Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made with the Welsh Government of the effectiveness of (a) death certification reforms and (b) the statutory medical examiner system; and if he will undertake a review of their implementation.

The Government is monitoring the impact of the death certification reforms which came into legal effect on 9 September 2024. Overall, the implementation of the reforms has been effective and medical examiners are conducting scrutiny of the causes of death in every case that is not investigated by a coroner. Medical examiners were introduced to provide additional safeguards in death certification, and they are obliged by law to make all the enquiries they consider necessary to conduct their scrutiny and to ensure there has been an opportunity for the bereaved to ask questions and raise concerns in every case. Feedback from bereaved people about the support provided by medical examiner offices is overwhelmingly positive.

Since the introduction of the reforms, the median time taken to register a death in England and Wales appears to have risen by two days, from seven days to nine days, though there is regional variation. This figure is for all deaths, as it includes those certified by a doctor and those investigated by a coroner. The median time taken to register a death varies depending on the type of certification, and deaths certified through the medical examiner route, which comprise approximately 80% of deaths registered each week, typically had a shorter period between death and registration compared to all deaths. It’s important to note that the medical examiner system was active on a non-statutory basis before the introduction of the statutory system on 9 September 2024, and this makes direct ‘before’ and ‘after’ comparisons challenging to draw conclusions from.

To improve the implementation of the reforms, the Welsh administration has implemented short-term fortnightly oversight meetings to engage all partners along the death certification pathway, including health boards, medical examiner services, coroners, funeral directors, registrars, primary care associations, and patient voice organisations, to monitor, improve, and learn lessons from the implementation through the 2024/2025 winter period.