Homerton Healthcare NHS Foundation Trust
Applications are invited from senior doctors working across City & Hackney for the post of Medical Examiner (ME) for Homerton Healthcare. Each post will attract 1 PA plus an on-call supplement for 1:6 weekend/bank holiday 8-10am cover.
We especially welcome applications from those with links to Hackney, General Practice colleagues, and those who would bring diversity to the team but will happily accept applications from those who are either established MEs or new to the role.
It is varied, rewarding and valuable work. We are looking for people with a curious mind and excellent communication skills.
The Medical Examiner system has been introduced nationally as part of the Department of Health and Social Care's death certification reforms programme for England and Wales. It became statutory from September 2024.
Medical examiners (MEs) are experienced doctors who review a case after someone has died. They are independent of the doctors who cared for the patient. They decide in collaboration with the treating doctors on the cause of death and speak to the bereaved to see whether they have any questions or concerns before the medical certificate of cause of death (MCCD) is written. They are supported by medical examiners officers (MEOs).
Main duties of the job
1. 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.
2. 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.
3. To support those doctors who call for medical advice on suspected natural causes of death before they prepare an MCCD, and provide general medical advice to the coroner.
4. 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.
5. 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.
6. To maintain comprehensive records of all deaths scrutinised and undertake analysis to provide information to the National Medical Examiner's office.
7. To participate in relevant clinical governance activities relating to death certification including audits, mortality review processes and investigations regarding formal complaints about patient care.
About us
Homerton Healthcare NHS Foundation Trust (HH) is an acute hospital located in the east London Borough of Hackney. The current Chairman is Sir John Gieve, and the Chief Executive is Ms Basirat Sadiq.
Homerton became one of the first ten NHS foundation trusts in the country in April 2004. This allows the Trust to secure certain freedoms to facilitate innovation in the way services are developed and provided. As well as our Trust Board, we also have a Council of Governors comprised of governors representing the local community.
In 2011 the Trust integrated with City & Hackney Community Health Services thereby providing it with an opportunity to develop new service models and pathways that cross traditional organisational boundaries.
Employing over 3000 people, the hospital has approximately 500 beds and manages a 50-bed nursing home, Mary Seacole Nursing Home, in Shoreditch, East London. In 2022, the Trust saw over 300,000 people in outpatient clinics, and over 126,000 people were treated in the accident and emergency department. The Trust also had contact with over 280,000 patients and clients within the community, often in their own homes.
The Trust has a turnover in the region of £220 million, performs consistently well against national performance targets, and has an ambitious objective to increase its income to £300 million over the next few years.
Job responsibilities
Qualifications
1. Registered with a licence to practice in the UK by the GMC.
2. 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 should be completed within the first three months of being in post.
3. 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.
Communications and key working relationships
To be a source of expert knowledge and advice for health professionals and wider stakeholder groups including:
1. All grades of clinicians across healthcare settings in Hackney, including acute care, general practice, hospice and mental health services
2. Clinical governance leads
3. MEOs and bereavement service staff
4. Mortuary staff
5. Coroners and their officers
6. Registrar of births and deaths
7. Local Authorities, including care homes and safeguarding teams
8. Spiritual and faith community leaders
9. Lead MEs and lead MEOs
10. Homerton Healthcare Medical Director
11. National Medical Examiner
You must be able to communicate with the bereaved of all faiths and communities in a sensitive and understanding manner. You will be familiar with the role and function of the Coroner and 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.
Knowledge
MEs must have up-to-date knowledge of a range of medical conditions and treatments, but will not be specialist in all areas. MEs must 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:
1. The determination of whether a death is natural or unnatural
2. Deaths that must be reported to the coroner
3. Deaths abroad where bodies are returned to England and Wales for disposal
4. Deaths where relatives wish to transport the body abroad for disposal
5. 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 will 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.
Maintaining Trust - 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.
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.
Person Specification
Knowledge, Skills and Performance
1. Medical practitioner registered and licensed to practise in the UK by the GMC, currently employed in City & Hackney healthcare system.
2. Candidates must have successfully completed the mandatory e-learning modules by the time they start the role. Candidates should attend a face-to-face training session within the first three months in post.
3. MEs should have up-to-date knowledge of causes of death and an understanding of the legal frameworks associated with death certification processes.
4. IT skills including use of email and commonly used software.
5. Knowledge of the special requirements of various faith groups and respect for equality and diversity.
Safety and Quality - Clinical Governance
1. 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 and organisational performance.
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.
Homerton Healthcare NHS Foundation Trust
Depending on experience according to the GP or Consultant pay scale.
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