Changes to the Medical Certificate of Cause of Death … · the Medical Certificate of Cause of Death ... • New MCCD has 5 parts: ... DH1 Does the body of the deceased pose a risk

Quality Education for a Healthier Scotland

The Certification of Death

(Scotland) Act 2011

Changes to

the Medical Certificate of

Cause of Death (MCCD)


Why is the MCCD changing?

• The implementation of The Certification of Death

(Scotland) Act 2011in April 2015 is intended to

improve the quality of MCCDs.

• The first phase of this improvement is the

introduction of a new paper MCCD form on the

6th August 2014.


Who does this apply to in the NHS?

CERTIFYING STAFF

• All grades of doctors signing a death certificate

• Secondary and primary care

NON CERTIFYING STAFF (for information)

• Nurses, midwives, and AHPs

• Administrative and support staff


6th August 2014

• All deaths certified after midnight of 5th August must be certified using the new MCCD, even if the death itself occurred earlier.

• If the old MCCD is used to certify a death after midnight 5th August, the Registrar will require the informant to contact the certifying doctor, or another doctor in the team, for a new MCCD before registration of the death can proceed.

• Old MCCD forms will only be accepted by the Registrar of Births, Deaths, and Marriages if the death was certified before midnight on 5th August.


New MCCD Format


Main Changes to MCCD Layout

• New MCCD has 5 parts: A to E.

• Double sided format.

• The Counterfoil is replaced by a Record of Issue

Sheet, which will be attached to the printed forms

as a 4-page mini booklet.



Introductory Section and

Sections A to E



INTRODUCTORY SECTION OF MCCD

Main changes:

• This section is new.

• There is now a serial number on the MCCD.

• Guidance for completion of the form is available

at www.nrscotland.gov.uk/MCCDGuidance

http://www.nrscotland.gov.uk/MCCDGuidance


INTRODUCTORY SECTION OF MCCD

EXAMPLE



PART A – DETAILS OF DECEASED

Main Changes:

• CHI number

• Health Board area in which death occurred


PART A – EXAMPLE

Name of deceased

JOHN SMITH

Date of death

(dd/mm/yyyy)

01/01/2014

Time of death

(24-hour clock – hh:mm)

21.37

Place of death WARD 6, CROSSHOUSE HOSPITAL

Health Board area in

which death occurred

NHS AYRSHIRE AND ARRAN

Community Health Index

(CHI) number

0712361732

Date of birth

(dd/mm/yyyy)

07/12/1936



PART B – DETAILS OF CERTIFYING

DOCTOR

Main Changes:

• GMC number.

• Business contact telephone number.

• Inclusion of the text ‘I hereby certify that to the best of my knowledge and belief the information contained in this Medical Certificate of Cause of Death is correct’.


PART B – EXAMPLE

Name JAMES FAIRLEY

GMC number 3456721

Business address CROSSHOUSE HOSPITAL

Business contact telephone

number

01563 521 000

For a death in hospital

Name of the consultant

responsible for the deceased

REBECCA YOUNG

I hereby certify that to the best of my knowledge and belief the

information contained in this Medical Certificate of Cause of Death is

correct.

Signature of certifying doctor James Fairley

Date 06 08 2014 For

registration

office use

RD

number

Year Entry

number



PART C – CAUSE OF DEATH

Main changes:

• The CAUSE OF DEATH section no longer states ‘I hereby certify that to the best of my knowledge and belief, the cause of death was as stated below’.

Instead this is addressed in both PART B (DETAILS

OF CERTIFYING DOCTOR) and PART D (HAZARDS).

• Otherwise the content is the same but in reformatted style


PART C – EXAMPLE

I Disease or condition directly leading to death *

(a) Intraperitoneal haemorrhage

1

Antecedent causes – Morbid conditions, if any, giving rise to the above cause, stating the underlying condition last

due to (or as a consequence of)

(b) Ruptured metastatic deposit in liver

6


(c) primary adenocarcinoma of ascending colon

2


(d)

II Other significant conditions contributing to the death, but not related to the disease or condition causing it

Non-insulin dependent Type 2 diabetes mellitus

20

Approximate interval between onset and death Years Months Days

PLEASE PRINT CLEARLY IN BLOCK CAPITALS AND DO NOT ABBREVIATE

* This does not mean mode of dying, such as heart or respiratory failure; it means the disease, injury or complication that caused death.



