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FAQs For Inquest Proceedings

What is an inquest?

     An inquest is a formal investigation into how someone has died. This takes place in the Coroner’s Court, where the Coroner runs the proceedings.


How is the Coroner’s role and jurisdiction different from other areas of law?

     There are no parties, or pleadings. It is the role of the Coroner to call relevant evidence in order to answer four important questions. These questions are known as statutory questions.

     Question 1 – who was the deceased?

     Question 2 – when did they die?

     Question 3 – where they died?

     Question 4 – how did they die?


Who are Interested Persons?

     This is someone who is entitled to participate in the inquest. Typically, these are family members, a Trust or a relevant organisation, and legal representatives.

     There may be other interested persons, depending on the circumstances of the case.


What is an Article 2 inquest?

     An Article 2 inquest is an enhanced investigation into a person's death.

     In an Article 2 inquest, the meaning of ‘how’ become wider, meaning ‘by what means and in what circumstances’.


Do Coroner’s support the family during the inquest?

     Inquests by their very nature are a difficult time for families. Coroners are encouraged to place the family at the heart of the process and bear in mind that this is often a challenging time.



Can the family have an input on inquest proceedings?

     Family members do not have an input in the inquest proceeding. It is for the Coroner to direct the investigation, they decide what evidence is needed and who needs to be called as a witness. For many this is, understandably, difficult as a family member often wants to have more of an input in the process.


Why have legal representation?

     Inquests are both a difficult and confusing time for many. Instructing legal representation can be beneficial to a family in understanding the inquest process in its entirety, but also to allow family members to communicate their concerns and issues regarding the death.

     Having the correct legal representation can help ensure that the most can be achieved through the inquest process.

     Representation typically allows for effective pre-inquest conferences and pre-inquest review hearings which can help navigate the direction of the inquest.


What is the Pre-Inquest Review Conference?

     This is an early conference with the Coroner, the family and legal representatives.


What is the benefit of this Pre-Inquest Review Conference?

     Helps the family have realistic expectations of what the inquest can resolve/not resolve.

     It allows the family’s legal representation to discuss the issues and concerns that the family have and wish for the Coroner to investigate.

     Help establish important evidence which should be used in the inquest.

     Support and explain the complex evidence which may be used. Often an inquest has a large amount of complex documentation which can be difficult to understand and comprehend.


Pre – Inquest Review Hearings

     This hearing is a pivotal point of pre-inquest hearings. Here the Coroner will decide the scope of the inquest, may request further documentation, identify the relevant witnesses and identify whether the Coroner needs to seek expert evidence.

     If legal representation believes that there are grounds for an Article 2 inquest, legal submissions may be required at this hearing, to allow the Coroner to consider their ECHR Article 2 obligations. In certain Article 2 inquests a jury may be required, this will be considered by the Coroner at this hearing.

     Legal representation at this stage can make a large impact on the proceedings of the inquest and ensuring that all family concerns/issues are being considered.


What happens at the inquest?

     Most organisations involved in an inquest will have legal representation. An advocate will ask questions of the witnesses.

     The Coroners’ Rules 2013 prevent Interested Persons from making any final submissions/summary to the Coroner about evidence. Therefore, having representation will ensure effective questioning of the witnesses and will deliver them in a way that the family will understand.


Does the family have to attend?

     An inquest is a difficult time for family members and can often take place over several days or even weeks. Family members may not wish to attend for the entire duration. Having legal representation allows for family members to decide when they would like to attend.

     Alternatively, many Coroners now have live remote links to the inquest, so family members can join remotely from the comfort of their own home, if this is preferable.


What happens if a Coroner believes a death could have been prevented?

     If the Coroner believes a death could have been prevented, they have the power to make a Preventing Future Death report, known as Regulation 28.

     The Regulation 28 report is used to notify the organisations of any circumstances that the Coroner considers a risk of future deaths and to invite the organisations response and proposal to mitigate the risk that has been raised.

     A Coroner should always consider whether a Regulation 28 report is required irrespective of whether Interested Persons are represented. However, having the correct legal representation will help establish the failures or gaps in the organisations’ systems which may give rise to a regulation 28 report.