Job overview
Medical Examiner post for scrutinising and confirming causes of deaths in Primary and Acute Care settings, covering West Dorset.
In 2007, in response to the recommendations of the Shipman Inquiry, the Department of Health (DoH) called for reform of the death certification process. Based upon the Inquiry’s findings, the DoH proposed that a new role of Medical Examiner be established within healthcare environments.
Medical Examiners (MEs) are appropriately trained senior doctors who will 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 the majority of deaths in England and Wales.
It is expected that the Medical Examiner will work collaboratively with the already established team of 9 Medical Examiners and 3 Medical Examiner Officers to undertake a review of all deaths in the 24-48 hours after notification of death on a Monday to Friday basis for primary care, hospice and both community and acute hospital deaths.
To ensure that the service is sustainable, and that conflicts of interest are avoided, the potential time commitment should be agreed with your Clinical Director/Practice Lead before applying.
Main duties of the job
· Maintain knowledge and ensure compliance with the legal and procedural requirements associated with the current processes of certification, investigation (by the Coroner’s Office) and registration of deaths within a Local Authority area.
· Support any Doctors who call for medical advice on suspected natural causes of death before they prepare an MCCD.
· Undertake a Daily Medical Examiner Review screen of all patient deaths
· To contact and discuss agreed cause of death details with bereaved relatives in a transparent, tactful and sympathetic manner, which respects different faith, cultural, ethnic and diversity considerations.
· Identify and distinguish between natural and unnatural causes of death and to decide where a death must be reported to, and investigated by, a Coroner.
· Act as the main point of contact with the Coroner for any appropriate referrals. You must be able to present complex medical information in such a way as to assist the Coroner in deciding whether to investigate a death about which they have been notified.
· Maintain 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 to determine the appropriate level of scrutiny required.
· To ensure CPD activities are undertaken to maintain skills and competencies and therefore to inform revalidation.
Working for our organisation
At DCHFT, we pride ourselves on the care we provide for our patients, and on the culture, we are creating for our staff. We work hard to create a fair, inclusive environment for our staff.
Our Mission is to work in partnership to provide high quality, compassionate services and to nurture an environment where people can be at their best. Our vision is healthier lives, empowered citizens, thriving communities.
We are a Trust that celebrates diversity, and we are committed to creating an inclusive environment for all employees. We welcome applications from people in all under-represented groups.
We understand that some applicants may choose to use artificial intelligence (AI) tools to assist in preparing their application materials. While this is not discouraged, we kindly remind candidates that all submissions must be truthful and accurately reflect your own experiences and suitability for this role.
Personal integrity and authenticity are central to our recruitment process. We value honesty and appreciate applications that are genuine and representative of the individual behind them.
Detailed job description and main responsibilities
COMMUNICATION AND WORKING RELATIONSHIP SKILLS
Internal:
Medical Director, Deputy Medical Director, Medical Examiners, Medical Examiner Officers, Divisional Managers.
External:
GP Practices (including GPs, Practice Managers and Administrative Staff), Community NHS Trusts (including GPs/Consultants, Administrative Staff, Service Managers and Medical Directors/Deputy Medical Directors, the Coroner and their officers, Registrar of births and deaths, Local Authorities (including care homes and safeguarding teams), Spiritual and faith community leaders, Regional Lead ME’s and MEO’s, the National Medical Examiners, Other health care providers including Undertakers.
MEs have professional independence in scrutinising deaths but will be accountable to the employing organisation‘s Board for achieving agreed standards or levels of performance.
MEs 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 must comply with guidance issued by the National Medical Examiner when carrying out ME duties
ANALYTICAL AND JUDGEMENTAL SKILLS
ME’s must have broad, up-to-date knowledge of medical conditions and treatments and be able to exercise judgement on when to seek specialist advice.
ME’s must have detailed knowledge on 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
Clinical Governance
· The ME must have up to date knowledge of Primary Care Network clinical governance structures and any relevant Community NHS Trusts clinical governance structures, and the possible paths for a case should a Coroner’s referral be necessary.
· The ME 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.
PLANNING AND ORGANISATIONAL SKILLS
Plan and prioritise own work, to ensure effective support to all areas and delivery of key objectives.
Regularly monitor and review plans and adjust for changes in local need and in response to changes in National policy guidance.
Planning and organising of own workload.
