The process of death certification and registration is complex, and no single department has policy and operational responsibility.

Alignment is needed, including the availability of the medical practitioner who attended the deceased, the medical examiner who scrutinises the proposed cause of death, and finally the Registrar who registers the death. The availability of general practitioners is not controlled by the Department, it is determined by local National Health Service arrangements, and the General Register Office is responsible for the availability of registrars.

The National Medical Examiner provides guidance to medical examiner offices for weekend and public holiday cover and urgent release of a body in circumstances where a bereaved families may have particular reasons to request urgent release of the deceased’s body for burial. The National Medical Examiner annual report for 2025 demonstrates the improving resilience in the system, with medical examiner offices in England reporting they were able to facilitate requests for rapid scrutiny in approximately 90% of requests. The medical examiner system has reduced inappropriate referrals to the coroner and the rate of postmortems, both of which can add significant additional time until burial.

Responsibility for ensuring that medical examiner services respond to local needs sits with trusts. Arrangements should reflect local health priorities and the needs of communities, particularly if there is regular demand for the urgent release of bodies at weekends and public holidays.

The Department is monitoring the introduction and implementation of the death certification reforms and continues work to drive improvement.

The Department has worked extensively with healthcare professionals and other stakeholders on the death certification reforms.

The Department’s formal consultation in March 2016 sought direct views from National Health Service clinicians, medical examiners, coroners, registrars, regulatory bodies, funeral industry, cremation and burial authorities, faith groups, and the public, regarding the feasibility of proposals for changes to the death certification process in England and Wales. The June 2018 consultation response demonstrated that there was widespread support for the aims of the reforms and for the introduction of medical examiners.

The Department and NHS England have continued to work closely with these groups to support the introduction of the medical examiner system, and post-implementation monitoring following the introduction of the reforms on 9 September 2024.

The Department also conducted impact assessments, published in 2018, 2022, and 2024, that demonstrated that any new cost to doctors or business from implementing the statutory system would be minimal or zero.

The National Medical Examiner publishes an annual report setting out how medical examiners have exercised their functions. These reports reflect on how the statutory system continues to be implemented smoothly, reporting unprecedented reductions in unnecessary referrals to coroners, a 99.7% reduction of uncertified deaths, and ensuring the bereaved remain at the heart of the reforms, with half a million bereaved taking up the opportunity to ask questions, and raise concerns with a medical examiner in 2025.

The Department is monitoring the introduction of the reforms.

The Department has worked extensively with healthcare professionals and other stakeholders on the death certification reforms.

The Department’s formal consultation in March 2016 sought direct views from National Health Service clinicians, medical examiners, coroners, registrars, regulatory bodies, funeral industry, cremation and burial authorities, faith groups, and the public, regarding the feasibility of proposals for changes to the death certification process in England and Wales. The June 2018 consultation response demonstrated that there was widespread support for the aims of the reforms and for the introduction of medical examiners.

The Department and NHS England have continued to work closely with these groups to support the introduction of the medical examiner system, and post-implementation monitoring following the introduction of the reforms on 9 September 2024.

The Department also conducted impact assessments, published in 2018, 2022, and 2024, that demonstrated that any new cost to doctors or business from implementing the statutory system would be minimal or zero.

The National Medical Examiner publishes an annual report setting out how medical examiners have exercised their functions. These reports reflect on how the statutory system continues to be implemented smoothly, reporting unprecedented reductions in unnecessary referrals to coroners, a 99.7% reduction of uncertified deaths, and ensuring the bereaved remain at the heart of the reforms, with half a million bereaved taking up the opportunity to ask questions, and raise concerns with a medical examiner in 2025.

The Department is monitoring the introduction of the reforms.

The Department has worked extensively with healthcare professionals and other stakeholders on the death certification reforms.

