Key takeaways
Medical examiners required
All deaths must be independently reviewed.
Doctors get more flexibility
No need to see patient within 28 days.
Certificates record wider information
New fields support better public health data.
On 9 September 2024, the statutory system of medical examiners and new regulations governing death certification came into force. The new regulations require that all deaths in England and Wales in any health setting, including acute, non-acute and community settings, that are not investigated by a coroner are reviewed by a medical examiner for independent scrutiny.
The process now allows for medical practitioners to complete a medical certificate of cause of death (MCCD) if they attended the deceased in their lifetime. The practitioner is no longer required to have seen the patient within 28 days prior to their death and will propose a cause of death, if they can do so, to the best of their knowledge and belief.
The attending practitioner must share the proposed cause of death and MCCD with a medical examiner, who will scrutinise these and offer a conversation about the cause of death with the informant or deceased’s family. Once the cause of death is confirmed, the MCCD is sent to the registrar by the medical examiner, which starts the 5-day statutory timeframe to register the death. The attending practitioner or medical examiner will determine which deaths need to be referred to the coroner.
The Department of Health and Social Care have published updated guidance for medical practitioners completing MCCDs which is available here.
A new MCCD has also been implemented. The new certificate requires the following additional information to be included:
Details of the medical examiner who scrutinised the cause of death;
The deceased’s gender and ethnicity, as declared by the patient in their medical records;
In relation to maternal deaths, the MCCD will record whether the deceased was pregnant within the year prior to their death and whether pregnancy contributed to their death;
The addition of a new line “1d” in the cause of death, with part 2 remaining unchanged; and
Any medical devices and implants will be recorded.
Should you require any further information or would like advice with regards to how these changes affect your organisation’s death certification process, please feel free to contact us.
