THE MEDICAL EXAMINER PROCESS
All deaths should be reviewed by a Medical Examiner (ME). This is an independent, senior doctor who was not involved in the care of your loved one. We also have Medical Examiner Officers (MEOs) who coordinate the entire process of ensuring the required certificate of cause of death can be issued. You will have a named Medical Examiner Officer (MEO) who will be your main point of contact throughout the entire process. The bereavement assistant also supports the Medical Examiner Officers (MEOs).
The Medical Examiner (ME) reviews the medical notes provided by the GP and has a discussion with your designated Medical Examiner Officer (MEO) and the GP responsible for the care of your loved one. This is to ensure that the information entered on the Medical Certificate of Cause of Death (MCCD) is correct and that all information relating to the death is recorded appropriately. The Medical Examiner is NOT the same as the Coroner.
Your designated Medical Examiner Officer (MEO) will ensure you are informed of the cause of death and they will answer any questions you may have about the Medical Examiner process. You will also be asked if you have any concerns regarding your loved one’s care during their final illness. Although they may not be able to answer all of your questions immediately, they will advise you of sources of additional support or information.
Who are Medical Examiners and Medical Examiner Officers?
Since 2019, some senior NHS doctors have received specialist training in order to become Medical Examiners (ME). Alongside their normal working specialities, their job is to give independent advice about causes of death (except for deaths that have been referred directly to the Coroner).
Medical Examiners (ME’s) look at the relevant medical records and discuss the causes of death with the GP who was involved in the care of your loved one, and who will complete the Medical Certificate of Cause of Death (MCCD).
The Medical Examiner (ME) will provide an independent view as they have not provided care for your loved one.
During the independent review, if the Medical Examiner (ME) finds issues with care that needs further investigation, they will refer these to someone who can do this. This is usually an internal investigation with the appropriate care giver.
Medical Examiner Officers (MEO’s) are specially trained Administrative staff who coordinate the entire process. They offer families and carers an opportunity to raise questions or concerns about the causes of death, or about the care their loved one received before their death. They can explain what the medical language means and make it easier to understand.
Each family is assigned a Medical Examiner Officer (MEO) who will remain their point of contact.
Coroners
When the Medical Examiner (ME) identifies a case that requires a referral to the Coroner, it is the Coroner who investigates the death independently and not the Medical Examiner.
Why am I being asked if I have any concerns?
A discussion with the Medical Examiner Officer (MEO) provides you with an opportunity to have an open and honest conversation with someone who was not involved in providing care to your loved one. Any worries or concerns you may have can be discussed and the Medical Examiner Officer (MEO) will be able to help you identify whether you need to make a direct complaint or whether they can provide your feedback and concerns to the care provider responsible.
If there is a requirement for further investigation, unless the death has been referred to the Coroners, this will not cause a delay in the death certification process.
As well as answering your questions, any feedback or concerns received can help the NHS provide better care for loved ones in the future.
Can I ask the Medical Examiner Office to talk to someone else if it’s too difficult for me to speak with them?
Yes of course, the Medical Examiner Officer (MEO) will ask you who you would like us to speak to instead.
We understand that this is a difficult time for you and speaking to the Medical Examiner office is your choice.
Will funeral plans take longer?
The Medical Examiner office will make every effort to avoid any delays and work with families to meet the legal requirements for registering deaths.
What can I do if I have questions or concerns about the Medical Examiner process?
If you are not satisfied with the information provided by the Medical Examiner office, we suggest you discuss this with your appointed Medical Examiner Officer (MEO) first.
If you are still not satisfied, you can also contact the Patient Advice and Liaison Service (PALS) on 01438 285811 where staff will be happy to listen to your concerns and ask the appropriate member of the Trust staff to contact you to talk through your concerns as quickly as possible.
Access to medical records
During the independent review, the Medical Examiner will be able to view information held by relevant care providers using the Hertfordshire and West Essex Shared Care Record. The Shared Care Record is secure technology that allows authorised staff involved in an individual’s care to electronically access an up-to-date summary of their health and care records from multiple services. This includes, for example, records from other hospitals; hospices; community, mental health, and adult social care services; out of hours providers; and GP practices. There will still be occasions when more detail is required, and the Medical Examiner will contact a service directly to request this. More information about the Hertfordshire and West Essex Shared Care Record is available at https://www. hertsandwestessex.ics.nhs.uk/your-health-and-care/support/ shared-care-record/
MEDICAL CERTIFICATE OF CAUSE OF DEATH (MCCD)
To enable the Medical Certificate of Cause of Death (MCCD) to be completed, Medical Examiner Officers (MEO’s) must follow a standard procedure. Please be aware that this process may take a few working days, depending upon circumstances.
