Medical Examiner Service and Medical Certificate of Cause of Death

Somerset NHS Foundation Trust provides a Medical Examiner (ME) Service, which is a national system for reviewing deaths that occur in hospital and in the community. The ME is a senior doctor working in the Trust, who is independent and was not involved in the patient’s care and treatment.

With the assistance of trained Bereavement and Medical Examiner Officers (B&MEO), they will review all deaths within the hospital and the community to establish the cause prior to the issuing of the Medical Certificate of Cause of Death (MCCD). Following this review, the ME or one of the B&MEOs, will contact you. This will be a routine call which will give you the opportunity to discuss the care and treatment your loved one has received and share any feedback you may have. The B&MEOs are able to answer any questions you may have on further practical steps you need to follow in the days to come.

Following discussion with the ME, the doctor who cared for and treated your child will endeavour to complete the MCCD as soon as possible.

Sometimes this can take a little longer due to the availability of the doctor and, in some cases, the ME or the treating doctor may need to speak to HM Coroner before we can issue the MCCD. You will be informed of any delays which may occur.

There is further information on Coroner’s referrals on page 8.

The opening hours for the Bereavement and Medical Examiner Office are 10am until 4pm Monday to Friday excluding Bank Holidays. Contact number 01823 343753.

Can I donate my child’s organs?

Every year the lives of many people are saved with the help of donated organs. You may not realise that donated tissue, such as eyes, skin, bone, and heart valves can save or dramatically improve the quality of life for others.

Dependent on the circumstances your child may be able to donate one or more organs or tissues, offering invaluable help to others.

Organ and tissue donations are best undertaken within 24-48 hours of death. We recognise that a decision such as this is personal, and there is absolutely no pressure or need to discuss this if you do not wish to do so. If you would like more information about donations, speak with a member of staff as soon as possible.

Spiritual Care

Irrespective of your faith group or religion, the Hospital Chaplains can offer support to you and your family, if you would like it. They are available seven days a week and can be contacted on:

01823 342515 or email Chaplains.Acute@SomersetFT.nhs.uk

The hospital Chapel is located on Level 1 of the Duchess Building and is always open. You are welcome to use it for quiet reflection or prayer.

The Chaplains can put you in touch with officiants of other religions.

Paying last respects

If you wish to spend time with your child soon after their death, contact the Bereavement & Medical Examiner Office on 01823 343753 for a viewing appointment. We will endeavour to accommodate your request around the limitations of the Mortuary staff’s other work, this cannot be guaranteed and in times of escalation, it may not be possible.

Out of hours, including weekends, call the Clinical Site Team via the hospital switchboard on 01823 333444. They will try to facilitate a viewing around the limitations of their work, however it may not be possible in times of escalation. If you wish to see your child again before the funeral you may feel that a Funeral Director’s Chapel of Rest would be a more appropriate place to do so.

If HM Coroner is, or is likely to be, involved in your child’s case, then we are unable to facilitate a viewing and it would need to be discussed with HM Coroner’s Officer who is dealing with your child’s case.

How do I obtain my child’s death certificate?

You can obtain a copy of the death certificate following the registration of their death with Somerset Registration Service. You can only register a death once the Medical Certificate of Cause of Death (MCCD) has been issued. The team caring for your child or the staff in the Bereavement & Medical Examiner Office will contact you when the MCCD is completed and explain what your next steps are.

If your child’s death is being investigated by HM Coroner, then your child’s doctor will not be able to issue the MCCD. In these circumstances, HM Coroner’s Office will advise you when and how you can register your child’s death and obtain the death certificate.

Choosing a Funeral Director

You do not have to wait until you have the Medical Certificate before you speak to a Funeral Director. We would ask you not to confirm any date for the funeral until you know an appointment has been made for you to collect the paperwork.

When choosing a Funeral Director, you should feel comfortable and confident with them. Funeral Directors can manage all or part of the funeral arrangements. They can give advice on available options and provide support to help you make decisions.

Bereaved parents no longer pay the cost of their child’s burial or cremation. The Children’s Funeral Fund for England opened on 23rd July 2019 and covers costs for children under 18 and stillbirths after the 24th week of pregnancy. The scheme is open to all regardless of a family’s income. Through the scheme, funeral providers are reimbursed for burial and cremation costs and for providing a coffin, shroud or casket so that parents do not have to worry about those expenses.

Parents can claim through the scheme themselves if they choose not to use a Funeral Director.

The Funeral Director needs to know and discuss with you:

• The name, age and religion of the child who has died

• The place of death

• Any requests left by the child who has died

• Whether you would like a burial or cremation

• The style of coffin

• The type of service, hymns, cars, flowers, newspaper notices (if any), etc.

A list of Funeral Directors in the Somerset area is provided on pages 28-32.

Registering the death

The death must be registered within five calendar days of the death (unless HM Coroner is involved) and can be done at any Registry Office in Somerset. Call 01823 282251 to book an appointment directly with the Registry Office.

The person registering the death must be one of the following:

• a relative of the deceased, present during the last illness

• a person who was present at the time of death

• a person making the funeral arrangements

The person registering the death will be required to show ID such as a driving licence or passport.

The Registrar will ask you for the following information regarding the person who has died:

• The date and place of death and their usual residential address

• Full name

• Date and place of birth

• Occupation if they were old enough to be in employment.

• Whether an allowance from public funds was being paid.

The Registrar will give you

• Certified copies of the Death Certificate

The Somerset County Council leaflet within this pack provides details of who may require a certified copy of the Death Certificate and information about the Tell Us Once service. This leaflet is for guidance only and you should still check for other people you need to contact independently.

• Form BD8 (white form)

Only applicable if not using the ‘Tell Us Once’ service.

• A certificate for burial or cremation (green form)

This allows a burial/cremation to take place and should be handed to your Funeral Director as soon as possible

Coroner’s Referrals

Under certain circumstances the involvement of His Majesty’s Coroner may be necessary. Examples are:

• all sudden and unexplained deaths

• where the cause of death is unknown and a doctor cannot issue a certificate

• any death through unnatural or suspicious causes, for example suicide, violence, poisoning, accidents

• if the death occurred resulting from an operation or procedure

HM Coroner for Somerset is an independent judicial officer who enquires into those deaths that fall into the above categories.

HM Coroner’s Officers are independent representatives and work to the guidance of HM Coroner. They will be contacted by the doctor and HM Coroner who will decide one of 3 things:

• that the death was from natural causes and the doctor is permitted to issue the Medical Certificate of Cause of Death

• the cause of death is unknown, and a post-mortem examination is required

• the cause of death is unnatural, and an inquest is to be held