Death Certification Review Service: standard reviews

Each year we review over 6000 Medical Certificates of Cause of Death (MCCDs). These are randomly selected for review by National Records of Scotland. These reviews are designed to check the quality and accuracy of MCCDs. The reviews also:

  • provide clinical governance of the death certification review process
  • improve how information about the cause of death is recorded

Review checks

We complete the reviews before the death registration process. This is to make sure that the information below is accurate on the certificate:

  • the deceased name and date of birth
  • the date, time and place of death
  • the certifying doctor details
  • for hospital deaths, the name of the responsible consultant
  • cause of death including any antecedent causes that directly led to the death
  • disposal hazards
  • other information from post mortem examination, including:
    • attendance on the deceased
    • accurate hazards
    • reporting to the Procurator Fiscal
    • maternal deaths
  • the certifying doctors signature

Types of review

There are three standard types of review. The reviews make sure that the certificate accurately reflects the cause of death. They also detail accurate sequencing of antecedent causes that directly led to the death.

Level 1

  • Review period: Complete in one working day
  • Medical reviewer checks: MCCD content and speaks to certifying doctor

Level 2

  • Review period: Up to three working days
  • Medical reviewer checks: MCCD content, the patients’ medical records and speaks to the certifying doctor

Hybrid level 1

  • Review period: Complete in one working day. Only used in exceptional circumstances
  • Medical reviewer checks: MCCD content and speaks to certifying doctor

National Records of Scotland is responsible for randomly selecting around 12% of MCCDs. This does not include sudden or suspicious deaths, both of which need to be reported to the Procurator Fiscal. It also does not include stillbirths. This means that we review around 6,000 MCCDs a year, with 10% selected for Level 1 review and 2% for Level 2 review.

Resources