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Death certification: Links to funeral director guidance

Information on death certification

Please note - this piece is being updated

National Association of Funeral Directors

The changes to cremation forms are summed up on the National Assocation of Funeral Directors website. It is worth checking back here.

Coronavirus Bill

The Coronavirus Bill published by the Government says the following:

Managing the deceased with respect and dignity

The steps the government is taking to respond to the COVID-19 pandemic will save lives. However, sadly, as has already been seen, people will lose loved ones as a result of this disease. We want to ensure the deceased are treated with the utmost respect and dignity and that the current procedures in relation to death and still-birth registration and management are modified to enable this and to protect public health. This will take account of the fact that families who have lost a loved one may be self-isolating, and that there may be reduced capacity to register and manage deaths as a result of pandemic-related sickness absence.

The bill intends to make changes to

- mean a coroner is only to be notified where a doctor believes there is no medical practitioner who may sign the death certificate, or that they are not available within a reasonable time of the death

- introduce powers to enable the provisions under the Burial and Cremation (Scotland) Act 2016 relating to the collection of ashes to be suspended and replaced with a duty to retain until the suspension is lifted, except where family wishes are known. Also, suspend an offence in section 49 of the 2016 Act, allowing any relative of the deceased to complete the cremation application form, regardless of the required hierarchy set out by section 65 of the 2016 Act

- expand the list of people who can register a death to include funeral directors acting on behalf of the family

- enable electronic transmission of documents that currently have to be physically presented in order to certify the registration of a death

- remove the need for a second confirmatory medical certificate in order for a cremation to take place

- remove the Coroners and Justice Act 2009 requirement that any inquest into a COVID-19 death must be held with a jury. Other notifiable diseases will still require an inquest with a jury

- suspend the referral of certificates to the Death Certification Review Service (DCRS) for review in Scotland under the Certification of Death (Scotland) Act 2011. The timing of the suspension to be at the discretion of Scottish ministers

 

If the scientific advice indicates that the number of people who might die from COVID-19 is likely to significantly exceed the capacity locally to manage the deceased and other contingency measures have been deployed, local government will have the ability to take control of a component or components of the death management process in their area.

For example, local authorities may choose to direct local actors such as funeral directors, mortuaries owners, crematoriums owners and others, to streamline the death management process. This may include an increase in the operating times of crematoriums, directing companies to use their vehicles to move bodies, or directing others not directly involved in the funeral sector, to provide necessary support.

Only in the most extreme situations where there is a risk to public health would the powers of direction be used and only be used when scientific evidence and operational advice suggests that it is necessary. Activating the powers will ensure the local death management system continues to work effectively to protect public health and the dignity of the deceased. Personal choice will be respected as far as possible, especially in regard to how we handle loved ones after they have passed.

 

 

 

 

 

Readers' comments (5)

  • what about telephone consultation in the last 28 days?

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  • Video consultation - never seen
    these in terminal care! That bit is a surreal joke.

    Paragraph 28 of the pre Covid guidelines wa unclear and suggested you could certify
    without having seen in life - this chart looks just
    as unclear - you can certify even if you have never seen and not seen in last 28 days. WhT a mess - or am I missing something?

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  • Dear All,
    I am sorry DO NOT USE THIS CHART, it is wrong. There is no 28 days limit as to whether you can complete the death certificate.
    Paras 4(2)&(3) of Schedule 13 of the Covid 2020 act now allow any doctor to sign a death certificate for any patient and there is NO time limit. There never has been. All the 1953 Act requires is that the doctor attended the patient during their last illness.
    Also the reporting to the Coroner advice is wrong.

    DO NOT FOLLOW THIS ADVICE IT IS WRONG.



    Regards
    Paul Cundy

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  • Dear All,
    to further the point the only changes to the signing of the MCCD under the emergency Act is the relaxation of having "attended" the deceased. Now you can sign an MCCD even if you did not attend. Nothing else has changed.
    Regards
    Paul Cundy

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  • Here is the detail.


    Part 18 of the 2020 Covid Act refers to Part 1 Schedule 13, which contains temporary modifications to the provision of MCCDs. So the Act itself changes parts of the 1953 Act as amended in 1987 but via the devil in the detail hidden at the back.

