For resources related to MCCDs in the context of the COVID-19 pandemic, please visit our dedicated webpage

The legislative context and key differences from pre-2015

The Certification of Death (Scotland) Act 2011 was designed to introduce a system of independent scrutiny of death certificates. This aims to improve the quality and accuracy of the information on MCCDs and to improve public health information.


The act introduces a system of review of MCCDs by Medical Reviewers through random scrutiny of a representative sample of all MCCDs that are not reported to the procurator fiscal, or involving stillbirth. Each review examines the appropriateness and accuracy of the completed certificate. They do not examine the clinical care prior to death.

Additional key differences introduced by the Act from 13th May 2015 include:

  • The end of additional paperwork and fees for cremations to make the process the same for everyone

  • The necessity that all deaths must be registered before either a burial or cremation can take place.


Link to the Death Certification Review Service - Top Tips for Certifying Doctors

Link to the Scottish Government Certification of Death Act webpages

Link to Healthcare Improvement Scotland Death Certification in Scotland webpages

Link to National Records of Scotland Registering a Death webpage

Death Certification, the Review Process and Discussions with Families


In this short film (aimed at medical staff in Scotland), Dr George Fernie (Senior Medical Reviewer, Healthcare Improvement Scotland) is seen in conversation with Dr Katherine Ritchie (Scottish Clinical Leadership Fellow) regarding the completion of Medical Certificates of Cause of Death (MCCD), talking about the content of these with families and the MCCD review process. 

A transcript for this video can be found here.