Understanding the Role of a Medical Examiner
A Practical Guide to Understanding What a Medical Examiner Does and How They Can Help After a Death.
The medical examiner system plays an important role in reviewing the cause of death when a death is not being investigated by the Coroner. This guide explains the role of a medical examiner, what the review involves and how they may communicate with the bereaved family. It also outlines the difference between a medical examiner and a Coroner, helping you understand what to expect during the process following a death.
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You may encounter several different people and organisations after someone dies, each with their own responsibilities. Some of these roles may not be immediately familiar, so understanding what they do can help clarify the process. For an overview of the people involved after a death, please see our main guide below.
The Role of a Medical Examiner
A medical examiner is involved in reviewing the cause of death when someone dies in England and Wales and the death is not being investigated by the Coroner. The medical examiner system provides an independent review of the medical circumstances surrounding a death. It is intended to help ensure that causes of death are recorded accurately, that concerns can be raised and that deaths requiring further investigation are identified.
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For families, the process may introduce another person or team to contact after a death. Understanding the role of a medical examiner can help explain what happens, why someone may get in touch and how this differs from the role of a doctor or Coroner.
What Is a Medical Examiner?
A medical examiner is a senior doctor who reviews the proposed cause of death. They are independent of the medical care provided to the person who has died and should not normally have been involved in that person’s treatment.
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Their role is to check that the proposed cause of death is appropriate based on the available medical information. They may review medical records, speak to the doctor completing the Medical Certificate of Cause of Death and consider whether the death needs to be referred to the Coroner. Medical examiners do not replace the doctor who cared for the person. Instead, they provide an additional level of independent scrutiny before the cause of death is formally recorded.
Why Was the Medical Examiner System Introduced?
The medical examiner system was introduced to improve the quality and consistency of death certification and to provide greater transparency around the circumstances of a death. Since September 2024, deaths in England and Wales that are not being investigated by a Coroner must be reviewed by a medical examiner.
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The system is designed to:
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Provide an independent review of the proposed cause of death.
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Identify deaths that may need referral to the Coroner.
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Improve the accuracy and consistency of death certificates.
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Give bereaved families an opportunity to ask questions.
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Allow concerns about care or the circumstances of a death to be raised.
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The medical examiner’s role is not to investigate every death in the same way as a Coroner. Their review is generally part of the medical certification process.
What Does a Medical Examiner Actually Do?
The medical examiner reviews information about the person who has died and considers whether the proposed cause of death is medically appropriate.
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Their work may include:
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Reviewing the person’s medical records.
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Considering the circumstances and setting of the death.
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Discussing the proposed cause of death with the attending doctor.
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Checking whether the death should be referred to the Coroner.
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Confirming that the Medical Certificate of Cause of Death can be completed appropriately.
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Offering the family an opportunity to ask questions or raise concerns.
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The medical examiner does not normally carry out a post-mortem examination themselves. If further investigation is required, they may advise that the death should be referred to the Coroner.
Will the Medical Examiner Contact the Family?
A member of the medical examiner’s team may contact the family or offer them an opportunity to discuss the death. This contact may be handled by a medical examiner officer, who supports the medical examiner and helps communicate with bereaved people, doctors and other professionals.
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The family may be asked whether they have any questions about the proposed cause of death or whether they have concerns about the care provided. They do not have to know medical terminology or understand the certification process before speaking to the team.
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​The purpose is to give families an opportunity to raise relevant questions and ensure that any concerns can be considered. It does not necessarily mean that something has gone wrong or that the death is being treated as a formal investigation.
What Is a Medical Examiner Officer?
A medical examiner officer is a separate role which supports the medical examiner and helps manage the practical and administrative side of the review.
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They may:
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Contact the bereaved family.
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Explain the medical examiner process.
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Ask whether the family has questions or concerns.
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Gather relevant information.
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Communicate with doctors and other professionals.
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Pass concerns or questions to the medical examiner.
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The medical examiner officer is not the same as the medical examiner. The officer supports the process, while the medical examiner is the senior doctor responsible for reviewing the proposed cause of death.
What Is the Difference Between a Medical Examiner and a Coroner?
The roles of a medical examiner and a Coroner are related, but they are not the same. Both may become involved when questions arise about the cause or circumstances of a death, but they have different responsibilities.
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A medical examiner reviews the proposed medical cause of death and checks that it is supported by the available medical information. They usually deal with deaths that are not being formally investigated by the Coroner. As part of this process, the medical examiner may identify concerns that need further investigation or decide that a death should be referred to the Coroner.
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Alternatively, a Coroner investigates deaths that meet specific legal criteria. This may include deaths that are sudden, unexpected, violent, unnatural or where the cause is unknown. The Coroner may arrange a post-mortem examination, request further information or hold an inquest. They also have responsibility for deciding when a person can be released for funeral arrangements if a formal investigation is taking place.
