During this time it is vital that the MCCDs are completed accurately and meet current requirements for registration. Accurate MCCDs will help inform Public Health into the disease process, and distinguish between deaths directly caused by COVID-19 and those deaths that were contributed to by COVID-19. Accurate death certification also allows existing co-morbidities to be recorded accurately, helping to inform Public Health of ‘at risk’ groups as we continue to try and protect the vulnerable individuals in our population.
MCCDs that fail to meet the requirements of the Registrar will be rejected and the informant turned away if present. The death will then be notified to the coroner, even if there is no other reason to refer the death. This creates unnecessary burdens and work for the coroner and their officers. It also causes distress to the bereaved if this part of the process handled badly and in an insensitive manner. It is equally important in this difficult time that the bereaved be given an honest and open cause of death for their loved one.
It is also important to protect out Pathologists during this pandemic, by preventing unnecessary post mortem examinations – either coroner or consented post mortems, and to ensure that we do not over burden the coroner’s office with inappropriate referrals.
The eLearning designed for medical examiners has several important modules on death certification and referral to a coroner. The training can be accessed here: https://www.e-lfh.org.uk/ and you will need to register an account to access the training material. The following modules are recommended for the QDC role:
02_01 - The Medical Certificate of Cause of Death
02_02 - Completion of the Medical Certificate of Cause of Death Part 1: Formal Section
02_03 - Completion of the Medical Certificate of Cause of Death Part 2: Cause of Death
02_04 - Completion of the Medical Certificate of Cause of Death Part 3: Scenarios
06_03 - Scenario: When is Old Age Acceptable on an MCCD?
06_04 - Scenario: Expected Deaths Outside Hospital Including Palliated Cases
06_06 - Scenario: Death After Coronary Stenting
06_07 - Scenario: GP Case Cause of Death not Justifiable by Circumstances
06_11 - Scenario: Death of a Woman with Epilepsy
09_01 - HM Coroner’s Office Part 1: Office Structure and Remit
09_02 - HM Coroner’s Office Part 2: Coroner's Right to Investigate
09_03 - HM Coroner’s Office Part 3: Coroner's Investigation
09_04 - The Unnatural Death Part 1: Coroner's Jurisdiction
09_05 - The Unnatural Death Part 2: Unnatural Originating Events
09_06 - The Unnatural Death Part 3: Neglect or Medical Care
09_10 - Reportable Deaths.
The Royal College of General Practitioners has also provided an update training session in changes to death certification during the COVID crisis which can be accessed here: https://elearning.rcgp.org.uk/course/view.php?id=378