The Department’s formal consultation in March 2016 sought direct views from National Health Service clinicians, medical examiners, coroners, registrars, regulatory bodies, funeral industry, cremation and burial authorities, faith groups, and the public, regarding the feasibility of proposals for changes to the death certification process in England and Wales. The June 2018 consultation response demonstrated that there was widespread support for the aims of the reforms and for the introduction of medical examiners.

The Department and NHS England have continued to work closely with these groups to support the introduction of the medical examiner system, and post-implementation monitoring following the introduction of the reforms on 9 September 2024.

The Department also conducted impact assessments, published in 2018, 2022, and 2024, that demonstrated that any new cost to doctors or business from implementing the statutory system would be minimal or zero.

The National Medical Examiner publishes an annual report setting out how medical examiners have exercised their functions. These reports reflect on how the statutory system continues to be implemented smoothly, reporting unprecedented reductions in unnecessary referrals to coroners, a 99.7% reduction of uncertified deaths, and ensuring the bereaved remain at the heart of the reforms, with half a million bereaved taking up the opportunity to ask questions, and raise concerns with a medical examiner in 2025.

The Department is monitoring the introduction of the reforms.

The National Medical Examiner (NME) Annual Report for 2025 has assessed the potential impact of medical examiner scrutiny on the completion of Medical Certificates of Cause of Death (MCCDs). The typical time to register deaths is seven to eight days, compared to six to seven days under the previous arrangements which offered significantly less assurance and required next of kin to register deaths more quickly.

The NHS England and NHS Wales Shared Services Partnership monitor the work of medical examiner offices, including the time taken, though the integrity of scrutiny. Between October and December 2025, 105 medical examiner offices in England, or 84%, reported a median time of five days or fewer to send MCCDs to registrars after a death. More than a third reported a median time of three days or fewer.

The Office of National Statistics (ONS) published an interim report on the death certification reforms in October 2025 which noted there had been a general downward trend in the overall median time throughout 2025, and it is now closer to pre-death certification reform levels. A further full ONS report is expected to be produced by the end of 2026.

The NME has oversight of the medical examiner system and regularly reviews performance of individual offices through regional medical examiners who provide support and challenge.

The NME report for 2025 sets out priorities for further improvement and a commitment to identify and reduce or eliminate avoidable delays to death certification without compromising the integrity of independent medical examiner scrutiny.

The NME report has also assessed the potential impact of delays on bereaved families and funeral arrangements, concluding that all those involved in certification and registration must continue to work together to avoid causing unnecessary delay and distress to bereaved families.

The bereaved are at the heart of the death certification reforms. The NME report demonstrates the commitment to provide a better service for the bereaved, reporting that where bereaved people request more rapid registration of deaths, to avoid unnecessary distress for bereaved families, medical examiner offices were able to facilitate 90% of these requests for rapid scrutiny.

Feedback received by medical examiner offices, and presented in the NME report, from the bereaved on the medical examiner process continues to be overwhelmingly positive, noting the compassion shown by medical examiners and officers and the comfort and reassurance they provide.

The National Medical Examiner (NME) Annual Report for 2025 has assessed the potential impact of medical examiner scrutiny on the completion of Medical Certificates of Cause of Death (MCCDs). The typical time to register deaths is seven to eight days, compared to six to seven days under the previous arrangements which offered significantly less assurance and required next of kin to register deaths more quickly.

The NHS England and NHS Wales Shared Services Partnership monitor the work of medical examiner offices, including the time taken, though the integrity of scrutiny. Between October and December 2025, 105 medical examiner offices in England, or 84%, reported a median time of five days or fewer to send MCCDs to registrars after a death. More than a third reported a median time of three days or fewer.

The Office of National Statistics (ONS) published an interim report on the death certification reforms in October 2025 which noted there had been a general downward trend in the overall median time throughout 2025, and it is now closer to pre-death certification reform levels. A further full ONS report is expected to be produced by the end of 2026.

The NME has oversight of the medical examiner system and regularly reviews performance of individual offices through regional medical examiners who provide support and challenge.

