How to get a medical certificate of cause of death

If you need to arrange a funeral, you’ll find that you need to gather some paperwork, starting with the medical certificate of cause of death (MCCD).

Your loved one’s doctor or healthcare provider will be able to offer you guidance on how to get the MCCD. But it’s important to be aware that the death certification process is changing in 2024. It was due to change in April but the deadline for the changes has been pushed to September 2024. Here, you can find everything you need to know about the certificate, as well as how the process is changing, so you have a clearer idea of what to expect, and who to speak to.

What is a medical certificate of cause of death?

A medical certificate of cause of death (MCCD) is a document that explains how and where a person died. You’ll need an MCCD to register a death with your local register office.

Changes to the death certification process in summary

Here’s a summary of the changes that’ll be happening later this year – it'll give you a better idea of what to expect. There’s more detail about the role of a medical examiner and how that affects getting a medical certificate of cause of death later on in this article. 

• An independent medical examiner will go over the details of the person’s death to make sure their doctor has accurately recorded the cause of death on the MCCD. 
• The medical examiner can support family and friends of the person who’s died by answering any questions they might have about the death of their loved one. 
• The new version of the medical certificate of cause of death will include more details such as notes from the medical examiner, the person’s ethnicity, if it was a maternal death, and if the person had any implants or medical devices such as pacemakers so that funeral directors can be informed. 
• If there is no attending doctor available to fill out the medical certificate of cause of death the medical examiner will take this on. But this should only happen in exceptional circumstances. 
• Attending doctors still have a responsibility to refer a death to a coroner if the cause can’t be found or if it’s due to an accident or a crime. 

Professionals involved in issuing a medical certificate of cause of death

Attending doctor: This is a medical practitioner who has cared for the person who died. This could be a doctor who treated them while they were in hospital, or it could be their GP for example. They’re responsible for proposing a cause of death and filling out the medical certificate of cause of death. 

Medical examiner: The medical examiner is an independent medical practitioner who’s responsible for reviewing the cause of death that’s been proposed by the attending doctor. They’ll go through the facts and make sure the cause of death is accurate. 

Coroner: This is another medical professional who will only get involved in the death certification process if the cause of death is unknown to the attending doctor. They may carry out a post-mortem to figure out the cause of death. Then the MCCD will be issued to the register office. 

How do I get a medical certificate of cause of death?

Depending on where your loved one passed away, getting the medical certificate can differ slightly. With the current system there may still be instances where the attending doctor gives you the MCCD so you can pass this onto the registrar to register the death. But with the new system it’s likely that you’ll have a telephone conversation with the medical examiner before the MCCD is issued so that you have the opportunity to raise any concerns you may have had about their death.  

Once you’ve spoken to the medical examiner the MCCD can then be sent to the register office. This can be sent digitally. But if you’re not sure whether you need to collect the medical certificate or if it’ll be sent directly to the register office, ask the attending doctor or medical examiner for more information. 

After the medical certificate has been issued, you have five days to register the death.

What are the 2024 changes to the cause of death certification process?

The main changes to getting a medical certificate of cause of death or MCCD include: 

1. All deaths in England and Wales will have independent scrutiny by a medical examiner (unless a coroner needs to get involved)

This means that a medical examiner will go over the cause of death that the attending doctor has recorded on the medical certificate. This is to make sure that the cause of death is carefully reviewed and confirmed by an independent medical professional who has not been involved in caring for the person who’s died. This provides better safeguarding for the public than the previous system where an independent medical examiner didn’t confirm the cause of death.  

The medical examiner can also provide support to the bereaved. So if you’ve lost a loved one and want to speak to a medical professional who wasn’t involved in caring for them, the medical examiner can talk to you about the cause of death and what happened. This gives you the opportunity to raise any concerns you had about their care leading up to their death. 

2. A new medical certificate of cause of death will replace the old version

The new medical certificate of cause of death will still include information from the attending doctor who first records the cause of death.  

But it will also include:  

• Details from the medical examiner who scrutinises the cause of death 
• The ethnicity of the person who died (if self-declared by the person on their medical records) 
• If it was a maternal death  
• Info about any implants or medical devices the person had that can then be transferred to the certificate of burial or cremation 

The new medical certificate of cause of death will be a paper version. But a digital version will be available at a later date so that the MCCD can be more easily shared between the attending doctor, the medical examiner and the register office. 

3. If there is no attending doctor the MCCD will be filled out by a medical examiner

This means that when there’s no attending doctor available to fill out the MCCD, or they can’t reach the person who died in good time, then the death will be referred to the coroner. The coroner will then need to refer this to the medical examiner, unless there is reason for the coroner to investigate the death.  

Referring someone’s death to the coroner because there is no attending doctor available should only happen in exceptional circumstances and when all possible attempts to get an attending doctor to fill out the MCCD have been exhausted.  

This change to the death certification process makes sure that the medical certificate of cause of death is not issued by just any medical professional who may not have been involved with the care of the person who died. It means that families know that the cause of death has been confirmed by a professional and can still ask questions about what happened if they need to. 

What about referrals to the coroner?

Attending doctors will still have to refer deaths to the coroner if they can’t confirm the cause of death or if there is reason to believe an inquest into the death is needed. They won’t need to notify the medical examiner that they’ve done this. If the coroner finds they don’t need to carry out an investigation they will pass this back to the attending doctor who will fill out the MCCD and pass it onto the medical examiner. 

Under the new regulations coroners will no longer need to notify the register office when they decide there’s no need for them to investigate the death. But they will still need to let the register office know if no further investigation is needed following an inquest or post-mortem. 

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