THE MEDICAL EXAMINER
AND REGISTRATION

DEATH HAS OCCURRED:

Some deaths are expected; the deceased may have been on end-of-life care, and some deaths happen suddenly and unexpectedly. Before we can attend, the death must be confirmed and formally pronounced, and this will need to be done by someone medically qualified. Call the GP, Community Nurse, or, if you have already called an Ambulance, the Paramedic can confirm that death has occurred. When death occurs in Residential Care, a qualified member of staff will carry out the procedure.

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Initially, the death will be reported to the deceased's Medical Practitioner, their GP. This may be through an attending Paramedic, a Community Nurse, or an Out-of-Hours Doctor. The system should ensure the necessary communication, but we recommend that you contact the Doctor's Surgery on the next working day to confirm they have been informed. Once you have contacted the Doctor's Surgery, there isn't much that can be done until the Medical Certificate of Cause of Death has been completed. However, this doesn't mean you can't start thinking about funeral arrangements. We are here to support you; the next step is to call us to schedule an appointment.

THE MEDICAL EXAMINER:

Once the GP has been notified of the death, they will report it to the Medical Examiner, who will independently review the medical history and determine the next steps. The Medical Examiner needs to be sure that death was expected. Sometimes they will contact the Next of Kin to ask questions and clarify information. If the Medical Examiner is satisfied that no further review is necessary, they will notify the GP that a Medical Certificate of Cause of Death can be issued. We emphasise the importance of maintaining contact with the Doctor's Surgery, as the communication link isn't always reliable. If you haven't heard anything after three days, contact the GP again. Communication is vital to this process; however, the Medical Examiner will require approximately five working days to complete their review.

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WHAT IS A MEDICAL EXAMINER?

The Medical Examiner's Office is a team of independent senior doctors who have not been involved in the deceased's care before their passing. The Medical Examiner is supported by Medical Examiner Officers, who work full-time in the office and ensure processes run smoothly. The Medical Examiner will work with the relevant Doctor to ensure that the information contained on the Medical Certificate of Cause of Death (MCCD) is correct and that referrals to the Coroner are made, if necessary, in a timely and appropriate manner to avoid delays.

Medical Examiners and Medical Examiner Officers offer families and carers an opportunity to raise questions or concerns about the cause of death of a loved one or about the care they received beforehand. This will usually be done over the phone, and if required, a meeting can be arranged. A key role of the Medical Examiner is to make it easier for the bereaved to understand the wording on the Medical Certificate, which explains the cause of death. Medical examiners also review relevant medical records and discuss the cause of death with the physician completing the MCCD.

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DO YOU HAVE ANY CONCERNS?

A discussion with a Medical Examiner or their staff provides you with an opportunity to have an open and honest conversation and address any worries or concerns with someone who was not involved in providing care to the person who died.

It could be as simple as helping you better understand the treatment, causes of death, and medical terminology. There may be something about the care which you think did not feel right – this is an opportunity to ask questions. The Medical Examiner will provide an independent view of the causes of death and the care provided. The Medical Examiner and their staff will discuss your thoughts, questions, and concerns. If they identify care issues that require further investigation, they will refer them accordingly. In addition to answering your questions, this can help us provide better care for patients, their families, and carers by identifying areas for future improvement.

H M CORONER:

If the Medical Examiner decides that death was unexpected, unnatural or the deceased wasn't seen by their GP within the last fourteen days, they may notify HM Coroner. You should allow an additional five working days, or sometimes longer, before a final decision is provided. The H M Coroner will contact you to explain what will happen next, why they have assumed jurisdiction, and to answer any questions you have. Until death is certified by the GP or HM Coroner, the Registration of Death cannot be completed. Although funeral arrangements may begin, we recommend delaying the booking of a date and time until you have been informed that the death can now be registered. Any extended delay may risk the funeral being postponed.

REGISTRATION OF DEATH:

Once the death has been reviewed, formalised and certificated, this will be the time when you can register the death. You will be notified of the appropriate Registration Office to contact and required to book an appointment. Once you have been notified that registration can take place, you have five working days to complete the process. When attending the Registration Office, the Registrar will provide you with a 'Certified Copy of Entry'. This document is the official record of death and is commonly referred to as the 'Death Certificate'. You can purchase as many copies as you might need, as they will be required for various administrative purposes.