PART D – HAZARDS

Main changes:

• PART D is completed ‘to the best of your knowledge and belief’.

• This information is now required on the MCCD as the use of cremation forms will cease from April 2015.

• Therefore, in the meantime, this requires to be completed as well as the relevant cremation forms.

• Please note that hazard information was not previously seen by families.


PART D - EXAMPLE

To the best of your knowledge and belief: Y N

DH1 Does the body of the deceased pose a risk to

public health: for example, did the deceased have

a notifiable infectious disease or was their body

“contaminated”, immediately before death?

√

DH2 Is there a cardiac pacemaker or any other

potentially explosive device currently present in

the deceased?

√

DH3 Is there radioactive material or other hazardous

implant currently present in the deceased?

√



PART E – ADDITIONAL INFORMATION

Main changes:

• Reformatted style only


PART E – EXAMPLE

Post mortem examination by a pathologist (tick one)

PM1 Post mortem has been done and information is included above

PM2 Post mortem information may be available later

PM3 No post mortem √

Maternal Deaths (tick if applicable)

M1 Death during pregnancy or within 42 days of the pregnancy ending

M2 Death between 43 days and 12 months after the end of pregnancy

Attendance on deceased (tick one)

A1 I was in attendance upon the deceased during last illness √

A2 I was not in attendance upon the deceased during last illness: the

doctor who was is unable to provide the certificate

A3 No doctor was in attendance on the deceased

Procurator Fiscal (tick if applicable)

PF This death has been reported to the procurator fiscal

Extra information for statistical purposes (tick if applicable)

X I may be able to supply the Registrar General with additional

information


To Come from April 2015

Implementation of legislation (2011 Act) with :

• New national system of scrutiny of MCCDs.

• Cessation of the use of cremation forms.

• Electronic completion and transfer of MCCDs(where available).

• Electronic system of reporting to the Procurator Fiscal of sudden deaths.

• Healthcare Improvement Scotland takes over the process for administering and authorising the burial or cremation of those who have died outside the UK and are returned (repatriated) for burial or cremation in Scotland.

An education package on the new system of scrutiny will be available for medical and relevant non-certifying staff from NES from January 2015.


6th August 2014

• Only the new MCCD forms must be used from

6th August 2014 for deaths certified after

midnight on the 5th August.

• Old MCCD forms will no longer be accepted

(unless completed for a death certified prior to

6th August but registered after this date).

• Incomplete MCCD forms will not be accepted by

Registrars.


Frequently Asked Questions

Slide Query

2 The reason the change will be on the 6th August 2014 is that this is the first day of the junior doctors’ rotation.

4 The new MCCD form becomes operational for all deaths certified after midnight on the 5th of August.

Therefore, deaths certified before midnight on the 5th will be completed on old forms, and, as an informant

has 8 days to register the death with the Registrar of Births, Deaths, and Marriages these will be accepted for

registration for the following 8 days. After the 6th informants would need to seek a new legitimate form should

they first arrive with an old MCCD, as this form would no longer be in force.

If the certifying doctor is unavailable another doctor in the team can issue a new MCCD (in the new format)

as the old style MCCD form will have no legal status.

6 Please emphasise that the new MCCD is double sided.

Any counterfoils that have been completed as part of old MCCD forms must be retained when the books of

old MCCDs are removed from clinical areas

12 PART A requires the Health Board area in which the death occurred (not where the death is to be registered).

15 It is recommended that medical staff do not supply their personal mobile numbers on the MCCD.

21 There is no longer a tick box for ‘don’t know’ so this section is now completed ‘to the best of your knowledge and belief’. ‘Hazard’ information was not previously seen by families so this may raise issues that the informant and / or bereaved were unaware of.

Documents

Changes to the Medical Certificate of Cause of Death … · the Medical Certificate of Cause of Death ... • New MCCD has 5 parts: ... DH1 Does the body of the deceased pose a risk