Major changes to death certificates in England & Wales. Understand the new system, how it benefits families (save £82) and what it means for medical professionals and coroners. Get all the details here.

Introduction:

The death certification system in England and Wales is undergoing a significant reform, taking effect on September 9th, 2024. This long-awaited change introduces a statutory medical examiner system, ensuring independent review for all deaths.

What are the benefits of these reforms?

  • Improved Accuracy: Medical examiners provide independent scrutiny of the cause of death listed by the attending doctor, potentially leading to more accurate death certificates.
  • Enhanced Data: The reforms aim to improve the quality and consistency of mortality data used for public health initiatives.
  • Reduced Delays: By expanding the pool of doctors eligible to complete death certificates, the new system aims to minimise delays for bereaved families.
  • Uncertified Death Reduction: The introduction of Medical Examiner Certificates minimises the occurrence of uncertified deaths.
  • Reduced Costs: the £82 medical examiner fee (also known as doctors’ fees) typically associated with Cremation Form 4 will be eliminated. That’s because the form itself is being retired, as part of the reforms.

Key Changes for Different Parties Involved:

  • Medical Practitioners: Attending doctors can now complete the Medical Certificate of Cause of Death (MCCD) even if they haven’t seen the deceased within the last 28 days of their life (as long as they know the cause of death and a coroner referral isn’t required).
  • Medical Examiners: These senior medical professionals will scrutinise all MCCDs before they are submitted to the registrar. They will also be available to answer questions and address concerns raised by bereaved families.
  • Coroners: Coroners will continue to investigate deaths that meet specific criteria. However, the new system aims to streamline the process by reducing unnecessary referrals.
  • Registrars: Their role involves copying the cause of death from the MCCD onto the death certificate. They will no longer refer cases to the coroner unless new information arises, or they have questions about the certified cause of death.
  • Funeral Directors: The reforms eliminate the need for Cremation Form 4 (completed by the attending practitioner) as medical examiner scrutiny replaces the role of crematorium medical referees (CMRs) in reviewing the medical circumstances of a death. CMRs will be phased out after a transitional period.

What’s New with the Medical Certificate of Cause of Death (MCCD)?

From September onwards, the MCCD will include:

  • Signature of both the attending practitioner and the medical examiner.
  • A new line for formulating the cause of death (line 1d).
  • Option to record the deceased’s ethnicity (if known).
  • Indication of whether it’s a maternal death.
  • A section for recording pacemakers or other medical implants.

Conclusion:

The new death certification reforms aim to bring about a more robust and efficient system in England and Wales. With independent scrutiny, improved data, and streamlined processes, these changes aim to benefit families, public health initiatives, and various parties involved in the death certification process.