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Starting from 9 September 2024 in England and Wales all deaths will have to be referred to Medical Examiners. In this blog, we give a quick overview of the incoming changes and how they are revolutionising death certification.
Key reforms in death certification
The death certification system in England and Wales, which has remained largely unchanged for over 50 years, is set to undergo significant reforms. Starting from 9 September 2024, every death will be subject to either a Medical Examiner's scrutiny or a Coroner's investigation. This change follows numerous inquiries and reports highlighting the need for reform, including the Shipman Inquiry and the mid-Staffordshire NHS Foundation Trust Public Inquiry.
The non-statutory system, introduced by NHS England and NHS Wales Shared Services Partnership in 2019, has become standard practice for scrutinizing deaths not investigated by a Coroner. The new statutory system will make this independent scrutiny mandatory for all deaths. This system is grounded in sections of the Coroners and Justice Act 2009 and the Health and Care Act 2022, with detailed regulations set to ensure seamless implementation.
Impact on healthcare providers and professionals
From September 2024, medical practitioners, including GPs and hospital doctors, will need to refer deaths for independent scrutiny by Medical Examiners. This reform simplifies the current process, which often requires coroner involvement if the attending practitioner has not seen the patient recently. Now, the attending practitioner must share the Medical Certificate of Cause of Death (MCCD) with a Medical Examiner before it is submitted to the Registrar.
Medical Examiners will play a crucial role, providing independent scrutiny and serving as a contact point for bereaved families. They are senior medical practitioners trained in both clinical and legal aspects of death certification. Their role will ensure that the cause of death is accurately recorded and reviewed, improving the overall efficiency and reliability of death certification.
These changes are welcomed and will ensure all deaths receive an independent review by a Medical Examiner. I do wonder if there will be an increased timescale for registering a death especially in September when the new process goes live"
Charlotte Toogood, Legal Services Director, Kings Court Trust
Benefits and implementation
The introduction of Medical Examiners is expected to improve mortality data accuracy and streamline the certification process. New MCCDs will include additional details, such as ethnicity and the presence of medical devices, enhancing the quality of information for statistical and health management purposes.
Healthcare providers must prepare for these changes by establishing processes for referring deaths to Medical Examiners. Training for Medical Examiners and Medical Examiner Officers will be provided, and existing guidance will be updated to reflect the new statutory requirements. This transition aims to ensure a smooth implementation and better support for bereaved families while enhancing the accuracy of death certification.
These reforms mark a significant step towards modernising the death certification process in England and Wales, ensuring every death receives appropriate scrutiny and contributing to better health data and public trust in the system. See the below infographic for the full process of death certification.
Please note: This process refers to all deaths that don't need to be referred to Coroners.
Our opinion of the death certificate reform
As we understand it, the reform on death certificates shouldn’t affect the work of Kings Court Trust or their partners of Financial Advisors, Will Writers, and Funeral Directors. We welcome these changes as they will help support the bereaved and streamline the process.
For more support, around what to do when someone dies read this blog or click the 'Explore our useful guides' below.
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