Chief Coroner HH Judge Peter Thornton QC, the first holder of this position, submitted his first annual report (the “Report”) to the Lord Chancellor on June 30 of this year as required by the Coroners and Justice Act 2009 (“the 2009 Act”).

Coroners in England and Wales are tasked with investigating deaths of a violent or unnatural nature, deaths that occur in prison and deaths with an unknown cause. These investigations take many forms and may result in an inquest. Up until 2010, when the position of Chief Coroner was created by the 2009 Act, there was no official head of the coroner system.

The Chief Coroner takes on this leadership role within the coroner system, although coroners are still locally appointed and paid. His role includes setting new national standards and frameworks under which coroners will operate and implementing any reforms.

Ultimately the Chief Coroner’s role is to improve the standard of the coroner service for bereaved families and the Report highlights both statutory reforms as well as reforms that have been made over the past year by the Chief Coroner that he believes will work towards achieving this overarching goal. The reforms centre around two main themes, improving consistency and reducing delays across the coroner service.

1.    Consistency

In the Report, the Chief Coroner declared that he wants “a national consistency of approach and standards between coroner areas” and to achieve this he has implemented a number of reforms. Training is now compulsory for the first time for all coroners and the Chief Coroner has produced formal guidance, circulated to all coroners and published online, on a variety of topics to promote good practice. In addition, the Chief Coroner is working on a new scheme for the standardisation of salaries and fees for coroners across the country. Finally, the Chief Coroner has introduced a new mandatory retirement age for newly appointed coroners of 70, and older coroners are encouraged to retire at 75.

2.    Reducing delays

In an effort to reduce delays, the Chief Coroner has written to all coroners reminding them of the need to set dates and having timely hearings. Most inquests should be held within six months of the death and the Chief Coroner requires notification of any investigations that are still taking place more than a year after the death. Additionally, the Chief Coroner has advised coroners that they should request medical reports within 4-6 weeks of the inquest being opened, and that long delays in producing reports are unacceptable.

A variety of other reforms are discussed in more depth in the Report, ranging from changes to the way that coroners are appointed, mergers between smaller coroner areas and changes to the role of Senior Coroner. Whereas Senior Coroners were previously just expected to fulfil the usual duties of a coroner, e.g. investigating suspicious deaths, they are now expected to take on more of a management role, delegating work, organising the local coroner system and collaborating with police and local authorities.

Given that the 2009 Act only came into force in April 2010 and that Judge Thornton’s position didn’t take effect until September 2012, these reforms are evidently still in their infancy. However, the Chief Coroner believes that there are “already signs of positive change” as, in his opinion; the reforms are “beginning to take effect”.