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Before you can register the death, you must ensure that all required documentation has been received. If the Medical Examiner were involved, they would have instructed the GP to complete the Medical Cause of Death Certificate. Sometimes this is emailed to the Registrar; at other times, you will need to collect it from the GP Surgery. Unless you have been informed otherwise, contact the surgery to confirm whether you need to collect the Certificate. If HM Coroner were involved, they would have already sent the Registrar the required documentation. In some instances, HM Coroner may not conclude their investigation and will need to hold an Inquest. In most cases, the Coroner will issue an Interim Certificate to allow the funeral to proceed, but registration will be postponed until the Inquest has concluded.

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If you have been notified that you may register, or have received an Interim Certificate from the HM Coroner, contact us immediately. We will then be able to book the day and time for the funeral.

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WHO SHOULD REGISTER?

Once the ''Medical Certificate of Cause of Death " has been issued, you should take it to the Registrar of Births and Deaths. This will enable registration, which must be completed within five days of death, as required by law. The ''Medical Certificate of Cause of Death " will often be issued by the GP who attended to the deceased during their illness. You will collect the Certificate from the surgery if the deceased passes away at home, and you should call the surgery to arrange this. However, if the death occurred in the Hospital, you should contact the Patient Affairs Office to arrange collection. There is no charge payable for this Certificate.

WHO IS ELIGIBLE TO REGISTER?

• A relative was present at the death

• A relative in attendance during the last illness

• A relative residing in the sub-district where the death occurred

If death is reported to the Coroner, registration cannot occur until the Coroner, or we, inform you. If a coroner is involved, a different registration procedure may be in place, and we'll guide you through these variations should they arise.

WHAT INFORMATION WILL THE REGISTRAR REQUIRE?

Specific information concerning the death will be on the Medical Certificate of Cause of Death. However, other information regarding the deceased will be required:

• Their full name, any previously used names or maiden name.

• Date and location of birth.

• Occupation or husband's occupation, if married.

• The address of the deceased was provided, as well as the date of birth of the Widow or Widower.

The Registrar will also inquire whether the deceased person received any pension or allowance from the Government or public funds, including those from the Civil Service, Naval Base, and Armed Forces. These details will be required so that the Registrar can forward a copy of the death certificate directly to these organisations on your behalf.

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WHERE SHOULD YOU REGISTER?

You must register the death at the office within the district where the death occurred. An appointment must be made; our local Registrars are listed below. Should death occur outside Portsmouth, we can provide you with the details of the relevant Registrar and make the appointment for you. If you have difficulty reaching the Registrar, please let us know. We'll take you there and bring you back, and there is NO charge for this service. Should you, as a relative, live a long distance away from the Registrar, you can, in certain circumstances, register by declaration. Please let us know.

WHAT DOCUMENTS ARE ISSUED?

Once the death is registered, the Registrar will release three documents. The first is a White Certificate (BD8 Rev) containing a Social Security form. This enables you to claim any arrears or benefits due to the deceased person's estate and ensure that the widow's correct benefits are paid if applicable. The white Certificate is issued free of charge. Secondly, a Green Certificate, also known as the Registrar's Certificate for Burial or Cremation. This Certificate is required by the Burial or Cremation authority and must be given to the Funeral Director. Should the deceased be resting in a hospital, as per your instructions, we will require the green Certificate as evidence before any collection can be carried out. This Certificate is provided free of charge.

Thirdly, they will provide you with a Certified Copy of the Entry, known as the ''death Certificate'' a copy of the actual entry in the Register of Deaths. These can purchase copies of the Certified Copy of Entry for a small fee. Additional copies of the Certificate will be necessary for the Grant of Probate or Letters of Administration. You may also require copies of this Certificate for informing Banks, Building Societies, Insurance companies, Solicitors and if you intend to claim a funeral payment through the DWP. These organisations will accept only original certificates, not photocopies.

If you have any further questions or would like to speak with someone regarding the registration process, please do not hesitate to contact our office. Alternatively, you may contact the local Registrar for Births, Deaths, and  Marriages. Please note that you will need to make an appointment to register a death.