The Medical Examiner Officer (MEO) will contact the GP Surgery your loved one was registered with and ask them to complete the Medical Certificate of Cause of Death (MCCD). The GPs are not always available immediately to complete the Medical Certificate of Cause of Death (MCCD) when requested but you will be kept informed of any unavoidable delays.
On completion of the Medical Certificate of Cause of Death (MCCD), the Medical Examiner/Bereavement Office will email it to Hertfordshire Registration Service and will call you to confirm this has been done.
Please do not book a registration appointment until the paperwork has been sent to the registration service.
REGISTERING A DEATH
To register the death, the GP must have issued the Medical Certificate of Cause of Death (MCCD) first. You will then be able to book an appointment to visit one of the Hertfordshire Register Offices (listed under the section Registration Office Information).
Deaths must be registered in the county in which they occur. However, if for any reason you are unable to attend the area where the death occurred, please contact the registration service for advice regarding the registration.
To make an appointment to register a death, please book online via the Hertfordshire website: www.hertfordshire.gov.uk/registeradeath or use the QR code below.
THE DEATH CERTIFICATE
This is a certified copy of the entry in the register of deaths. You will need to consider how many certificates you require and there is a fee for each death certificate. This is currently £12.50 per certificate. The Registrar will provide you with as many copies of the death certificate as you require. You can prepay for certificates online when you book an appointment.
You will need to tell the Registrar:
• The date and place of death and the deceased’s usual address
• The deceased’s full name and maiden name if appropriate
• The deceased’s date and place of birth
• The deceased’s occupation, the name and occupation of the spouse or registered civil partner if applicable
• The deceased’s marital status and date of birth of the surviving spouse or registered civil partner
THE GREEN FORM
This is a certificate that the Registrar needs to provide to the funeral director for the burial or cremation to go ahead.
The Green Form can be emailed to your chosen funeral directors when you attend your appointment to register the death. Alternatively, if you have yet to appoint a Funeral Director the Green Form will be given to you to give to the Funeral Directors when appointed.
TELL US ONCE SERVICE
Hertfordshire Registration Service provides assistance with the National ‘Tell Us Once’ Service with the DWP (Department for Work and Pensions) when you register a death within Hertfordshire.
The Registrar will provide you with a unique reference number so you are able to access the Tell Us Once Service. You cannot use this service without this reference number.
www.gov.uk/tell-us-once
Alternatively you can telephone them on 0800 731 0469
When you visit the DWP website, have your loved one’s National Insurance number to quote along with the unique reference number and continue to follow the instructions so that all central and local government and council departments can be informed of the death.
ORGANISATIONS TELL US ONCE WILL CONTACT
• HM Revenue and Customs (HMRC) - to deal with personal tax and to cancel benefits and credits, for example Child Benefit and tax credits (you need to contact HMRC separately for business taxes, like VAT)
• Department for Work and Pensions (DWP) - to cancel benefits and entitlements, for example Universal Credit or State Pension
• Passport Office - to cancel a British passport
• Driver and Vehicle Licensing Agency (DVLA) - to cancel a licence, remove the person as the keeper of up to 5 vehicles and end the vehicle tax (you must contact DVLA separately if you either sell the vehicle or keep it and tax it in your own name)
• The local council - to cancel Housing Benefit, Council Tax Reduction (sometimes called Council Tax Support), a Blue Badge, inform council housing services and remove the person from the electoral register
• Veterans UK - to cancel or update Armed Forces Compensation Scheme payments
• Social Security Scotland - to cancel benefits and entitlements from the Scottish Government, for example Scottish Child Payment
HMRC and DWP will contact you about the tax, benefits and entitlements of the person who died.