The NME report for 2025 sets out priorities for further improvement and a commitment to identify and reduce or eliminate avoidable delays to death certification without compromising the integrity of independent medical examiner scrutiny.

The NME report has also assessed the potential impact of delays on bereaved families and funeral arrangements, concluding that all those involved in certification and registration must continue to work together to avoid causing unnecessary delay and distress to bereaved families.

The bereaved are at the heart of the death certification reforms. The NME report demonstrates the commitment to provide a better service for the bereaved, reporting that where bereaved people request more rapid registration of deaths, to avoid unnecessary distress for bereaved families, medical examiner offices were able to facilitate 90% of these requests for rapid scrutiny.

Feedback received by medical examiner offices, and presented in the NME report, from the bereaved on the medical examiner process continues to be overwhelmingly positive, noting the compassion shown by medical examiners and officers and the comfort and reassurance they provide.

The National Medical Examiner (NME) Annual Report for 2025 has assessed the potential impact of medical examiner scrutiny on the completion of Medical Certificates of Cause of Death (MCCDs). The typical time to register deaths is seven to eight days, compared to six to seven days under the previous arrangements which offered significantly less assurance and required next of kin to register deaths more quickly.

The NHS England and NHS Wales Shared Services Partnership monitor the work of medical examiner offices, including the time taken, though the integrity of scrutiny. Between October and December 2025, 105 medical examiner offices in England, or 84%, reported a median time of five days or fewer to send MCCDs to registrars after a death. More than a third reported a median time of three days or fewer.

The Office of National Statistics (ONS) published an interim report on the death certification reforms in October 2025 which noted there had been a general downward trend in the overall median time throughout 2025, and it is now closer to pre-death certification reform levels. A further full ONS report is expected to be produced by the end of 2026.

The NME has oversight of the medical examiner system and regularly reviews performance of individual offices through regional medical examiners who provide support and challenge.

The NME report for 2025 sets out priorities for further improvement and a commitment to identify and reduce or eliminate avoidable delays to death certification without compromising the integrity of independent medical examiner scrutiny.

The NME report has also assessed the potential impact of delays on bereaved families and funeral arrangements, concluding that all those involved in certification and registration must continue to work together to avoid causing unnecessary delay and distress to bereaved families.

The bereaved are at the heart of the death certification reforms. The NME report demonstrates the commitment to provide a better service for the bereaved, reporting that where bereaved people request more rapid registration of deaths, to avoid unnecessary distress for bereaved families, medical examiner offices were able to facilitate 90% of these requests for rapid scrutiny.

Feedback received by medical examiner offices, and presented in the NME report, from the bereaved on the medical examiner process continues to be overwhelmingly positive, noting the compassion shown by medical examiners and officers and the comfort and reassurance they provide.

I am aware of the case that she raises, and I know the honourable member has written to the Foreign, Commonwealth and Development Office about it and that officials are in touch with her constituent. There is no guidance on the specific circumstances she raises.

Civil registration fees, including those for issuing certificates, are set at a level to recover the full cost of delivering the service in line with HM Treasury’s Managing Public Money Principles.

Registration officials can waive, reduce, or refund any fee in exceptional circumstances due to hardship or for compassionate reasons.

Civil registration fees, including those for issuing certificates, are set at a level to recover the full cost of delivering the service in line with HM Treasury’s Managing Public Money Principles. All fees are reviewed to prevent them falling below cost recovery levels; the fee for a certificate was last increased in May 2024.

The National Medical Examiner produces the Good Practice Series, a topical collection of focused summary documents, designed to be easily read and digested by busy front-line staff, including medical practitioners, with links to further reading, guidance, and support. The collection is published online by the Royal College of Pathologists.

In June 2022, the National Medical Examiner’s Good Practice Series No. 7 - Mental health and eating disorders was published, and a copy is attached. The paper explores the role medical examiners can play in identifying links between mental health disorders and causes of death, notifying others when lessons can be learned so that care of future patients with mental health conditions is improved, and ensuring medical certificates of cause of death are completed appropriately.

