Published Tuesday 1 April 2025 at 15:22
After two decades of dedicated service, Dr James Adeley is preparing to step down as Senior Coroner for Lancashire and Blackburn with Darwen.
In an exclusive interview with The Shuttle, as he looks ahead to retirement – or, as he puts it, “graduating from work” – he reflects on the moments that shaped his career, the cases that stayed with him, and his plans for a well-earned break.
Dr Adeley’s work reached a national audience through Cause of Death, a groundbreaking TV series offering an unprecedented look inside the coroner’s office.
The fact Cause of Death ended up in prime time viewing on Channel 5, with all the billing it got, was something of a surprise, it is a little unusual being recognised – although if I take the suit off, nobody recognises me!
The series was widely praised for its sensitivity and depth, particularly in showcasing Dr Adeley’s team’s handling of cases during the COVID-19 pandemic and his culturally sensitive approach to Muslim burials.
Very few people understand what a coroner does,
One of the most powerful moments in the series was when a mortuary technician spoke to the deceased as if they were still alive. That really resonated with people – it showed that a deceased person is still important.
I’m incredibly pleased people understand our role now. Death still has a lot of taboos in this country, but Cause of Death has begun to break these down and allows people to talk about death more openly.
His career has been defined by compassion, innovation, and an unwavering commitment to justice – a legacy that has transformed the coroner’s service and touched countless lives.
From his pioneering use of digital autopsies to his role in the acclaimed TV series, Dr Adeley has brought transparency, efficiency, and humanity to an often-misunderstood profession.
Dr Adeley’s journey to the coroner’s office was anything but conventional he tells The Shuttle.
Originally an Ear, Nose, and Throat surgeon, he later retrained as a lawyer, working in NHS litigation and professional disciplinary cases. This rare combination of medical and legal expertise made him uniquely qualified for the role of coroner, a position he has held since January 2005.
In his office, that he helped to design, are black and white portraits of Dr Adeley alongside his great-grandfather, Dr Wilfrid Fox, encased together with their own surgical instruments. His great grandfather, a dermatologist at St Georges Hospital London – visited Marie Curie in Paris to collect radium to treat the King, as well as planting Winkworth Arboretum that is now part of the National Trust.
When I became a coroner, I saw an opportunity to bring my knowledge of both fields to the table, this role demands precision, compassion, and an understanding of the impact of loss on families.
Under Dr Adeley’s leadership, Lancashire became one of the first regions in the UK to offer digital autopsies using advanced post-mortem scanning technology.
This technology allows us to provide quicker results while reducing the need for invasive procedures, this respects the deceased and their families.
The scanning service, now a national model, is unique in being run by NHS radiologists, radiographers, and mortuary technicians, with an impressive 94% diagnostic success rate.
We started scanning about eight years ago, and it required a great deal of cooperation to set up. It is something we are immensely proud of.
With 4,500 cases referred annually, around 1,600 require post-mortem examinations, with the vast majority now being CT scans rather than invasive procedures.
We’re here to investigate how a death occurred, but also to support bereaved families and help prevent future deaths.
Over the years, Dr Adeley has presided over around 7,000 inquests, each one carrying its own weight.
There are cases that resonate for different reasons.
The 60-year-old married father-of-two said:
When my children were growing up, child deaths were particularly difficult. Now that my grown-up children drive, road traffic accidents hit close to home.
One particularly difficult moment, he says, was the loss of his colleague and friend, Irene White, which was featured in an episode of Cause of Death.
That was our loss, our grief and that was very difficult for the team and me.
Dr Adeley has overseen significant modernisation in the coroner’s service, helping to design the new coroner’s court 13-years ago.
Dr Adeley took inspiration from youth courts, which, he says are less austere.
We thought carefully about the layout, colour palette, durable materials, and how the court could be fully digital for documents and external attendance for people who had difficulty getting to court.
He is sat for this interview, on his 30-year-old recycled Herman Miller Aeron, surrounded by his artwork.
Local authority budgets don’t quite stretch to this,” he notes dryly “and I spend so much time here that it needs to be a nice place to work”.
He added:
We are now fully digital, which saves a vast amount of money and time. When Covid hit, we were fully remote and able to deliver the same service, although nobody would have known that we were not sat in the same office.
Championing organ donation
One of Dr Adeley’s proudest achievements is his role in supporting organ donation. At one time, Royal Preston Hospital was producing more organs than any other hospital in the UK.
My view on organ donation is that if it is possible, then the answer is always “yes”, because people die waiting for organs each year. We have a choice between saving a life or someone dying because they did not receive and organ in time. Even when I am on holiday, I do not sign off – I will always take the call and say yes when it is possible.
He is also passionate about tissue donation that includes skin donation to assist burns victims and corneal donation to allow people to see again.
He explains “the combination of the CT scanning service with our approach to tissue donation, allows the donation of heart valves. Tissue donation improves the recipients’ quality-of-life.
So, what is next for Dr Adeley?
I’m not retiring – I’m graduating from work, he laughs.
I plan to spend more time with my family, playing tennis, sailing, and building things. I love construction projects – walls, cars, anything hands-on. It is fun.
Being a man who is used to writing an awful lot, surely a book must be on the cards?
No, he says firmly. I intend to read Lawrence of Arabia, but I am not writing anymore – well I do like to write handwritten letters of thanks. It always means so much more to the recipient, to know you have taken the time to put pen to paper. I will probably take to writing letters of complaint instead, using phrases like ‘cavalier attitude’
His hands-on nature extends beyond his work.
He said: Local authorities spend money on their services and quite rightly so.
But when he was told there was no budget to re-decorate the administrators’ office, he took matters into his own hands.
I came in between Christmas and New Year and got my roller out, I even added a rather nice blue accent wall!
If I would have said to you, we had a team-building exercise carpet cleaning with a Rug Doctor, you would think I had taken leave of my senses. But we were all moving furniture and cleaning, and it worked extremely well! he recalls with a smile.
As he steps away from the coroner’s court, his impact will, without doubt be felt for years to come.
His final verdict?
I was lucky to find my niche – what I was meant to do
I have an incredible team who support bereaved families, work with organ donation, funeral directors, police, hospitals and the registrars to provide the best service possible, which families can trust during their most difficult times. It has been a privilege to serve the people of Lancashire.