RESPONSIBILITY FOR PATIENT/CLIENT CARE, TREATMENT AND THERAPY
To participate in and support clinical governance activities relating to Structured Judgement Reviews (SJRs), M&M review processes, complaints and audits.
RESPONSIBILITY FOR POLICY / SERVICE DEVELOPMENT
Support the development of policies relating to the Medical Examiner Process.
Contribute to the planning of relevant service developments within and across the organisation including internal and external stakeholders.
RESPONSIBILITY FOR FINANCE, EQUIPMENT AND OTHER RESOURCES
Manage computerised databases and reports.
Analyse and manoeuvre data creating additional reports for use by others.
Ensure that all records, supporting documentation and action plans are accurately maintained.
RESPONSIBILITY FOR HUMAN RESOURCES, E.G. SUPERVISION, TRAINING, HR ADVICE AND MANAGEMENT
No direct reports. However, you will be expected to take responsibility for your own continuing professional development and take part in continuing medical education activities, in accordance with any relevant standards for maintaining your GMC licence to practice and membership of any relevant professional body.
You will be committed to the concept of lifelong learning and produce and maintain a Personal Development Plan in agreement with your appraiser.
You will be required to attend relevant local, and national, activities to maintain up-to-date knowledge and to ensure compliance with legal and procedural requirements associated with the current processes of certification, investigation (by Coroner’s) and registration.
RESPONSIBILITY FOR INFORMATION RESOURCES AND ADMINISTRATIVE DUTIES
This post will have at least one full-time Medical Examiner Officer (Community Deaths) to manage the Medical Examiner process, but each ME is required to:
· To maintain comprehensive records of all deaths scrutinised and undertake analysis to provide information to the National Medical Examiner officer
· Responsible for complying with the Trusts Information Governance policies for Governance and confidentiality
MENTAL, PHYSICAL, AND EMOTIONAL EFFORT
The ME may need to use a computer for a prolonged period. The ME system operates within a reactive area of service delivery interacting with people invariable degrees of distress and demonstrating potentially irrational/unpredictable behaviour
Person specification
Education, Qualifications and Training
Essential criteria
* Full GMC Registration Entry on the GMC Specialist Register via; CCT (proposed CCT date must be within 6mths of interview) or GP Register
Desirable criteria
* MRCPath (Medical Examiner mandatory eLearning modules and face to face training session)
Experience and Knowledge
Essential criteria
* Working knowledge of practice in a healthcare environment in the UK.
* Experience of working within the NHS
* Up-to-date knowledge of causes of death and an understanding of the legal frameworks associated with death certification processes.
* Ability to manage and comply with sensitive information-based processes under a tight timescale with a proportionate approach.
* Understanding of the Primary Care sector, including GP Practices, Community NHS Trusts and associated services.
Desirable criteria
* Knowledge of the special requirements of various faith groups and respect for equality and diversity.
* Knowledge of local and national clinical governance systems and an understanding of how the ME can work collaboratively to improve patient safety by identifying sub-optimal clinical performance.
* Ability to identify available data sources to support the detection and analysis of concerns and to recognise gaps in available knowledge.
* Ability to identify and disseminate examples of good practice amongst relevant clinical colleagues.
Current Skills and Abilities
Essential criteria
* Ability to work within information based processes under tight timescales.
* Ability to communicate effectively within the team and with other people in other disciplines.
* Ability to communication effectively and sensitively with the relatives or representatives of the deceased when explaining the cause of death.
* Excellent organisational skills.
* Excellent management skills- able to demonstrate effective and efficient working practices.
* IT Skills for the purpose of efficient scrutiny and routine analysis of information. Including use of clinical systems and Microsoft Office e.g. Excel
Management Training, Organisational Skills and Strategic Vision
Essential criteria
* To always sustain professional integrity and independence, particularly where there is the potential for a conflict of interest.
Desirable criteria
* Have the resilience to manage own reaction to potentially distressing situations and support others in the team.
Teaching and Communication
Essential criteria
* Ability to assist or deliver training to enhance skills within the ME’s team and junior doctors/General Practitioners in the process of death certification.
Personal Attributes
Essential criteria
* Strong interpersonal skills demonstrating the ability to communicate in difficult and emotional situations with empathy and professionalism.
* Ability to work as part of a team and organise a fluctuating workload around competing priorities and numerous interruptions.
* Ability to demonstrate transparency when explaining cause of death to bereaved families and make it easier to raise concerns.
* Proactive and self-motivated with a flexible working approach.