We believe the answer of 17 February 2025 refers to the answer given to Question 29570. The Department’s monitoring of the impact of death certification reforms, including the time to register a death, includes consideration of:

• the annual report of the National Medical Examiner, which was published on 11 September 2025, and the next annual report is expected in early Summer 2026. The report published on 11 September 2025 is available at the following link: https://www.england.nhs.uk/long-read/national-medical-examiner-report-2024/;
• published data from the Office of National Statistics (ONS), including the Analysis of death registrations since death certification reform, published on 9 October 2025, and we expect the ONS to publish a further report later in 2026. This report is available at the following link: https://www.england.nhs.uk/long-read/national-medical-examiner-report-2024/; and
• feedback from a wide range of partners including NHS England, the National Medical Examiner, the Welsh Government, the General Register Office, the funeral sector and faith groups, and the Royal College of Pathologists.

Responsibility for ensuring that medical examiner services respond to local needs sits with trusts. Most medical examiners’ work can be undertaken during normal office hours with cover for weekends and public holidays likely to be required in most areas. Arrangements at each office should reflect local health priorities and the needs of communities, particularly if there is regular demand for the urgent release of bodies at weekends and public holidays. The National Medical Examiner provides guidance to medical examiner offices for weekend and public holiday cover and for the urgent release of a body in circumstances including where a bereaved families may have particular reasons to request urgent release of the deceased’s body for burial. This guidance is available at the following link:

https://www.rcpath.org/static/3590bf7f-a43e-4248-980640c5c12354c4/Good-Practice-Series-Urgent-release-of-a-bodyFor-Publication.pdf

Data indicates that 90% of urgent requests for swift scrutiny are met. The chief reason why requests were not met is because the cause of death is complex and therefore additional time was required to determine the cause.

The five-day timeframe in England and Wales to register a death starts once the medical examiner has sent the medical certificate of cause of death to the registrar. While the guidance provided on GOV.UK is up to date, the General Register Office for England and Wales will continue to work with relevant departments to ensure that this information best supports the bereaved. Civil registration is a devolved matter in Scotland and Northern Ireland.

To ask His Majesty’s Government whether they intend to update the Government website page on registering a death, specifically the requirement to do so within five days.

I offer my condolences to the noble Baroness on her loss. She has a point. I have discussed this with officials and we are looking at how we can improve the website and make some changes to it. That will be done, and I will write to the noble Baroness within a month, when it has been completed.

My Lords, recently, it took nine days to register my sister’s death, instead of the five stated on the website. The medical examiner’s office and the registrar both told me that, every day, bereaved families are confused and distressed, as they believe that they are breaking the law because they think it is death that triggers the five-day clock and not the medical examiner signing the papers off. The noble

Baroness, Lady Hollins, told me that her medical examiner was taking up to a month to do this and that there were further delays in registering the death. Will the Government update the website, adding the certifying hospital doctor—the first step that the public encounter—ahead of the medical examiner’s role, to clarify the timeline? Will the Government review the five-day rule in the light of delays in some ME and registrar services?

There are two points here. The median figure that we have assessed for the issues that the noble Lord has raised is nine days. The published data does not break down the journey between the medical certificate of death and the registration of death. From the Home Office’s perspective, the registration process is more or less on target at the five-day period. Where there is a delay on occasions, it is between death occurring and the medical examiner’s certificate being issued. I will be drawing that issue to the attention of my noble friend Lady Merron, as it is a Department of Health matter. Again, the Government are committed to trying to resolve and improve performance on this.

My Lords, has the Minister seen the article in last week’s Times:

“Death certificates take twice as long after reforms choke system”,

with only one in six being delivered within a fortnight, adding to the costs for the funeral director and to the distress of relatives? What action are the Government taking to deal with that delay?