11. Pathology

The purpose of autopsies

Review of the autopsy reports raises the question of the differing expectations of the coronial autopsy in complex medical cases, and whether the results of autopsies are expected, or not, to contribute to clinical governance and audit. As discussed in the section on histopathological sampling above, more investigation can be done once the needs of the coroner are satisfied, with consent from relatives.

In the recent Shipman reports ⁴⁸ and proposals for reform of the ‘coronial system’ ⁴⁹, it is indicated that information from all autopsies should be used more in medical audit. For this to be useful, the quality of autopsy reports needs to be of a more uniform standard. It is hoped that more harmonisation and standardisation may develop if and when the reforms to the coroner’s and death certification systems in England and Wales are implemented ⁴⁹.

Finally, NCEPOD will be undertaking a survey of the quality of all autopsy reports in England, Wales, Northern Ireland and Guernsey, from a representative selection of examinations of deaths in the community as well as in hospital. The results will provide a better baseline of performance data to enable more focussed critical review of future autopsy activity.

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