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Nigel's surgery 13: Verification and certification of death
We have updated this mythbuster to include changes following the Coronavirus (COVID-19) pandemic.
Verification of death is the process of confirming the fact of death. It is different to certification of the cause of death.
The Coronavirus Act 2020 put in place changes to registration and certification of deaths in the UK. Later changes have been made to regulations and procedures.
Schedule 13 of the Coronavirus Act 2020 gives information on:
- registering and certification of deaths
- medical certificates of causes of death
- delivery of documents by alternative methods
We have produced a joint statement on death certification during the COVID-19 pandemic with the General Medical Council and Healthcare Improvement Scotland on death certification during the COVID-19 pandemic.
- the British Medical Association (BMA) has provided guidance to death certification and cremation
- the Department of Health & Social Care have produced guidance on verifying death in times of emergency.
- NHS England and NHS Improvement have produced excess death provisions guidance for the medical certificate of cause of death, registration and notification of deaths to coroners.
Before the pandemic verification of death outside hospital was carried out by a competent adult (usually a GP, nurse or paramedic).
During the pandemic a more flexible approach was needed. This was to reduce the spread of infection and improve the timeliness of verification. All registered professionals must follow their professions’ code of practice and conduct. These require professionals to acknowledge the limits of their professional competence. They should only carry out practice and take responsibility for activities in which they are competent.
In addition to medical practitioners, registered nurses or paramedics, verification of death can also be carried out by other non-medical professionals. They are usually and normally independent of family members, who can verify death using remote clinical support.
The Department of Health & Social Care have produced new guidance for remote clinical support for verification of death. The BMA have produced a flow chart for Remote Verification of Expected Death (VoED) Out of Hospital.
This guidance provides remote support by people (such as care workers) who have not had training in verifying death. This is so the verification process can be completed by a clinician safely and speedily. When this happens, the guiding clinician officially verifies death. They record details in the medical record. They then make sure the death certification process or reporting to coroner is complete. In some circumstances, it will remain appropriate for the ‘competent adult’ to physically attend to verify death.
When someone dies, a doctor has to complete a medical certificate of cause of death (MCCD). The certificate must be completed by a doctor who is registered (including tempo-rary registration) and licensed to practice with the GMC
The Office for National Statistics have produced guidance on completing a medical certificate of death during emergency period.
NHS England and NHS Improvement have produced guidance for the medical certificate of cause of death, registration and notification of deaths to coroners.
Under COVID-19 arrangements, where the GP has completed the Medical Certificate of Cause of Death (MCCD), it will be emailed to the registrar’s office, rather than being col-lected from the surgery.
The rules on completion of the MCCD were changed following the Coronavirus Act 2020. For a doctor to complete a MCCD without referral to the coroner any doctor must have seen (including by video link) the patient in the 28 days before death. Or, they must have seen the person after death.
The coroner must be notified for any death that is unexpected, unnatural, violent or of an unknown cause.
An unexpected death is one that is:
- not anticipated or related to a known illness that has been previously identified
COVID-19 as a cause of death (or contributory cause) is not a reason alone to refer a death to the coroner under the Coroners and Justice Act 2009. COVID-19 is a notifiable disease under the Health Protection (Notification) Regulations 2010. However, this does not mean referral to a coroner is required under its notifiable status.
- Last updated:
- 12 August 2020