We are aware that there has been some uncertainty in the community regarding how death certification is now managed in general practice.
Since September 2024, national legislation requires that all deaths in England and Wales are independently reviewed by either a Medical Examiner or a Coroner before the death can be registered. This process applies to every GP surgery, hospital, and hospice.
When someone passes away in the community, GP practices must refer the case to the Medical Examiner’s Office. The Medical Examiner will review the patient’s medical records and confirm whether the Medical Certificate of Cause of Death (MCCD) can be issued by the GP, or if it needs to be issued by the Coroner instead.
If the patient had not been seen face-to-face by a GP prior to their death, the certificate must legally be issued by the Coroner, even if the death was expected or the patient was under hospital or palliative care.
This is a national change, designed to ensure transparency and consistency across all health services.
Families do not need to take any additional action. The Medical Examiner or Coroner will contact the next of kin directly to explain the process and confirm when the death certificate has been issued.
We recognise that this period can be distressing, and we want to reassure families that our team continues to complete all necessary steps promptly and with compassion.
For more information and support, you may find the following links helpful:
If you are registered with our practice at Shefford Health Centre and would like to speak with one of our clinicians for bereavement support, please contact the surgery to arrange an appointment.
If you are not registered with our practice, please contact your own GP surgery, who will be able to offer similar support and guidance.
Losing someone close to you is deeply difficult. This page explains what happens next, including the new national process involving Medical Examiners.
What happens when someone dies
When a person dies, one of the first steps for the next of kin or representative is to obtain a Medical Certificate of Cause of Death (MCCD).
Depending on the circumstances, the death will either:
- be certified by a doctor (GP, hospital doctor or hospice doctor), or
- be referred to the Coroner if the death was unexpected, unexplained or unclear.
New national process (from 9 September 2024)
A new law requires all deaths in England and Wales to be independently reviewed by either:
- a Medical Examiner, or
- a Coroner,
before the death can be registered.
What is a Medical Examiner?
A Medical Examiner (ME) is an experienced NHS doctor—trained to review deaths independently and help support bereaved families.
Their role includes:
- Reviewing the proposed cause of death
- Checking the deceased’s medical records
- Speaking with the bereaved family
- Ensuring the death is explained clearly
- Identifying any concerns that may need further review
How the new process works
For community deaths (those occurring outside hospital):
- The GP refers the death to the Medical Examiner’s Office, unless it is a clear Coroner referral.
- The Medical Examiner reviews the medical records.
- They contact the GP to confirm the proposed cause of death.
- The GP completes the MCCD (death certificate) if appropriate.
- The MCCD is sent back to the Medical Examiner.
- The Medical Examiner approves it and forwards it to the Registrar.
- The Medical Examiner (or their officer) contacts the next of kin to explain the process, answer questions and listen to any concerns.
This additional review is designed to provide reassurance and transparency.
Although the aim is to avoid delays, death registration may occasionally take longer than the usual 5 working days due to the extra step.
Talking with the Medical Examiner
As part of the process, you will be offered a conversation with a Medical Examiner or Medical Examiner Officer.
This gives you the opportunity to:
- Understand what has been written on the death certificate
- Ask questions or request clearer explanations
- Raise any concerns about the care your loved one received
- Provide feedback to help improve NHS services
If the Medical Examiner identifies concerns, they may request further review or refer the case to the appropriate team.
Important information for bereaved families
- You do not need to do anything differently under the new system.
- The Medical Examiner’s Office will contact you directly.
- You cannot register the death until the Medical Examiner has completed their review and sent the MCCD to the Registrar.
- In some cases, this process may take longer than 5 days, especially if more information or further review is needed.
