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In 2003, a report of a fundamental review into death certification and investigation in England, Wales and Northern Ireland was presented to Parliament from the Home Office that included the statement:
"There is, indeed, a general lack of evidence about the utility of and justification for coroners' autopsies on the scale on which they are practiced in England and Wales. If the 121,000 autopsies a year that are now performed were surgical procedures carried out on living people there would long ago have been an evidence base compiled to assess the utility and justification for the scale of intervention."1
The Shipman Inquiry made a similar point about the lack of audit of the coronial autopsy, and also raised the question of whether too many unnecessary coronial autopsies were being performed2.
The present NCEPOD study is a contribution to an evidence base concerning coronial autopsies. With an ever increasing proportion of all deaths in England and Wales being referred to a coroner, it is important to view the coronial autopsy objectively and make recommendations that could improve the standard of practice and reporting. In the preceding chapters of this report, many of the issues have been indicated and discussed in detail, with recommendations presented. In this section, the fundamental purpose of the coronial autopsy is reflected upon, and the overarching aspects that emerged from the study are presented along with some broader recommendations. Finally, the future of autopsy practice is discussed.
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