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What You Need to Know About Death Certification (MCCD) and Cremation from 25th March 2022 Following Expiry of the Coronavirus Act Temporary Provisions

The Coronavirus Act 2020, which introduced easements to death certification processes and cremation forms, expired at midnight on 24 March 2022. Some changes have been retained on a permanent basis through other measures, and other processes revert to previous practice.

The following provisions are continuing after 24 March 2022:

  • The period before death within which a doctor completing a Medical Certificate of Cause of Death (MCCD) must have seen a deceased patient will remain 28 days (prior to the coronavirus pandemic, the limit was 14 days).
  • It will still be acceptable for medical practitioners to send MCCDs to registrars electronically.
  • Regarding cremation, the requirement for a confirmatory medical certificate (form Cremation 5) has been permanently removed.

The following emergency provisions are changing with the expiry of the Coronavirus Act on 24 March 2022:

  • The provision temporarily allowing any medical practitioner to complete the MCCD, introduced as a temporary measure by the Coronavirus Act, will be discontinued.
  • Informants will have to register deaths in person, not remotely.

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Issuing the MCCD

The doctor who attended the deceased during their last illness has a legal responsibility to complete a MCCD and arrange for the delivery of it to the relevant registrar as soon as possible to enable the registration to take place. It is encouraged that this is done electronically by scanning and emailing the MCCD to the relevant register office. The operational arrangements for this should be agreed with the register office concerned. Deaths are required by law to be registered within 5 days of their occurrence unless there is to be a coroner’s post-mortem or an inquest.

The certifying doctor must also advise the informant that the MCCD has been issued. (‘issue notice’)

Medical practitioners should continue to issue the notice to informants before they make their appointment with the registrar (as it states who can register and what the informant needs to know to register) in paper or electronic form, as confirmation that the MCCD has been sent to the register office. The ‘notice to informant’ is the tear off section on the right hand side of the MCCD.

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Retaining and Destroying the Original MCCD

Under the revised arrangements for issuing MCCDs, where medical practitioners have sent a copy of the MCCD to a registrar electronically, they are not now required to deliver the paper copy. This can be securely destroyed. It is recommended medical practitioners retain the paper copy for a short period (4 weeks is recommended) to allow for the registration to have taken place and any issues resolved (for example the e-copy may be poor quality and require resending).

Medical practitioners should ensure paper and E-copies of MCCDs are securely disposed of when no longer required in line with GDPR principles.

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Who Can Complete the MCCD

‘Medical practitioner’ for the purposes of an MCCD must be a doctor.

Only a medical practitioner who has attended the deceased for their last illness will be allowed to complete a MCCD.

‘Attended’ means seen in person or by video during their last illness. Although there is no clear legal definition of ‘attended’, it is generally accepted to mean a doctor who has cared for the patient during the illness that led to death and so is familiar with the patient’s medical history, investigations and treatment. The certifying doctor should also have access to relevant medical records and the results of investigations. There is no provision under current legislation to delegate this statutory duty to any non-medical staff. In general practice, more than one GP may have been involved in the patient’s care and so be able to certify the death.

A medical practitioner with GMC registration will be able to sign the MCCD if they attended the deceased during their final illness up to 28 days before death, or viewed the body in person after death, and can state the cause of death to the best of their knowledge and belief.

There is often confusion around the issue of seeing the deceased after death in order to issue the MCCD. If you have attended the deceased during their last illness AND can give a cause of death but it is more than 28 days since you last saw them alive, the law says that you can issue the MCCD if you view the body in person after death. You would need to be confident that you are able to demonstrate that you did attend the deceased during their last illness and that they had a condition that meant that their death was not unexpected despite it being some time since you last saw them. If the clinician has any doubt, then we would always suggest discussion with the coroner’s office (or Medical Examiner where these have been rolled out into the community setting).

Doctors are required to certify causes of death “to the best of their knowledge and belief”.

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Issuing Cremation Form 4

It is expected that the Doctor signing the form Cremation 4 will have treated the deceased during their last illness and have seen the deceased within the 28 days prior to death – including visual/video consultation or viewed the body in person after death (including for verification), and to be able to state the cause of death to the best of their knowledge and belief.

All Doctors completing Form 4 should be available to discuss the case with the crematorium medical referee if necessary, so please provide a mobile number on the form.

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