Tell Us Once will also contact some public sector pension schemes so that they cancel future pension payments. They’ll notify:
• My Civil Service Pension
• NHS Pensions for NHS staff in England and Wales
• Armed Forces Pension Scheme
• Scottish Public Pension Agency schemes for NHS staff, teachers, police and firefighters in Scotland
• Local Government Pension Schemes (LGPS)
Stevenage Register Office
Opening Times
Mon: 9am – 5pm
Tue: 9am – 5pm
Wed: 9am – 5pm
Thur: 9am – 5pm Fri: 9am – 5pm
Closed for lunch 12:30pm – 1:30pm
Address: Danesgate House, Danesgate, Stevenage, SG1 1WW
Hertford Register Office
Opening Times
Mon: 9am – 5pm
Tue: 9am – 5pm
Wed: 9am – 5pm
Thur: 9am – 5pm
Fri: 9am – 4pm
Address: County Hall, Pegs Lane, Hertford, SG13 8DE
Hatfield Register Office
Opening Times
Mon: 9am – 5pm
Tue: 9am – 5pm
Wed: 9am – 5pm
Thur: 9am – 5pm Fri: 9am – 5pm
Address: 19b, St. Albans Road East, Hatfield, AL10 0NG
Bishop’s Stortford Register Office
Opening Times
Mon: 9am – 4pm
Tue: 9am – 4pm
Thur: 9am – 4pm Fri: 9am – 4pm
Closed for lunch 12:30pm – 1:30pm
Address: Riverside House, 2 Hockerill Street, Bishop’s Stortford CM23 2DL
Watford Register Office
Opening Times
Mon: 9am – 5pm
Tue: 9am – 5pm
Wed: 9am – 5pm
Thur: 9am – 5pm
Fri: 9am – 5pm
Closed for lunch 12:30pm – 1:30pm
Address: 31 Hempstead Road, Watford WD17 3EY
Hemel Hempstead Register Office
Opening Times
Mon: 9am – 5pm
Tue: 9am – 5pm
Wed: 9am – 5pm
Thur: 9am – 5pm
Fri: 9am – 5pm
Closed for lunch 1pm – 2pm
Address: The Forum, Marlowes, Hemel Hempstead, Hertfordshire HPI 1DN
St Albans Register Office
Opening Times
Mon: 9am – 5pm
Tue: 9am – 5pm
Wed: 9am – 5pm
Thur: 9am – 5pm Fri: 9am – 5pm Closed for lunch 12:30pm – 1:30pm
Address: The Gatehouse, 1, Victoria Square, St Albans AL1 3TF
Cheshunt Register Office
Opening Times
Mon: 9am – 4pm
Wed: 9am – 4pm
Address: Bishop’s College, Churchgate, Cheshunt, EN8 9XH Fri: 9am – 4pm
THE CORONER
Coroners are independent judicial officers who inquire into deaths, which appear to be of an unknown cause or have occurred suddenly, if the deceased underwent surgery or if they had any recent falls or injuries which has contributed to their death, or have not been seen by a GP in the required time frame.
ISSUE OF THE MEDICAL CERTIFICATE UNDER THE CORONER’S AUTHORISATION
A referral to the Coroner does not necessarily mean a post mortem will be required.
If the person who has died had any recent operations or significant injuries that contributed to their death it MUST be reported to the Coroner. If the GP can give a clear cause of death then the Coroner may allow them to issue the Medical Certificate of Cause of Death. This is at the discretion of the Coroner’s Office though, depending on the circumstances leading to the death.
In these cases, a delay of a few working days is usually incurred whilst the coroner looks at the circumstances. The coroner’s officer will advise when the coroner has given permission for you to call the Register Office to book an appointment to register the death.
CORONER’S POST MORTEM
A referral for a post mortem is made when the cause of death cannot be determined by the GP or Medical Examiner. When the GPs are unable to issue a Medical Certificate of Cause of Death (MCCD) the Medical Examiner office are required to inform the Coroner.
The Coroner does not require consent from the next of kin for this and it is part of a legal process.
The Coroner’s Officer, a representative of the Coroner, will keep you informed throughout the process of when the post mortem will take place and when you are going to be able to register the death.
The Coroner’s office can be contacted on 01707 292 707 or via email: coroner.service@herfordshire.gov.uk
FUNERALS
You can contact a Funeral Director of your choice who will be able to advise and discuss the funeral arrangements with you. Contact details of our sponsors are provided within this booklet. However, you are under no obligation to choose from the selection provided. A Will may have been made by your loved one, which may include requests about their funeral arrangements.
FUNERAL DIRECTORS
The Medical Examiner office is not able to recommend a particular funeral director. There are no universal standards that apply to funeral directors, however some are members of professional organisations, which operate a code of conduct. The National Association of Funeral Directors (NAFD) and the Society of Allied and Independent Funeral Directors (SAIF) are examples of these.
A Funeral Director should be expected to give you a written quotation, which may not be exceeded without permission. This includes an estimate for a standard funeral, as well as any additional services.
FUNERALS ABROAD
If the person is to be removed out of England or Wales (this includes, Scotland, Northern Ireland and Eire), The Funeral Director will make representation on your behalf to the appropriate agencies and advise you of the necessary documentation.