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A medical examiner does not replace the Coroner. Instead, the medical examiner’s review can help identify deaths that require a Coroner’s investigation. If a death is referred to the Coroner, the family may need to wait for the relevant enquiries or examinations to be completed before the funeral can take place. For more information, see our guide to understanding the role of the Coroner.
Does Every Death Need a Medical Examiner?
In England and Wales, deaths that are not being investigated by the Coroner are subject to medical examiner scrutiny. However, the process may look different depending on the circumstances.
If a death has already been referred to the Coroner, the Coroner’s investigation takes precedence and the medical examiner may not be involved in the same way. The hospital, doctor, medical examiner’s office or Coroner’s office should explain what is happening where the circumstances require further clarification.​
Can the Medical Examiner Delay a Funeral?
The medical examiner process may affect the timing of the Medical Certificate of Cause of Death and death registration, which can have an impact on funeral arrangements.
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However, a medical examiner does not generally delay a funeral in the same way that a post-mortem examination or Coroner’s investigation might. If a death is referred to the Coroner, the investigation and any required examinations may affect when the person who has died can be released for the funeral. Your funeral director can help explain any delays and liaise with the relevant organisations where appropriate.
How Clive Pugh Funeral Directors Can Help
When a medical examiner is involved, families may have questions about what the review means and whether it will affect the funeral arrangements. At Clive Pugh Funeral Directors, we can help explain the practical steps and act as your main point of contact throughout the funeral process.
Depending on the circumstances, we can:
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Explain what is likely to happen next.
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Help clarify which organisation is responsible for different parts of the process.
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Liaise with hospitals, medical examiner teams and the Coroner’s office where appropriate.
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Explain how any delay may affect funeral arrangements.
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Coordinate arrangements once the necessary paperwork has been completed.
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Keep family members informed as arrangements progress.
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Our role is to manage the practical arrangements and help you understand what needs to happen, while the medical examiner and other relevant professionals carry out their own responsibilities.
With You Every Step of the Way
Date and Time
Following registration, a date and time can then be arranged.
Cremation or Burial
In many cases a loved one will have left their own specific preference. Once the decision for a cremation or burial has been made, a venue for the service and order of events can be agreed upon.
Chapel of Rest
Our private chapel is available for you to spend time with your loved one, also allowing your relatives and friends the chance to say "goodbye".
The Funeral Service
We will liaise with the Clergy, Humanist Minister or Celebrant of your choice. Alternatively, if no specific Minister is requested we can suggest a Minister who will guide you through the order of service. The readings, hymns and eulogies will all be discussed.
Additional Resources
For reliable information about medical examiners and death certification, the following sources are useful:
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NHS England: Medical Examiners – Information about the medical examiner system and its purpose.
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GOV.UK: Medical Examiner System – Government guidance and information about medical examiners.
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GOV.UK: What to Do After a Death – General guidance covering the steps following a death.
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GOV.UK: When a Death Is Reported to a Coroner – Information about when a death may need to be referred to the Coroner.
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For local registration information, you can also visit:
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Coffins, Caskets and Urns
We offer a large range of traditional coffins, caskets and urns. You can choose from many different styles and we offer a range of price points. Should you want to offer a unique tribute to your loved one, ask us about our customisation options. If you are looking for something in particular, please let us know. We will make every effort to accommodate your needs.
Vehicles
We take pride in being able to offer a comprehensive selection of vehicles. A horse drawn hearse is also available upon request.
Frequently Asked Questions
Who Appoints the Medical Examiner?
Medical examiners work within a local medical examiner office, usually linked to an NHS trust or group of NHS organisations. They are appointed through the medical examiner system and must be independent of the care provided to the person who has died.
Can I Ask the Medical Examiner Questions?
Yes. Families should be given an opportunity to ask questions or raise concerns about the proposed cause of death or the care provided. A medical examiner or medical examiner officer can explain the process and advise whether another organisation should deal with a particular concern.
Can I Request a Medical Examiner’s Review?
The medical examiner process is normally initiated by the doctor or organisation responsible for completing the death certification. If you have questions or concerns about the cause of death, you can raise them with the medical examiner team when they contact you, or ask the relevant doctor or hospital how to make contact.
Does a Medical Examiner Visit the Place Where Someone Died?
Usually, no. The medical examiner’s review is generally carried out by considering medical records, the circumstances of the death and information provided by the doctor. They do not normally need to visit the home, hospital or care home where the death occurred.
What Happens If I Do Not Agree With the Cause of Death?
If you have concerns about the proposed cause of death, explain them to the medical examiner or medical examiner officer. They can consider the information you provide and may discuss the cause with the doctor who completed the medical certificate. If the concerns indicate that further investigation may be needed, the death may be referred to the Coroner.
Is There a Charge for the Medical Examiner’s Review?
No. The medical examiner review is part of the statutory death certification process and is not a service that bereaved families are expected to pay for.