    Thus Schedule 13 Part 1 England and Wales can in my opinion be read to mean;

    Para 2
    Funeral Directors can now provide the Registrar with the details of the dead person, namely the MCCD and may now sign the Register in place of family to formally record the death.

    Para 3
    Giving information to the Registrar other than in person. Information from the informant (the informant is not the doctor signing the MCCD) i.e. the information on the MCCD, may be given to the Registrar by phone or by other means as guided by the Registrar General. See Para 5 later, electronic delivery.

    In particular Para(3)(4), people who are ill, caring for others, at risk of infection or for any other reason, including Registrar Office staff shortages, can be exempted for giving information to the Registrar. (so what happens if no one wants to do it? What does the Registrar do then?).

    Para 4
    These are the important changes.

    Para 4(2)(a) and (b).
    These relax the 1953 Act requirement for the MCCD to be signed the doctor(s) attending during the last illness. Now ANY Registered Medical Practitioner can complete the MCCD where the attending RMP is “unable to” or it is “impractical for that” RMP to do so,

    as long as,

    The RMP who does sign is able to state to the best of their belief an opinion as to the the cause of death.

    So any GP in the practice can sign on behalf of any other GP who may be ill, in hospital or isolating.

    And this is an even bigger change.

    Para 4(3),
    now any RMP can sign even in the case of a patient NOT attended during their last illness. So you can complete an MCCD for any patient. Yes, any RMP can sign for any patient providing they are able to state to the best of their belief a cause of death.

    Para(4)(b)
    These relate to the MCCD. In the case of Para 4(2)&(3) where the RMP was not in attendance, the words relating to “last seen” and “seen by my after death”, can be ignored, for obvious reasons.

    Para 5,
    This para says that if you sign under Paras (2)&(3) above, i.e. were not in attendance, you still assume all the other duties and responsibilities under the 1953 Act and the doctor who did attend, but is unable to sign, is absolved of them. You sign you are responsible.

    Para 6,
    This relates to the Registrar and their reporting deaths to the Coroner if the patient were not attended by an RMP. They can now accept the MCCD even if it is completed by an RMP who did not attend the patient, i.e. under Para 4(3) above.

    Para 5
    This is the bit that says that the MCCD can be “delivered” by any means, electronic or other means as long as its authorised by the Registrar General.

    Para 6
    This relaxes the obligation on the REGISTRAR to report any death to the Coroner (please note not the RMP) if the RMP has declared that did not seen the body after death or in the 14 days prior to death. It is now 28 days before death.

    Unless I have misinterpreted this could this be a problem, because they have not catered for the Para(2)&(3) where obviously the answer is going to be never, so will they have to report every instance of a Para 4(2)or(3) MCCD? Should the RMP annotate the MCCD to the effect they are signing under Covid 2020 Para 2 or 3?

    Para 7
    This says you do not have to report to the Coroner any MCCD signed under Para 4(2)&(3) above.

    Para 8
    Any death notification processes started under the old laws will continue under those regulations.

    Para 9
    Says any death notification process that starts under these new laws will continue under these rules to completion even if the rules are changed meantime.

    Any documents delivered under the electronic process as at Para 5 will still have to be eventually delivered or sent to the Registrar within 3 months of the ending these new rules. So keep the originals



    It also says the Registrar General may change the dates on which documents have to be delivered and may change any of the above!


    Covid 2020 also makes changes to the Cremation Regulations.

    Part 19 paras (1) to (11) of Covid 2020 has detailed modifications to the 2008 No. 2841 CREMATION, ENGLAND AND WALES, The Cremation (England and Wales) Regulations 2008

    They can be taken as a whole and simply mean that the Form 5 is expunged from any and every aspect of the Medical Referees duties and responsibilities. The Medical Referee can rely entire;ly upon the single Form 4.

    Please note these new laws do not make any changes to the law that relates to the signing and completion of the Form 4. All the previous discussion and debate regarding whether you are compelled to complete, who can complete, what you record in the response to the questions, whether you have seen the body before or after death, truth and honesty of your answers; all remain unchanged. The Covid 202 Act does not change anything in relation to the completion of the Form 4. The only mention of the Form 4 in the Covid Act is in referenced to its being equivalent to both itself and the Form 5.

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