Frequently asked questions
· What will happen when someone dies from April 2024?
· What happened before April 2024?
· What is the medical examiner office?
· Why is this change happening?
· Will bereaved families need to do anything different?
· Will the new arrangement mean delays in registering a death?
· Will funeral plans or release of the body take longer?
· What questions will the medical examiner’s office ask?
· Why am I being asked if I have any concerns?
· Can I nominate someone else to talk, if it’s too difficult for me?
· What if I do not want to speak to the medical examiner or their staff or I do not want to tell them about my concerns?
· What would happen if something was not right?
· What can I do if I have questions or concerns about the medical examiner process?
· How can I contact the medical examiner office?
· What is the coroner service?
· What is the registrars’ office?
· Where can I find more information?
What will happen when someone dies from April 2024?
From April 2024, wherever someone dies – in the community as well as in hospital - and the death is expected, their doctor will contact the medical examiner office for them to review and confirm the cause of death before issuing the medical certificate of the cause of death (MCCD).
If the medical examiner is satisfied, the doctor will be able to issue the MCCD. The doctor will send this directly to the registrars’ office who will then issue a death certificate to the family. The registrar will then issue the family with a ‘certificate for a burial’ to give to the funeral director, or an application for cremation to complete and give to the crematorium.
During this process, the doctor or medical examiner will talk to the family about the cause of death, answer any questions they may have and explain what happens next. There’s more information about this below.
What happened before April 2024?
Previously, when someone died at home, in a care or nursing home or in a hospice, and the death was expected, the doctor involved in their care completed the MCCD, which was then forwarded to the register office to register the death.
If someone died in a hospital and the death was expected, then the medical team would contact the medical examiner, who would review the medical records and work with doctors to complete the MCCD.
What is the medical examiner office?
The medical examiner office is a team of independent senior doctors who have not been involved in the care of the person who has died. Medical examiners are supported by medical examiner officers, who work fulltime in the office and help make sure processes run smoothly.
The medical examiner will work with the doctor to ensure that the information contained on the medical certificate of cause of death (MCCD), is correct and that referrals to the coroner are made, if necessary, in a timely and appropriate manner to avoid delays.
Medical examiners and medical examiner officers offer families and carers an opportunity to raise questions or concerns about the cause of death of a loved one or about the care they received beforehand. This will usually be done over the phone and if required a meeting can be arranged.
A key role of the medical examiner is to make it easier for the bereaved to understand the wording on the medical certificate which explains the cause of death. Medical examiners also look at the relevant medical records and discuss the causes of death with the doctor filling in the MCCD.
Find out more on the NHS website.
Why is this change happening?
The law is changing to provide better support for bereaved people, increase safeguards and identify opportunities to improve care. Medical examiners already scrutinise the majority of deaths in England and Wales, identifying concerns and helping improve care for patients and support for bereaved people.
The new law will further strengthen those safeguards, ensuring that all deaths are reviewed and the voices of all bereaved people are heard.
Medical examiners will:
- seek to confirm the proposed cause of death by the medical doctor and the overall accuracy of the medical certificate of cause of death
- discuss the proposed cause of death with those bereaved and establish if they have questions or any concerns relating to their loved one
- support appropriate referrals to senior coroners
- identify cases for further review to ensure best practice
Will bereaved families need to do anything different?
Bereaved families will not need to do anything different because of this change, except have a telephone discussion with the medical examiner officer. The families will continue to have five days after the death has been reviewed to register it with the registrar’s office. Registering the death provides a permanent legal record of death and enables the family to make funeral or other arrangements, and to settle the deceased’s estate.
Will the new arrangement mean delays in registering a death?
Medical examiners are working closely with GPs and other community-based health care professionals to make sure the new arrangement goes as smoothly as possible. They are also working with coroners and registrar offices to organise out of hours service arrangements.
If the medical examiner needs more information before they can confirm the cause of death, there may be a short delay before the MCCD can be issued and sent to the registrars’ office. This may also be the case during particularly busy periods such as after bank holidays. However, they will do all they can to make sure the MCCD is issued as quickly as possible and will keep the bereaved family updated.
Will funeral plans or release of the body take longer?
GP practices are working closely with medical examiner offices to make every effort to avoid any delays and work with families and carers to meet the legal requirements for registering deaths.
