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Since 9 September 2024, every death in England and Wales is independently reviewed — either by a coroner, where the coroner has a duty to investigate, or by a medical examiner. The medical examiner is a senior doctor who was not involved in caring for the person who died. They check the proposed cause of death, then send the medical certificate of cause of death to the registrar so the death can be registered. The service is free.
The statutory medical examiner system began in England and Wales on 9 September 2024. From that date, every death must be independently reviewed: either the coroner investigates it, or a medical examiner scrutinises the cause of death. Medical examiners had existed on a non-statutory basis since 2019; what changed in September 2024 is that the scrutiny became compulsory and the medical certificate of cause of death now goes to the registrar from the medical examiner rather than from the family.
How long it takes:
No official figure is published for how long a medical examiner's scrutiny takes, and we are not going to invent one. GOV.UK says the doctor confirming the death and contacting the medical examiner "can take a few days", and that you must wait for the medical examiner's office to confirm you can register.
💡 What this means for you: Expect a phone call from the medical examiner's office before you can register the death. This is now a standard part of the process.
The Medical Examiner system aims to:
The attending practitioner — a doctor who attended the person during their lifetime — proposes a cause of death on the medical certificate of cause of death (MCCD) and sends it to the medical examiner. Since 9 September 2024 there is no longer any requirement that the doctor saw the patient in the 28 days before death, or saw the body afterwards.
A qualified Medical Examiner (a senior doctor) reviews the death and medical records to ensure the proposed cause of death is accurate.
The medical examiner's office contacts you to explain the cause of death and answer any questions about it or about the care the person received. GOV.UK states this is voluntary and you do not have to speak to them.
The ME either approves the MCCD, discusses amendments with the certifying doctor, or refers the death to the coroner if needed.
The medical examiner sends the MCCD to the registrar — you no longer carry it there yourself — and tells you that you can contact the register office. The five-day registration deadline runs from the day the registrar is notified of the cause of death, not from the date of death.
The medical examiner's office will typically:
The conversation is voluntary — GOV.UK says you do not have to speak to the medical examiner's office. No official figure is published for how long the call takes. You do not need to prepare anything.
No. Since 9 September 2024, scrutiny applies to every death in England and Wales that a coroner is not investigating — not just deaths anyone has questions about. It is an independent check on the cause of death, not an investigation.
The death cannot be registered until the medical examiner has finished, so the certificate for burial or cremation cannot be issued before then. No official figure is published for how long scrutiny takes. You can talk to a funeral director in the meantime, but the funeral cannot go ahead until the registrar has issued the certificate for burial or cremation.
Tell the medical examiner's office. They can discuss your concerns with the medical examiner and the certifying doctor. The medical examiner may seek further information or refer the death to the coroner.
Yes. Giving families a chance to raise concerns is one of the reasons the system was set up, and the medical examiner's office can point you to the relevant NHS complaints route.
No official timings are published for the stages before registration, so we have not put day numbers against them. What is fixed is the order, and where the legal deadline starts.
A doctor confirms the death and contacts the medical examiner. GOV.UK says this can take a few days.
The medical examiner scrutinises the proposed cause of death and their office contacts you.
The medical examiner sends the MCCD to the registrar and confirms to you that you can register.
You register the death — within five days of getting that confirmation, including weekends and bank holidays.
If you need more than five days, GOV.UK says to tell the register office immediately.
The circumstances in which a doctor must notify the coroner are set out in the Notification of Deaths Regulations 2019, as amended on 9 September 2024. In summary, the death must be reported where the doctor suspects it was due to:
It must also be reported where the doctor:
The old rule that a death had to be reported if no doctor had seen the person in the 28 days before death was withdrawn on 9 September 2024. If the coroner does take the case on, they take over from the medical examiner and the coroner's office will contact you.
Individual medical examiner offices set their own arrangements for things like meeting in person rather than speaking by phone, or putting information in writing. Ask the office dealing with the death.
Scotland has no medical examiners. Deaths that are not reported to the Procurator Fiscal are certified by the doctor, who sends the MCCD straight to the registration office. National Records of Scotland says around 12% of MCCDs are then selected at random by an automated system for review by the Death Certification Review Service, run by Healthcare Improvement Scotland. Scotland's registration deadline is 8 days from the date of death.
Northern Ireland has no statutory medical examiner system. Deaths are certified by a doctor and registered with a district registrar, or reported to the Northern Ireland Coroners Service. NIDirect says a death should be registered within five days.
The statutory medical examiner system began in England and Wales on 9 September 2024. Every death that a coroner is not investigating must now be scrutinised by a medical examiner — a senior doctor who was not involved in the person's care — before the death can be registered. It does not apply in Scotland or Northern Ireland.
No. Since 9 September 2024 scrutiny applies to every death in England and Wales that a coroner is not investigating, not just deaths anyone has questions about. Expect a call from the medical examiner's office — this is a normal part of the process, and GOV.UK says speaking to them is voluntary.
No official figure is published for how long a medical examiner's scrutiny takes. GOV.UK says only that the doctor confirming the death and contacting the medical examiner can take a few days, and that you must wait for the medical examiner's office to confirm before you register. The five-day deadline runs from that confirmation, not from the date of death.
The death cannot be registered until the medical examiner has finished, and the certificate for burial or cremation is issued at registration — so the funeral cannot take place before then. You can talk to a funeral director in the meantime. No official figure is published for how long scrutiny takes.
The medical examiner's office will confirm your relationship to the person who died, explain the cause of death in plain English, and answer questions about it or about the healthcare the person received. GOV.UK says the conversation is voluntary and you do not have to have it.
Yes. Giving families an opportunity to raise concerns about care is one of the reasons the system was created, and the medical examiner's office can point you to the relevant NHS complaints route.