How to Confirm a Death

Dealing with the practical and administrative tasks following the death of a loved one is never easy, particularly if it is sudden or unexpected. The circumstances surrounding each death will be different, but in all cases there will be processes to follow and legal requirements to plan and manage, starting with the death confirmation.

Please note, on 9th September 2024 the process for certifying and registering deaths in England and Wales changed, with the introduction of the Statutory Medical Examiner Service.

The following provides some guidance on what happens in various settings following a death.

Confirmation or Verification of a Death

Firstly, it is important to understand the difference between Verification or Confirmation of Death and Certification of Death.

Verification of Death (VoD), (Confirmation of Death in Scotland) is the process of confirming the fact of death and documenting it formally in line with national guidance.

Death confirmation can be done by a ‘competent adult’, which is usually a doctor, GP, registered nurse or paramedic.

Certification of Death, is the process of issuing a Medical Certificate of Cause of Death (MCCD), which establishes and states the probable cause of death.

The MCCD is completed by a registered medical practitioner. In accordance with the new guidelines, in England and Wales the cause of death must first be scrutinised and verified by a Medical Examiner, who will also give the bereaved an opportunity to ask questions or raise any concerns. The MCCD will then be submitted to the Registrar.

For more information on MCCDs, please see below.

If the cause of death is unclear or if there are unusual circumstances, the death will be reported to the Coroner who may need to investigate further or request a post mortem or an inquest. For more information on reporting a death to the Coroner, please see below.

Please note that the Medical Certificate of Cause of Death is different to the Death Certificate, which is issued by the Registrar once the death has been registered. For more information, go to What the Registrar Will Issue in How to Register a Death.

When someone dies at Home

A Death at Home that was Expected

If the death was expected, it may be that family and friends are already present. The time immediately after a death may be an opportunity for you to sit peacefully alone with your loved one or to gather people together to say a quiet goodbye.

Verification of Death (VoD) will usually be undertaken by a member of the healthcare team involved in the person’s care, or by a GP or paramedic.

Once the death has been verified, the cause of death must be established by a registered medical practitioner. In accordance with new guidelines, in England and Wales, the cause of death will then be scrutinised and verified by a Medical Examiner. The Medical Examiner will offer the bereaved an opportunity to ask questions and raise concerns.

The Medical Certificate of Cause of Death (MCCD) will then be completed and submit it to the Registrar. For more information on MCCD, please see below.

A Death at Home that was Sudden or Unexpected

If the cause of death is unclear or if there are unusual circumstances, the death may be reported to the Coroner. For more information on reporting a death to the Coroner, please see below.

In Hospital

A doctor or medical professional at the hospital will confirm the death of the patient and cause of death proposed by a registered medical practitioner. In accordance with new guidelines, in England and Wales, this will then be scrutinised and verified by a Medical Examiner, who will also offer the bereaved an opportunity to ask questions and raise concerns.

Then Medical Certificate of Cause of Death (MCCD) will then be completed and sent to the Registrar.

The deceased may be moved to the hospital mortuary whilst a decision is made about where they will lay at rest until the funeral. This will usually be in a Chapel of Rest or at home.

If there is any doubt about the cause of death or if there are unusual circumstances, the death will be reported to the Coroner. For more information on reporting a death to the Coroner, please see below.

In a Care Home

The death will usually be verified by a registered nurse, doctor or paramedic. However, if there is no trained person in attendance and the death was expected, remotely supported verification by a care worker can be used to prevent delays.

A registered medical practitioner must be notified so that they can establish a cause of death. In accordance with new guidelines, in England and Wales the cause of death will then be scrutinised and verified by a Medical Examiner, who will also offer the bereaved an opportunity to ask questions and raise concerns. The Medical Certificate of Cause of Death (MCCD) will then be completed and sent to the Registrar.

As with a death elsewhere, if there is doubt about the cause or if there are unusual circumstances, it must be reported to the Coroner. For more information on reporting a death to the Coroner, please see below.

In Hospice Care

Verification of Death (VoD) will usually be undertaken by a doctor, registered nurse or paramedic. A registered medical practitioner will establish the cause of death. In England and Wlaes, this will then be scrutinised and verified by a Medical Examiner, who will also offer the bereaved an opportunity to ask questions and raise concerns.

The Medical Certificate of Cause of Death (MCCD) will then be completed and sent to the Registrar.

If there is doubt about the cause of death, or if there are unusual circumstances, the death will reported to the Coroner. For more information on reporting a death to the Coroner, please see below.

Out-of-country death: when someone dies abroad

The death of someone close to you is always distressing. If you are abroad when they die, it can be even harder to cope. What you need to do will depend on the laws and customs of the country.

If you are travelling with the person who has died, contact the British Embassy, High Commission or Consulate nearest to you. They will be able to advise you. You will need to register the death and obtain a death certificate.

If you are in the UK when a family member or close friend dies abroad, contact the Foreign and Commonwealth Development Office (FCO) who will be able to keep you informed and help with arrangements.

For further information see the FCDO’s information on when a British National dies abroad or view the Government information about a death abroad.

The Medical Certificate of Cause of Death (MCCD)

The MCCD is a Legal Document that States the Cause of Death

Once a death has been verified by a registered medical practitioner, the proposed cause of death will be scrutinised by a Medical Examiner after reviewing the relevant medical records.

The Medical Examiner will then offer the bereaved an opportunity to ask questions and raise any concerns they may have.

Once this process is complete and the cause of death has been finalised, if there is no requirement to notify the coroner, the Medical Certificate of Cause of Death (MCCD) is sent to the Registrar’s office. At this point, the bereaved have 5 days to register the death.

Incomplete or Inaccurate MCCDs Can Cause Delays in Funeral Arrangements

Mistakes or omissions on the MCCD can cause delays, so it is important that all information, including underlying conditions and illnesses that may have contributed to the death, are recorded on the certificate.

Referral to the Coroner or the Crown Office and Procurator Fiscal Service

Why and When to Report a Death to the Coroner

If there are unusual circumstances surrounding a death, for example if it was sudden, violent or unnatural, or if the doctor cannot reasonably give a likely cause of death, then the case must be submitted to the Coroner for investigation.

A Coroner’s investigation may also take place following death by suicide, medical negligence, industrial disease or an accident.

What a Coroner Does

A Coroner is a government official who has the power to order or conduct an inquest into how a person died and, if the identity of the person is unknown, to investigate and confirm their identity.

The Coroner may request a post-mortem (also known as an autopsy) to establish a cause of death. The post-mortem is carried out by a pathologist who will examine the body to try to establish how the person died. If the post-mortem examination cannot establish this, the Coroner may request an inquest.

An inquest may also be held if the person might have died a violent or unnatural death or died in prison or police custody.

At the inquest, the Coroner will hear evidence from witnesses and experts. They will then decide whether further investigation is required.

For more information about Registering a Death when an inquest is being held, please see How to Register a Death.

For further information, please see the Government information about when a death is reported to a coroner.

Scotland: the Crown Office and Procurator Fiscal Service

The equivalent service to the Coroner in Scotland is the Crown Office and Procurator Fiscal Service (COPFS) which investigates sudden, suspicious or unexplained deaths. For more information see their Guide for Bereaved Family Members.