All deaths should be reported via RADAR. 

When your patient has died and this was expected with a plan in place, nurses who have received training in Verification of Expected Death (VOED) can be contacted to visit the patient so the VOED policy and the North West Model for Life Limiting conditions care after death can be followed NHS England — North West » North West Model for Life Limiting Conditions

When a  patient with learning disability or autism dies, the LeDaR process must be followed:  LeDeR :: YourSpace Mersey Care and  NHS England » Learning from lives and deaths – People with a learning disability and autistic people (LeDeR)

Certification of death is the process of completing the 'Medical Certificate of the Cause of Death' (MCCD) by a medical practitioner in accordance with The Births and Deaths Registration Act 1953, underpinning the legal requirements for recording a person's death.

Any medical practitioner (doctor) who has attended the deceased within their lifetime can complete an MCCD if they can establish the cause of death to the best of their knowledge and belief, and the death is not required to be notified to the coroner.

Although there is no legal definition of 'attended', it is generally accepted to mean a medical practitioner who has cared for the patient and who is familiar with the patient's medical history, investigations and treatments. The attending practitioner must also have access to relevant medical records and the results of investigations. It is a legal requirement for a medical practitioner who meets the necessary criteria to establish the cause of death and complete the MCCD. 

If the medical practitioner has not seen the person prior to death, then they will need to view the deceased directly and not via video link. This can take place either in the patient's home or in the funeral directors.

The following advice should be given to the family and those important to the deceased:

  • The GP will sign the Medical Certificate of the Cause of Death (MCCD) and send this to the Medical Examiner's office.
  • The Medical Examiner has five days to scrutinise the cause of death and may contact the family to give them the opportunity to ask any questions and confirm the cause of death before countersigning the MCCD certificate.
  • The Medical Examiner sends the certificate to the local registry office who will contact the family to come in and register the death.
  • The family should wait to receive the death certificate before booking a funeral with a funeral director in case there is further examination required by the coroner. Please refer family to 'What to do when someone dies: step by step' - GOV.UK (www.gov.uk)

Mersey Care documents and policies

Please visit the policy's and procedure pagefor the followng policies:

  • P39 VOED Policy
  • SD47 End of Life Care
  • 84 Administration of Medicines via a Syringe Driver
  • 85 Administration of Subcutaneous Hydration for the Dying Patient
  • MMP01 Safe Management of controlled Drugs
  • MCT08 Controlled Drug Policy
  • SD07 B Unified Do not Attempt Cardiopulmonary Resuscitation (DNACPR) Adult Policy

National / regional guidance

What to do when someone dies: step by step - GOV.UK (www.gov.uk)

Hospice UK Care after death Care After Death guidance

Hospice UK Verification of death by registered nurse Care After Death: Registered Nurse Verification of Expected Adult Death guidance

Learning from deaths

Reflection is a good way to discuss both good deaths and those we have found difficult.  Using the below form will give structure to your reflection and can be done either as an individual or as a team.  You can also utilise this reflective practice as part of the revalidation process and clinical supervision. 

Mersey Care Lessons Learned