Professor Alan Fletcher is the National Medical Examiner for England and Wales, appointed in March 2019. He was Lead Medical Examiner in Sheffield before this. He pioneered the medical examiner role since 2008 as part of the Department of Health reforms of death certification; personally reviewing over 22,000 deaths.

He has overseen the introduction of the medical examiner system in England and Wales. It is expected that the medical examiner system will become statutory in April 2023. The medical system ensures that every death is scrutinised by a medical examiner or a coroner to ensure issues with patient care are identified promptly, and as a consequence, to improve services and care for patients overall. Core to the system is providing bereaved people the opportunity to raise any concerns they may have about the care and treatment provided to the deceased person. Professor Fletcher maintains his clinical practice as Consultant in Emergency Medicine and General Medicine at Sheffield Teaching Hospitals.

Research Interests and Research Subject Specialisms:
Professor A. Fletcher is a renowned researcher whose interests lie at the intersection of law and medicine, particularly within the field of coronial law. With a focus on advancing our understanding of medical reviews and related subjects, Professor Fletcher's research explores critical issues surrounding death certification processes, the impact of the Medical Examiner role on patient safety, and the intricate dynamics of occupational associations with fatalities. His expertise extends to topics such as emergency medicine, analgesia methods, and the broader implications of medical science in legal contexts. Professor Fletcher's commitment to innovative research and his multidisciplinary approach make him a leading authority in contemporary coronial law and medical jurisprudence.

Teaching specialisms;
Professor A. Fletcher is a distinguished faculty member at the Centre for Contemporary Coronial Law, where he imparts his extensive expertise in courses primarily focused on medical reviews and subjects related to medical science. With a wealth of experience in both the academic and practical realms, Professor Fletcher brings a unique perspective to the classroom, offering students valuable insights into the intricate intersections of law and medicine within the coronial context. His commitment to excellence in education and dedication to advancing knowledge in the field make him a key contributor to the academic mission of the Centre.

Publications and Research:
Original Papers:
Edwards, N.D., Fletcher, A., Cole, J.R., & Peacock, J.E. (1993). Combined infusions of morphine and ketamine for postoperative pain in elderly patients. Anaesthesia, 48(2), 124-127.

Fletcher, A., & Dolben, J. (1996). A hospital survey of the care of elderly patients with diabetes mellitus. Age and Ageing, 25(5), 349-352.

Fletcher, A.K., & Burke, D.P. (2002). Presentation to accident and emergency with crying or screaming and likelihood of child protection registration. Emergency Medicine Journal, 19(1), 17-18.

Fletcher, A.K., Rigby, A.S., & Heyes, F.L.P. (2003). 3-in-1 femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized controlled trial. Annals of Emergency Medicine, 41(2), 227-233.

Fletcher, A.K., Rigby, A.S., & Heyes, F.L.P. (2004). 3-in-1 femoral nerve block provided fast pain relief for femoral neck fracture. Journal of Bone and Joint Surgery, 86-A, 441.

Mason, S., Fletcher, A., McCormick, S., & Perrin, J. (2005). Developing assessment of Emergency Nurse Practitioner competence. Journal of Advanced Nursing, 50(4), 425-432.

Cooke, V.A., & Fletcher, A.K. (2006). Deep vein thrombosis among injecting drug users in Sheffield. Emergency Medicine Journal, 23(10), 777–779.

Fletcher, A., Dorries, C., & da Costa, D.F. (2006). Improving the Death Certification Process; the Sheffield Medical Examiner Pathfinder Pilot. Retrieved from link.

Fletcher, A.K. (2011). Coroners’ Rule 43 Reports. Journal of Clinical Risk, 17(4), 217-219.

Basu, S., Fletcher, A., & Adisesh, A. (2015). Death and work: recognition of occupational association and coroner’s investigation. Occupational Medicine, 65, 197–201.

Furness, P.N., Fletcher, A.K., Shepherd, N.A., Bell, B., Shale, D., & Griffin, K. (2016). Reforming death certification: Introducing scrutiny by Medical Examiners. Retrieved from link.

Fletcher, A. (2017). Pilot of the Department of Health medical examiner system. Retrieved from link.

Fletcher, A., Coster, J.E., & Goodacre, S. (2023). Saying something about every death: the impact of the new Medical Examiner role on patient safety. British Medical Journal (submitted, awaiting publication).

Case Reports:
Fletcher, A., & Weetman, A.P. (1997). Co-existence of hereditary angioedema and Turner’s syndrome: a therapeutic paradox. Postgraduate Medical Journal, 74(877), 41-42.

Fletcher, A.K., & Locker, T.E. (2003). TNK tPA during cardiac arrest for massive pulmonary embolism. Retrieved from link (accessed Sept 2003).

Ramlakhan, & Fletcher, A.K. (2007). It could have happened to Van Gogh; a case of fatal purple Foxglove Poisoning. European Journal of Emergency Medicine, 14, 356-359.

Kerr, D., & Fletcher, A. (2010). Fatal Nefopam Poisoning. Emergency Medicine Journal, 23(10), 777–779.

Reviews:
Fletcher, A.K., & Weetman, A.P. (1998). Hypertension and hypothyroidism. Journal of Human Hypertension, 12(2), 79-82.

Jenkins, R.C., & Fletcher, A.K. (1999). Endocrine testing in renal failure. Medical Biochemistry, 1(2), 131-143.

Fletcher, A.K. (2004). Oxygen therapy in acute exacerbations of COPD. Respiratory Disease in Practice, 20, 13-15.

Whiteside, M.D., & Fletcher, A.K. (2010). Anaphylaxis – no time to act. Journal of Royal College of Physicians of Edinburgh, 40, 145–8.

Chapters and Books:
Fletcher, A.K. (1999). The hypothalamo-pituitary-gonadal axis in acute illness. In: Frontiers of Hormone Research: The Endocrine Response to Acute Illness (Eds. Jenkins R.C. and Ross R.J.M.). S. Karger AG, Basel.

Fletcher, A.K. (2004). Poisoning. In: Medicine 2nd Edition (Eds. Axford J. and O’Callaghan C.). Blackwells.

Morris, F.P., & Fletcher, A.K. (Eds.) (2010). ABC of Emergency Differential Diagnosis. Blackwells.

Dorries, C.P. (A.K. Fletcher contributor) (2014). Coroners Courts. OUP.

Dorries, C.P., & Fletcher, A.K. (2013). The Coroner’s Inquest. In: Clinical Negligence 9th edition (Ed. Powers MJ, QC). (2022 10th edition in progress).

Posters and Abstracts:
11 posters and abstracts presented at international meetings.

Professional Online Profile Links/Affiliations
Lead Medical Examiner (of the documents and cause of
death) March 2008 to 2019
National Clinical Lead for e-Learning for Health (Medical
Examiners) 2009 to present
Chair RCPath Medical Examiners Committee 2015 to 2019
Member: Death Certification Reforms Strategic Board, DHSC 2016
to present
Member: Editorial Board, Emergency Medicine Journal 2015 to
present
Appraiser, Sheffield Teaching Hospitals 2004 to present