Medical certificate of cause of death (MCCD)

The medical certificate of cause of death (MCCD) is the form a doctor who cared for the person completes to record why they died. In England and Wales a medical examiner reviews it, and the registrar needs it before the death can be registered. If the cause is unknown, or the death was sudden or unnatural, the coroner (in Scotland, the procurator fiscal) is involved instead.

Who completes it

A doctor who attended the person, in their final illness or at another point in their life. In hospital that is usually the doctor on the ward, with the hospital bereavement team coordinating. At home it is the GP or another doctor from the practice. Since September 2024 in England and Wales, the doctor no longer needs to have seen the person in the 28 days before they died. Doctors issue it free of charge.

Where it goes

In England and Wales the certificate goes first to a medical examiner, and then to the register office electronically, so you may never hold the paper yourself. In Northern Ireland the doctor or hospital sends it electronically to GRONI and the district registration office. In Scotland it goes to the registrar, and some are chosen at random for checking by the Death Certification Review Service, which can delay registration by 1 to 3 working days. A Scottish family should ask which office received it, since that is where the appointment is booked.

What is written on it

The doctor sets out the cause the way medicine records it: the immediate cause, the conditions that led to it, and any others that contributed. “Old age” is accepted only for someone over 80 whose decline the doctor observed, and “natural causes” is not accepted unless a condition is named. The wording carries over to the death certificate. It can be changed before it reaches the registrar, but rarely afterwards.