Recommendation 283

Information gathering for an inquest

Guidance should be developed for coroners’ offices about whom to approach in gathering information about whether to hold an inquest into the death of a patient. This should include contact with the patient’s family.

The Judicial College has taken responsibility for training all coroners and coroner’s officers under the remit of the Chief Coroner’s Office from July 2013. The College has already supplied training to coroners on the Coroners and Justice Act 2009 and will develop training for all coroners’ officers on their roles.  This will cover how to involve bereaved families when gathering information in connection with the coroner’s investigation.  We anticipate that this training will be available from 2014.


The Judicial College has a programme of mandatory coroner training in place for 2013-14, including 12 courses covering the new legislation and two induction courses. A programme of annual continuation training for coroners began in April 2014 and is ongoing.

The Judicial College is also developing plans for coroner officer training. A training needs analysis questionnaire was issued to coroners officers in April 2014, and the Judicial College is using the results to design coroner officer training.