supported by the Lead ME and Medical Examiner Officers.

Main duties

• To ensure compliance with the legal and procedural requirements associated with the current and proposed 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 protocol.
• To discuss and explain the cause of death with next of kin/informants in a transparent, tactful and sympathetic manner.
• 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.
• To maintain comprehensive records of all deaths scrutinised and undertake analysis to provide information to the National Medical Examiners office.
• To participate in relevant governance activities relating to death certification including audits, mortality review processes and investigations regarding formal complaints about patient care.
• To support the training of services and junior doctors in their understanding of death certification and promote good practice in accurate completion of MCCDs.
• To work with medical examiner officers (MEOs), delegating duties as appropriate.
• To engage with lead ME and lead MEO for the region.
• 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 and skills required for post

Qualifications

Registered with a licence to practice in the UK by the GMC (at least five years post registration)

As a pre-condition of practicing, an ME 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.

Behavioural attributes

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:

• 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.

Performance criteria

Communications and key working relationships

To be a source of expert knowledge and advice for health professionals and wider stakeholder groups; these include:

Internal within own organisation:

• Site Chief Medical Officer
• Lead ME and MEO
• Deputy Chief Medical Officer / Chair Mortality Monitoring Group
• Clinical Lead for Learning from Deaths
• All grades of clinicians
• Clinical governance leads
• MEOs and bereavement service staff
• Mortuary staff.

External:

• Coroners and their officers
• Registrars of births and deaths
• General Practitioners and community based healthcare professionals
• Local Authorities, including care homes and safeguarding teams
• Spiritual and faith community leaders
• Other health care providers
• Lead MEs and lead MEOs
• Regional ME and MEO
• National Medical Examiner

Knowledge

MEs must have up-to-date knowledge of medical conditions and treatments and be able to exercise judgement about when to seek specialist advice.

MEs 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
• Certifying and registering deaths and the regulations to authorise cremation or burials of stillbirths abroad.

Accountability

MEs will have professional independence in scrutinising deaths but will be accountable to the employing organisations Board for achieving agreed standards or levels of performance.

MEs will have an independent professional line of accountability to a regional structure of NHS Improvement/NHS England outside the employing organisation and immediate line management structure.

MEs will comply with guidance issued by the National Medical Examiner when carrying out ME duties.

Safety and Quality Clinical Governance

MEs will be required 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.

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 National Medical Examiners office.

MEs may provide information to local Child Death Overview panels in respect of all child deaths which are not being investigated by the Coroner.

Maintaining Trust

Equality and Diversity

MEs will act in accordance with Equalities and Human Rights legislation and the organisations Equality and Diversity policies.

Independence

MEs must avoid any potential conflicts of interest. In cases where they have a personal or professional relationship with the deceased person, next of kin/informant, or with the attending doctor preparing the MCCD, they must transfer any scrutiny of the death to another ME.

Continuing professional development

MEs are expected to take responsibility for their own continuing professional development in accordance with any standards for maintaining a GMC licence to practice and membership of any relevant professional body. The ME role should be included in the whole practice appraisal.

MEs should maintain a Personal Development Plan in agreement with their appraiser.

There will be opportunities to attend local and national activities to maintain up to date knowledge.

Working Conditions:

MEs may need to use a computer for prolonged periods of time. The ME system operates within a reactive area of service delivery interacting with people in variable degrees of distress and demonstrating potentially irrational/unpredictable behaviour.

Person Specification

Professional

Essential

• Medical practitioner registered and licensed to practise in the UK by the GMC More than five years post registration.

Desirable

• Candidates must have successfully completed the mandatory e-learning modules by the time they start the role. Candidates must attend a face-to-face training session within the first three months in post

Knowledge

Essential

• Knowledge of community health systems ( experience in Merton and Wandsworth would be particularly valuable)

Communication

Essential

• Application form should include evidence of strong interpersonal skills demonstrating the ability to communicate in difficult and emotional situations with empathy and professionalism.

Experience

Essential

• Application needs to include some experience of supporting the bereaved

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

St George's Healthcare NHS Foundation Trust

Address

St George's Hospital

Blackshaw Road

Tooting, London

SW17 0QT

Employer's website

https://www.stgeorges.nhs.uk/work-with-us/ (Opens in a new tab)