1. Chief Coroner of England & Wales HHJ Mark Lucraft QC
November, 2018

2. Who is he?
Barrister in practice between Specialising in criminal law with an emphasis on serious and complex fraud.
Appointed QC in 2006
Recorder in 2004
Circuit Judge 2012.
Seconded to Central Criminal Court April 2015.
Appointed as Chief Coroner of England & Wales October 2016.
Permanent Judge at the Central Criminal Court February 2017.

3. Two roles - crime
Sitting as a judge at the Central Criminal Court (Old Bailey) – major criminal trials in London and South-East but also cases of national importance:
Homicide
Terrorism
Sitting in the Court of Appeal – Criminal Division – sentence and conviction appeals

4. Old Bailey Recent trials: 5 handed murder case – shooting
Attempted murder in a car
Terrorism – funding
Attempted murder
Murder/manslaughter, conspiracy to rob

5. Legal issues that arise
Joint enterprise
Young defendants
Mental health issues
Sentencing on manslaughter
Confiscation

6. Chief Coroner. National lead for coroners in England & Wales Training
Guidance
Reporting to Lord Chancellor and Lord Chief Justice
Sitting as a judge in the High Court on judicial reviews
Dealing with applications for inquests where there is no body
Applications for inquests after burial or cremation

7. Work in progress Key issue – consistency of approach.
Review of cases over 12 months – understanding why?
An appraisal scheme for coroners – January 2019
Mentoring for full-time coroners
Workshops for part-time coroners interested in full-time appointment.
Workshops for those considering applying to be assistant coroners.

8. Work in progress Guidance – 2017 - DoLS, and Organ Donation
2018 – prioritisation,
Coming soon: ‘short form’ inquests, second post-mortems
Reg. 28 reports.
Revising MoUs between coroners and others.
Pathologists willing to do coronial work

9. What next? Annual report due to be published.
Visits to coroner areas – on-going
Medical examiners – April 2019?
Local authority conference
Chief Coroner’s Conference.
Modern ways of working – going digital
Attacking inconsistency

10. Stats for headlines.
229,700 deaths reported to coroners in 2017.
What of deaths not reported?
Registered deaths – 533,118
43% of all registered deaths reported – 3% down on 2016
85,600 post-mortem examinations ordered by coroners in Since 1995 decrease from 61% to 31% (proportion of deaths)
Time to inquest (from date of death to conclusion) 21 weeks

11. Stats (2). Excluding DoLS, deaths in state detention 528.
Deaths while detained under Mental Heath Act.
Deaths in prison custody.
Deaths in police custody.
31,519 inquests opened in 2017 – down 18% - DoLS
In 127,601 cases - no post-mortem and no inquest.

12. Stats (3). 33,945 inquest conclusions recorded.
49% of conclusions take 2 forms: natural causes (27%), accident/misadventure (22%).Suicide at a steady 9%.
Figures at extremes of particular concern.
PMs rates -21% and and 59% why?
Note: 1,671 PMs using less invasive techniques
23% of all PMs include histology (as 2016). 20% PMs including toxicology + 5%
Time taken to inquest - 9 weeks and 45 weeks why?.

13. Challenges going forward.
Medical Examiners – key part of the reforms in the 2009 Act
Clarity of circumstances when a death should be reported to the coroner
Adequate provision of resources by local authorities
Consistency of approach by coroners
Consistency of reporting on preventing future death.
Dame Elish Angiolini report
Bishop James Jones report

14. Questions? HHJ Mark Lucraft QC