The New Death Certificates
The Medical Examiners (England) Regulations 2024 are now in force.
Terminology used on new Death Certificates (adapted from Suzy Lishman):
- ME Medical Examiner
- MEO Medical Examiner Officer
- MCCD Medical Certificate of Cause of Death
- RCPath Royal College of Pathologists
- DHSC Department of Health and Social Care
- MoJ Ministry of Justice
- GRO General Register office
- AP Attending Practitioner
- COD Cause of Death
FAQs
1.Who can actually complete the Medical Certificate of Cause of Death (MCCD)?
Answer: Any doctor who attended the deceased during their lifetime. It is imperative to request MCCD booklets now if not already done so, and to discard all old copies. They can take a few days to arrive.
2.Do you have to view the body of the deceased?
Answer: No. Viewing the body after death is not necessary. It is important and useful to have easy access to a summary of the deceased patient’s notes.
3.Who are Medical Examiners?
Answer: These are senior doctors from any speciality/GP who are independent, work part-time and review every non-coronial death i.e. those not being reviewed by the coroner. MEs work with Medical Examiner Officers
4.How can I contact the local ME?
Answer: The list is available on line: https://www.england.nhs.uk/patient-safety/medical-examiners/medical-examiner-offices/
5.How long does the process take to complete?
Answer: Up to 5 days but can be issued within one day.
Advantages of the Medical Examiners system
- There is now independent scrutiny of all deaths plus
- Greater transparency, reassurance and safeguarding around deaths
- There is equal scrutiny of burials and cremations
- Bereaved families are given the opportunity to ask questions and raise concerns.
- Both the quality and the accuracy of MCCDs are improved
- Better mortality data can be obtained
- It ensures appropriate referral to the coroner occurs
- It feeds into governance pathways to support learning and improve care
Questions that MEs can answer
- Cause of death of deceased
- Does this need to be reported to the coroner?
- Are there any clinical governance concerns?
In dealing with these questions:
- They must perform a proportionate review of medical notes
- They must work with the attending doctor/s
- They must interact with the bereaved family
New things about the MCCD
- Can be issued within 1 day
- Ethnicity is recorded
- Maternal death or pregnancy within the year prior to death is recorded
- Implants and any medical devices must be identified and declared if removed or not
- It carries the signature of the ME
Registration of deaths
- 5 days from issue of MCCD
- Registrar makes copies of COD
- Any queries go to ME to be sorted out. Ensure you are well prepared and informed as the ME will be in touch with the family of the deceased within 24 hours.
More information can be found on: https://www.gov.uk - An overview of the death certification reforms.
NB. Coroners are not obliged to investigate a cause of death and may discontinue an investigation. Also, Registrars will not review causes of death
Future Plans
- A digital case management system is in progress
- A digital MCCD is planned
- The updating of cause of death list is under review.
Dr Nelda Frater and Dr Evadney Keith
(Adapted from Suzy Lishman-MDU Webinar 2025)
March 2025
