- Medical Certificate of Cause of Death - this is written by the doctor who has been looking after the person who has died. This certificate may be given to you in a sealed envelope - most doctors will explain what is written or will show you the certificate before it is placed in the envelope.
- Formal notice - This is attached to the Medical Certificate of Cause of Death but is perforated so it can be removed easily. The doctor (or midwife) will remove this before placing the main certificate in a specifically designed envelope and give it to you. This confirms that the certificate has been signed and gives a list of people who are entitled to register the death and the information they will need to be able to do this. See the links below for more information on registering a death.
About the Medical Certificate
The information given on a Medical Certificate is the official record of the cause of someone's death. You will usually be shown or told what is given as the cause of death. The cause will be written in the technical medical language of the diagnosis so do ask if you do not understand what is written, or if you have any other questions. It is essential to ask questions if you disagree with what a doctor has written as it is difficult to change this after the registration.
This information will also be used to create national statistics of how many people die from which illnesses. These statistics are used to plan health care and other public services and it is therefore essential that they are as accurate as possible.
Although you may feel upset if someone's name or age is incorrect on the Medical Certificate from the doctor, this is actually less serious as the Registrar will use the information given by the Informant (the person who actually does the registration) about the deceased to create the entry in the register. Errors in the spelling of a name or an age may creep into a hospital record especially if someone has been admitted as an emergency or they are usually known by a name other than the one on their birth certificate.
Certificates for Babies
If a baby has been stillborn a Medical Certificate of Stillbirth will be written by either a doctor who was in attendance or a midwife. This is the one type of medical certificate where 'unknown' is permitted in the section for writing the cause of the stillbirth. There is also a different Medical Certificate of Cause of Death for babies who die within the first 28 days of life. This must be written by a doctor and may include information about the conditions affecting both the baby and the mother (for example if the baby was delivered prematurely due to pre-eclampsia).
Changes to how Medical Certificates are issued
In some parts of the country the Department of Health is working with coroners and registration services to test a new system of death certification. This is designed to improve the quality of death certification as well as making it easier for bereaved people to understand the cause of death and discuss any concerns they may have.
You will be told by the hospital or doctor if they are taking part in one of the pilot sites for the programme. The main difference you will notice is that you may be spoken to by an independent doctor called a Medical Examiner or one of their team - A Medical Examiner's Officer. This is an opportunity for you to ask questions about anything you do not understand about the cause of death.
Eventually all certificates will have to be agreed by a medical examiner although the act implimenting these changes has been delayed making it unclear when they will take effect. If the changes do come into force, all deaths not referred to the coroner will have to be agreed by a medical examiner regardless of whether someone is to be buried or cremated. The additional forms that now have to be completed when someone is to be cremated will eventually be abolished but do still have to be completed until the new regulations have come into force.
This new system will apply throughout England & Wales. Scotland and Northern Ireland are also proposing changes to death certification. However this is governed by the Scottish Parliament and the Northern Ireland Assembly so will follow different timetables and follow different models. Scotland has some trial sites in operation.