Lead Medical Examiner

The postholder will be responsible for leading the Medical Examiner Service based at ESTH, which includes scrutinising all inpatient deaths at Epsom & St Helier Hospitals NHS Trust, Sutton PCN and Epsom PCN plus the Integrated Care Partnership. This role is critical in ensuring the accurate and independent review of patients' deaths and the proper completion of death certification processes. It presents a unique opportunity to ensure compliance with national guidelines while supporting bereaved families.

You will lead a team of Medical Examiners and Medical Examiner Officers, collaborating closely with clinicians and other stakeholders to deliver high-quality services. This position has dual accountability to both the Site Chief Medical Officer and the Regional Medical Examiner for London.

There is already an established Medical Examiner Service based at Epsom and St Helier University Hospitals NHS Trust, which comprises of several Medical Examiners (including a Lead Medical Examiner) and Medical Examiner Officers (providing administrative support).

The Lead ME provides clinical leadership to the Medical Examiner Service based at Epsom & St Helier Hospitals NHS Trust, Sutton PCN and Epsom PCN plus the Integrated Care Partnership.

The Lead ME interacts with many clinical specialities, general practitioners and community partners to provide proportionate, but robust scrutiny of the medical circumstances leading up to a patient's death. This includes all other aspects of death certification. The role works collaboratively across organisational boundaries with multiple different partners, including two Coroners within London and Surrey, the relevant Registry Offices, ICB colleagues and Lead MEs from other acute organisations.

The Lead ME ensures 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.

The Lead ME ensures that the team maintains comprehensive records of all deaths scrutinised and undertakes analysis to provide information to the National Medical Examiner's office. This includes the quarterly return to the National ME Office.

The Lead ME participates in relevant clinical governance activities relating to death certification including audits, mortality review processes and investigations regarding formal complaints about patient care as required in all hospitals and GP practices covered by the service

St George's, Epsom and St Helier University Hospitals and Health Group cares for a population of four million people in South West London and North East Surrey. Our sites include St George's Hospital, one of 11 major trauma centres in the UK and the largest healthcare provider and major teaching hospital in the area; St Helier Hospital, home to the South West Thames Renal and Transplantation Unit and Queen Mary's Hospital for Children; and Epsom Hospital, home to the South West London Elective Orthopaedic Centre (SWLEOC).

Our ambition is to provide an outstanding level of care to our patients and communities.

By choosing to work here, you also choose to value and role model respect. This means having respect for the Trust and your roles and responsibilities, as well as colleagues, patients and anyone who interacts with the Trust. We offer an extensive range of services, including cancer, pathology, surgery, and gynaecology to 500,000 people in south west London and north east Surrey. We operate two busy general hospitals, Epsom Hospital and St Helier Hospital, and run services from other locations, including Sutton Hospital. St Helier Hospital is home to the South West Thames Renal and Transplantation Unit and Queen Mary's Hospital for Children, while Epsom Hospital is home to the South West London Elective Orthopaedic Centre (SWLEOC). Both Epsom and St Helier hospitals have Accident and Emergency departments (A&E) and Maternity services (Obstetrics)., MEs will 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 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 Examiner's 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 organisation's 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.

Context:

The Lead Medical Examiner is a key senior appointment suitable for an individual who is committed to ensuring that we scrutinise and learn from deaths that happen within our hospitals and in the community.

We are seeking an experienced and motivated medical professional to join our team as the Lead Medical Examiner at Epsom & St Helier Hospitals (ESTH). The ideal candidate will be resilient, clinically credible, possess integrity, and have strong communication skills to engage effectively., 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.
• The ability to lead a diverse team and inspire learning and good practice.

Lead ME will have professional independence but will be accountable to the relevant Trust Board., 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.

The Lead ME must have significant experience of working as an ME and will continue a minimum of 1PA for immediate scrutiny of deaths within the service. The successful candidate must have successfully completed the mandatory components of the national online medical examiner curriculum

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

• Internal within own organisation:
• Medical Director
• All grades of clinicians
• Clinical governance leads
• MEOs and bereavement service staff
• Mortuary staff.
• External:
• Coroners and their officers
• Registrar of births and deaths
• Local Authorities, including care homes and safeguarding teams
• Spiritual and faith community leaders
• Other health care providers to including GPs
• Lead MEs and lead MEOs
• National Medical Examiner.

Knowledge

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