All involved understand what a difficult and sensitive time it is for families when a loved one dies. They are working together to make sure that the new process does not cause undue delays or distress for the bereaved.
What questions will the medical examiner’s office ask?
The medical examiner or their staff will explain what is written on the medical certificate of cause of death (MCCD), what it means and will ask if there are any questions or concerns.
They will also discuss the medical examiner’s review and ask if there are any concerns or questions about the care the person received before their death. This is the best time to raise questions and speak about anything of concern.
You will have the opportunity to ask further questions if you wish to do so. In instances, where the medical examiner will not be able to answer your questions immediately, the medical examiner will help get answers, as appropriate, and advise you about any additional available support.
Why am I being asked if I have any concerns?
A discussion with a medical examiner or their staff provides you with an opportunity to have an open and honest conversation and address any worries or concerns with someone who was not involved in providing care to the person who died.
It could be as simple as helping you to understand more about the treatment and cause/s of death or to understand the medical language used. There may be something about the care which you think did not feel right – this is an opportunity to ask questions.
The medical examiner will provide an independent view of causes of death and the care provided. Medical examiners and their staff will discuss your thoughts, questions, and concerns and if they find issues with care that need further investigation will refer these on.
As well as answering your questions, this can help us to provide better care for patients, their families, and carers by recognising ways in which care can be improved in the future.
Can I nominate someone else to talk, if it’s too difficult for me?
Yes, the medical examiner or their staff may contact you to ask who you would like them to talk to instead or you can let your GP practice team know if you would rather appoint someone else as a first point of contact.
What if I do not want to speak to the medical examiner or their staff or I do not want to tell them about my concerns?
Medical examiners are independent, so please speak to them or their staff, if possible. They will help explain things to you and are specially trained to answer your questions.
However, we understand this is a difficult time for many people and so speaking to someone is completely your choice. If you are not sure, please talk to them first before deciding. They can give you more information which will help you decide if you want to go ahead – they are specially trained to help people during difficult times and will be very understanding and supportive of your wishes.
If medical examiners find any potential issues, they will be able to raise these with people responsible for the care of the person who died or refer the issues on to someone who can investigate further.
Speaking with the medical examiner and medical examiner officers can help improve the care provided by the NHS to other patients and carers in future.
What would happen if something was not right?
The medical examiner and medical examiner officers are here to listen to your questions and concerns, provide answers if possible and, if necessary, pass them on to someone who can investigate further.
Medical examiners will not investigate further themselves, as they must complete their work within set time limits for the death certification process.
What can I do if I have questions or concerns about the medical examiner process?
If you have any questions or concerns please complete this short survey
What is the coroner service?
Coroners are independent members of the judiciary – usually solicitors or barristers. They investigate all deaths where the cause is unknown, where there is reason to think the death may not be due to natural causes, or which need an inquiry for some other reason.
The coroner will investigate each case in an appropriate way. It may be as simple as consulting with the doctor who last treated the person who has died, or a postmortem examination may be needed. In some cases, the coroner may open an inquest, which is a judicial inquiry into the death.
The coroner service works with colleagues to minimise any delays and will keep the family informed about what is happening.
Find out more on the GOV.UK website
What is the registrars’ office?
Every local authority has a registrars’ office, whose role is to collect and record details of all births, deaths, marriages, and civil partnerships.
The person registering the death (usually next of kin or a family member) should contact their local registrars’ office to make an appointment. You should do this within five days after the death has been reviewed. The registrar will tell you what you need to do and what information you need to bring to the appointment.
The registrar will give you the documents you need to give to the funeral director so that a burial or cremation can take place.
The registrar will also tell you about the Tell Us Once service. Most local authorities offer this service on behalf of the Department for Work and Pensions (DWP). The service allows you to inform central and local government services of the death at one time rather than having to write, telephone or even attend each service individually. The Tell Us Once service is free to use and can save you a great deal of time and effort.
In most cases the registrar of death will offer you the Tell Us Once interview immediately after you have registered the death. The registrar will check with you which central and government services need to be notified. The notification is sent through immediately and you will be given a confirmation letter. In some cases the registrar will offer a telephone and online Tell Us Once service instead of the full face to face service and you can also choose this if you find it too difficult to complete the process in the same interview.
Where can I find more information?
More information about what do when someone dies is available at:
What to do when someone dies: step by step guide – UK Government
What to do after a death – Citizens Advice