ONE-TIME PAYMENTS AND ALLOWANCES
Bereavement Payment
If your husband, wife or civil partner has died you may be able to get a Bereavement Payment: a one-off, lump-sum payment of £2,000 which is tax-free. You may be able to claim a bereavement payment if:
• You were under state pension age when they died
• Your husband, wife or civil partner has paid enough National Insurance contributions
• Your husband, wife or civil partner died as a result of an illness or accident caused by their job or working conditions
Bereavement Allowance (Previously Widow’s Pension)
If you’re widowed you may be able to claim Bereavement Allowance, the taxable weekly benefit paid to you for up to 52 weeks from the date of death of your husband, wife or civil partner. You may be able to claim Bereavement Allowance if:
• Your husband, wife or civil partner had paid enough National Insurance Contributions
• Your husband, wife or civil partner died as a result of an illness or accident caused by their job or working conditions
• You’re a widow, widower or surviving civil partner aged 45 or over when your husband, wife or civil partner died
• You’re under state pension age
• You’re not bringing up children
Widowed Parent’s Allowance
You might be able to claim Widowed Parent’s Allowance if you’re widowed under State Pension age and have at least one dependent child.
You may also be able to claim if you’re pregnant and your husband has died, or you’re pregnant after fertility treatment and your civil partner has died.
You can get Widowed Parent’s Allowance until you stop being entitled to Child Benefit.
Funeral Payment
If you’re on a low income and need help to pay for a funeral you’re arranging, you may be able to get a Funeral Payment from the Social Fund. You might have to repay some or all of it from the estate of the person who died. You may be eligible for a Funeral Payment from the Social Fund if you or your partner are in receipt of certain benefits or tax credits.
This is only a guide. For further information and how to apply for bereavement benefits visit www.gov.uk or telephone the DWP Bereavement Service on 0800 731 0469.
WHO YOU SHOULD INFORM
Financial
Organisations
Tick once completed
General insurance companies for home, car, travel or medical
Private pension providers
Life insurance companies
Banks and building societies
Mortgage provider
Hire purchase or loan companies
Credit card providers and any store cards
Utilities and household contacts
Use Tell Us Once Service to inform DWP, DVLA, HMRC, Passport & identity Service/Blue Badge
Landlord or local authority if they rented a property
Any private organisation/agency providing home help
Utility companies if accounts were in the deceased’s name
Royal Mail – if mail needs re-directing
TV/internet companies with which the deceased had subscriptions
Mobile phone contract provider
When you contact any of the above organisations, ask to be directed to their bereavement department so that you get to speak to the right person who can help you.
FURTHER SUPPORT AND ADVICE
Sometimes it helps to talk to someone who is not directly involved with you or your family’s grief. Below are some organisations that may be able to provide you with some help and useful advice:
CRUSE Bereavement Care
Helpline (Herts area)
Cruse National Helpline
www.cruse.org.uk
WAY Widowed and Young www.widowedandyoung.org.uk
Age UK
www.ageuk.org.uk
www.citizensadvice.org.uk
Carers in Hertfordshire 01992 586969 www.carersinherts.org.uk Winston’s Wish
021 www.winstonswish.org | ask@winstonwish.org
Bereavement Network
www.childhoodbereavementnetwork.org.uk
Compassionate Friends
www.tcf.org.uk | helpline@tcf.org.uk www.griefencounter.org.uk
(Supporting bereaved children and their
Stand by Me Bereavement Support
www.stand-by-me.org.uk
7843
National Bereavement Service 0800 024 6121 www.theNBS.org
Stop Mail
If someone you know has died, the amount of unwanted marketing post being sent to them can be greatly reduced which helps to stop painful daily reminders.
By registering with the free service www.stopmail.co.uk the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks. If you cannot access the internet you can call 0808 168 9607, where you will be asked for very simple information that will take only a few minutes to complete. Alternatively, ask the bereavement team for a leaflet that can be returned in the post.
This free of charge service provided by the Bereavement Support Network will actively reduce the unwanted marketing mail but also can help reduce the likelihood of identity theft following the death of someone close. The information is not used for any other purpose and you only have to complete this once. Additionally to Stop Mail a comparable service can also be accessed from the Bereavement Register or Deceased Preference Service if you would prefer to use them.
Bereavement Support Network
www.bereavementsupport.co.uk
Is a free of charge online resource that provides clear advice and information following the death of someone close. From help with arranging a funeral, to what to do if there is no money, the website has been designed to give you guidance and support in a clear and easy to understand format.
You can also find a lot of practical information and advice online by visiting: www.gov.uk/after-a-death
You can also contact your local religious organisation for support or obtain advice from your General Practitioner (GP) or Practice Nurse.
East & North Hertfordshire Community Bereavement Booklet
Publication Date: July 2024
Review Date: July 2026
The Hospital would like to thank RNS Publications for publishing this information and the following pages contain some features from services o ering their help at this time.
Whilst the Hospital is grateful of their support it does not endorse or recommend any of the services that they provide.
