1. Certification of Death (Scotland) Act 2011

2. The Act is due to be fully implemented from 29 April 2015

3. Certification of Death (Scotland) Act 2011 The aims of the act are to: implement a new death certification system in Scotland which will introduce a single system of independent effective scrutiny; improve the quality and accuracy of medical certificates of cause of death (MCCDs); provide improved public health information; strengthen clinical governance in relation to death certification.

4. Certification of Death (Scotland) Act 2011 Scrutiny will be undertaken by Medical Reviewers and a Senior Medical Reviewer, who will carry out reviews to ensure the MCCD is completed accurately. There are two types of review: Level 1 – Check the MCCD and speak to certifying doctor (or another doctor in the team). 10% of all non PF deaths, approximately 4,000 per year or 77 per week will be carried out across Scotland. Level 2 – in addition to above: scrutiny of medical records and speaking to other relevant persons. Approximately 2000 per year or 40 per week will be carried out across Scotland.

5. Certification of Death (Scotland) Act 2011 Cases are selected at random, through the registration system, for Level One or Level Two reviews at the point of registration. The Medical Reviewer (MR) will be notified of the case and access to medical records will be required (mainly for Level Two), in order for the MR to carry out the review. Once the review is finished, the registration can be completed and the funeral can go ahead.

6. Advance Registration Allows funeral to go ahead before completion of review. Available only in special circumstances Religious/Cultural Compassionate Practical/Administrative

7. Local Implementation Groups Implementation Lead/Groups - responsible for ensuring local readiness for the new scrutiny system. Should include local NHS Board and hospice bereavement services All relevant staff are made aware of all the changes, and receive the necessary training on time. Develop co-ordinated processes to interact with the bereaved family and friends.

8. Certification of Death (Scotland) Act 2011 In order to minimise distress to the bereaved and prevent any delay to funerals it is essential that the MR can access hospital and GP records quickly and easily. Healthcare Improvement Scotland is now working with local implementation groups to ensure that each Health Board has a process and protocols in place to ensure quick and easy access to records for MRs.

9. Issues for Consideration How will Bereavement Co-ordinator’s role be affected/strengthened by the new system? How could Bereavement Co-ordinators support the new system to work effectively? The needs of the bereaved and minimising any additional distress are, of course, a priority. Are there any further issues which should be considered prior to implementation?

10. Death Certification Implementation Team Sarah Manson Policy Manager Sarah.manson@scotland.gsi.gov.uk Tel : 0131 244 2504 Sarah Dillon Policy Officer sarah.dillon@scotland.gsi.gov.uk Tel : 0131 244 2711 Contacts