Lancashire Teaching Hospitals’ Consultant in Critical Care Dr Huw Twamley has been appointed as the interim National Medical Examiner (NME) for England and Wales for a period of 12 months.
One of the most senior and influential positions in patient safety and mortality review in the NHS, the role recognises his leadership, expertise and commitment to improving standards, transparency and learning across the healthcare system.
Dr Twamley served as the Regional Medical Examiner for the North West region for the previous six years, based at the Trust. He supported 19 Medical Examiner (ME) offices, helping to embed standards, governance, and high‑quality processes around death certification and learning from deaths.
As National Medical Examiner, now Dr Twamley’s work will be carried out across 126 ME offices, involving more than 1,500 Medical Examiners and around 4,500 Medical Examiner Officers.
He is also pursuing a doctoral degree at the University of Greater Manchester, focusing on the impact of the Medical Examiner system on coronial jurisdictions. Dr Twamley’s academic interests align with his practical experience, strengthening his contribution to national policy and healthcare law. In addition, he is a tutor on the university’s Masters in Coronial Law course.
Dual‑trained in Intensive Care Medicine and Anaesthesia, holding a dual Certificate of Completion of Training (CCT), Dr Twamley has worked at the Trust for 17 years.
The Medical Examiner system became statutory in September 2024, marking a major reform in how deaths in England and Wales are certified, scrutinised and understood. Medical Examiners act as an independent safeguard for the public -– speaking to bereaved families, reviewing the circumstances of a patient’s death, and advising on whether referral to the coroner is appropriate.
Dr Twamley describes the Medical Examiner system as much more than a technical exercise: “We are not just a death certification service. We have become a voice for the bereaved, encouraged transparency and openness within healthcare organisations and identified valuable learning to improve care.”
He highlights the strong foundations built by teams across the country and acknowledges the support of national colleagues: “I would like to thank the Royal College for all their support of the Medical Examiner system, particularly Dr Suzy Lishman and Daisy Shale. The Medical Examiner/Medical Examiner Officer hub has become a valuable resource for shared learning and education.”
The National Medical Examiner provides strategic leadership across England and Wales, working with the Department of Health and Social Care (DHSC), NHS England, professional bodies and coroners.
In describing his new responsibilities, Dr Twamley explains: “It’s a similar role in many ways. Regionally, I was responsible for 19 Medical Examiner offices across the North West. Now I’m responsible for 126 offices, covering England and Wales. There’s much more strategic work though, particularly around delivery and collaboration with the Department of Health, which is responsible for the Medical Examiner system.”
While he acknowledges the step up feels challenging, he’s genuinely energised and motivated by the opportunity: “I’m still very much in the phase of meeting all the people I need to meet. But it’s really exciting. Although it’s well established, there’s still a lot of development and improvement we can deliver.”
The ME system reviews over half a million deaths each year, a figure that increases during winter pressures. Medical Examiners talk to bereaved families to understand their concerns and ensure clarity around certification. They also identify issues that may relate to patient safety or clinical governance and support appropriate referrals to coroners.
Dr Twamley outlines the challenges: “We speak to bereaved families, ensure deaths that need to be referred to the coroner are identified appropriately, and review deaths for patient safety issues. The challenge is making sure all of that works consistently and has the greatest possible impact.”
