Medical Certificate of Cause of Death (MCCD): A medical certificate of cause of death (MCCD) enables the deceased’s family to register the death. As of September 2024, wherever someone dies – in the community as well as in hospital - and the death is expected, the deceased’s doctor must contact the medical examiner office for them to review and confirm the cause of death before issuing the MCCD.
Medical Examiners
All deaths in the community are reviewed by a Medical Examiner (ME) if they are not referred to the coroner.
- In Lewisham, this service is provided by Lewisham & Greenwich Trust (LGT)
- In Southwark & Lambeth, this service is provided by Guy’s & St Thomas’ Trust (GSTT)
Cases will be discussed with the next-of-kin, and the attending clinician.
LGT → lg.medicalexaminerofficecommunitylgt@nhs.net
📞 0203 192 6045
GSTT → gst-tr.medicalexaminer@nhs.net
📞 020 7188 9450
1️⃣ Being told about a death
If we get a phone call to notify us that a patient has died, please ask the caller for the following information and add to the patient's record (if it's not already there):
- Full name, Last Address & Date of Birth
- NHS Number (if available)
- Full name and phone number of the person calling
- Date of death, location & current location of body
- Next of Kin
- Spiritual or Religious requirements (if any)
Always urgently task the 👤 Site Reception Lead, Site Care Coordinator and send a Teams message to the Lead Care Coordinator.
- A family member
- A member of staff from a residential or nursing home
- A clinician from a secondary care facility
- The police
- The coroner’s office
2️⃣ Update EMIS
To prevent further distress to relatives, EMIS must be updated immediately to reflect the death of a patient:
- Update registration status
- Cancel any future appointments
- Stop Texts auto-sending
- Cancel any pending referrals
- Cancel any pending letters to be sent
- Urgently task the 👤 Site Care Coordinator, or message the Death Certificate Teams chat if Care Coordinator is not working, so they can begin the certification process
- Send a task to all surgery staff notifying them of the patient's death
Death verification
Verification can be completed by any competent adult, therefore there is no obligation for a doctor to visit and view the body. It’s usually done by district nurses, paramedics, the police or funeral directors.
3️⃣ Referring to the Medical Examiner & contacting the family
- Check the patient’s record for which GPs have had direct contact with the patient (F2F or telephone consultation is fine), that can confirm the cause of death
- Of GPs that have had contact with the patinet, reach out to any working on the day
- If more than one GP has had contact with the patient and is working, reach out to the GP that contacted the patient last
- If there is no GP that has had contact the patient, make a referral to the coroner (see Referring to the coroner below)
- Confirm the cause of death with the GP
- For Lambeth & Southwark sites → confirm the GP’s GMC number
- For Lewisham sites → ask the GP to complete the MCCD
- Fill in referral form on DXS: Death Referral to Medical Examiner
- Email the referral form to the relevant ME 👉
- For Lewisham sites, also send the MCCD at this stage
- Please attach as much additional information as possible (e.g. hospital letters etc.)
- Add the patient to the next clinical meeting agenda to discuss
- Make contact with the next of kin, informing them of what to expect next
You can also send them 'Medical Examiner info for families' via Accurx
For deaths abroad, please inform the family that they will need to provide the death certificate provided by the local authorities registry office. The government’s website has helpful information to help guide them: https://www.gov.uk/after-a-death/death-abroad
- LGT (Lewisham & Greenwich) → lg.medicalexaminerofficecommunitylgt@nhs.net
- GSTT (Lambeth & Southwark) → gst-tr.medicalexaminer@nhs.net
- KCH (Bexley & Bromley) → kch-tr.communitymeoffice@nhs.net
Referrals should be made to the Medical Examiner local to where the person died. The full list of Medical Examiner details for England & Wales can be found online here.
4️⃣ Response from the Medical Examiner & returning the MCCD
- Wait to receive the response from the ME (can take up to 5 days for some sites)
- If the ME agrees with the proposed cause of death, and there are no significant concerns raised by the next of kin:
- For Lambeth & Southwark sites → the ME will authorise writing the MCCD
- For Lewisham sites → the ME will confirm the MCCD is OK (move on to step 5️⃣)
- If the ME does not agree with the proposed cause of death, they will contact the surgery via email
- For Lewisham sites → the GP should update the cause of death on the MCCD
- If at any point the next of kin raises any significant concerns, the patient will be referred to the coroner
- Ask the GP to complete or update the MCCD with the cause of death
- Send the MCCD to the ME
5️⃣ Deductions
Deductions should happen when:
- We receive confirmation from the hospital/coroner that the MCCD has been sent to the registrar
- Abroad: Once we’ve seen the death certificate
They may happen automatically, in which case they can be accepted once we’ve checked the MCCD has been sent.
Referring to the coroner
If the death is suspicious or has any forensic involvement, the police will refer to the coroner.
You may also need / want to refer to the coroner, if:
- There are no GPs at the surgery that met the patient in life
- The cause of death was unexpected to us, but there is no police involvement
- The cause of death is unknown
- The next of kin raise any concerns about the cause of death
If you’re unsure whether to refer to the coroner, you can ask the Medical Examiner’s Office for advice.
If you decide to refer to the coroner, do so by completing this online form
This applies if the body is lying in Southwark, Lambeth, Greenwich or Lewisham. If they are outside of these boroughs, they will need to be referred to the local coroner.