COVID-19: death certification and cremation

This guidance replaces existing BMA guidance on verification and certification of death and cremation during the COVID-19 outbreak.
Location: UK
Audience: All doctors
Updated: Monday 18 May 2020
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The Coronavirus Act 2020

The Coronavirus Act 2020 (commencement no.1) includes provisions regarding death certification and cremation forms bringing into force:

  • section 18 and schedule 13 (registration of deaths and still-births etc.)
  • section 19 (confirmatory medical certificate not required for cremations: England and Wales)
  • section 21 (modifications of requirements regarding medical certificates for cremations: Northern Ireland).

See our letter to the Home Office and Ministry of Justice on how the death certification measures are affecting GPs and what changes we’d like to see to ensure the safety of doctors.

In England and Wales

Deaths in the community during COVID-19

BMA guidance for GPs has been produced to outline the key issues, protocols and principles that should be considered during this time for verification of death, completing MCCDs and cremations forms.

Remote verification of death protocol

We have worked jointly with the RCGP to produce a protocol that can be used by various groups of professionals to verify death remotely with a clinician.

See the NHS guidance for more information on completing MCCDs, coroners, cremation and burial.

See the Government’s guidance on verifying death in times of emergency.

 

In Scotland

The chief medical officer in Scotland wrote to directors of public health, board medical directors and primary care leads on 24 March.

In the letter it outlines the key steps to be taken with regard to death certification during the pandemic.

In summary it:

  • clarifies terminology around cause of death associated with COVID-19 disease
  • clarifies that although COVID-19 is a notifiable disease, COPFS (Crown Office and Procurator Fiscal Service) do not need to be advised of COVID-19 deaths during the pandemic period
  • explains the fast track procedure for completion of the MCCD during the period of the pandemic
  • explains changes to the DCRS (death certification review service) during the period of pandemic.

The DCRS (death certification review service)

From 24 March 2020, and as an interim measure, the percentage of MCCDs selected for review by DCRS was reduced from the normal 14% to 4% (3.5% for level 1 reviews and 0.5% for level 2 reviews).

However, now that UK Coronavirus Bill has received Royal Assent there is provision in the legislation for the suspension of the selection and referral of MCCDs to DCRS for review altogether.

Scottish Ministers will take a decision on whether to suspend the review service, and further communication will follow. Suspension would mean that the MCCDs will not be randomised by NRS (National Records of Scotland) for scrutiny until the pandemic is over.

Requests for Interested Person Review will be kept on hold and re-visited once the pandemic is declared to be over.

 

In Northern Ireland

For Northern Ireland the chief medical officer and coroner have issued formal notifications and letters:

In summary:

  • death and still births: the medical practitioner to send a copy of the certification to the registrar by electronic means and or by telephone
  • there is no need to sign the death certificate if informed by phone or electronic means
  • the Act removes the requirement in Northern Ireland that a death from natural illness or disease must be notified to the coroner if the deceased had not been seen or treated by a registered doctor within 28 days prior to the death
  • removes the need for a second confirmatory medical certificate in order for a cremation to take place in Northern Ireland.
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