The Act established the roles of Senior Medical Reviewer (SMR) and Medical Reviewers (MR) supported by medical reviewer assistants (MRA).

Together these roles make up the Death Certification Review Service (DCRS), part of Healthcare Improvement Scotland.

The primary function of the DCRS is to conduct reviews of MCCDs promptly and thoroughly. In addition, there is an educative role of training, guidance, and support for certifying doctors and the healthcare team with a view to improving the accuracy of completion of these certificates and supporting effective communication pre-death.