What Happens First After a Death

If the death occurs in hospital

If the death occurs in hospital, the hospital staff will contact the person named by the deceased as next of kin. This may be, but need not be, a relative. You may, if you wish, request to see the hospital chaplain. The hospital will keep the body in the hospital mortuary until the executor arranges for it to be taken away. Most funeral directors have a chapel of rest in which the deceased will be held pending the funeral. Hospital staff will arrange for the nearest relative to collect the deceased’s possessions.

If the death occurs elsewhere

Expected death

If the death was expected, contact the doctor who attended the deceased during their final illness. If the doctor can certify the cause of death he or she will give you the following:

  • a Medical Certificate that shows the cause of death (this is free of charge and will be in a sealed envelope addressed to the registrar)
  • a Formal Notice that states that the doctor has signed the Medical certificate and tells you how to get the death registered.
  • You may wish to contact the deceased’s minister of religion if you have not already done so. Arrangements for the funeral may be made by a funeral director.

If death followed illness from HIV or AIDS there may be special rules about handling the body. The Terence Higgins Trust can advise on funeral arrangements. They can be contacted at the following address:

Terence Higgins Trust
52-54 Grays Inn Road
London
WC1X 8JU

Helpline: 0845 1221 200

Email: info@tht.org.uk

Website: www.tht.org.uk

Unexpected death

If you discover a body or the death is sudden or unexpected, you should contact the following people:

  • The family doctor (if known)
  • The deceased’s nearest relative
  • The deceased’s minister of religion
  • The police, who will help find the people listed above if necessary.

 The death may be referred to the coroner.

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If the death occurs abroad

If the death occurred abroad, or on a foreign ship or aircraft, you should register the death according to the local regulations of that country and get a Death Certificate.

Also register the death with the British Consul so that a record of the death will be kept in England. You will be able to get a copy of the Death Certificate from the consulate later or from the:

Foreign and Commonwealth Office
Nationality and Passport Section
Room E502
King Charles Street
London SW1A 2AH

Telephone: 020 7008 0186 (Open between 10am - 12noon Mon - Fri)

Email: BMDenquiries@fco.gov.uk

website: www.fco.gov.uk

 

Cause of death

If the cause of death is quite clear the doctor will give you a Medical Certificate and a Formal Notice that the Medical Certificate has been signed.

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Post-mortem

If the death was known to be caused by a natural illness but the doctors wish to know more about the cause of death, they may ask the relatives for permission to carry out a post-mortem examination. This is a medical examination of the body which can find out more about the cause of death and should not delay the funeral.

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Reporting a death to the coroner

In any of the following circumstances the doctor may report the death to the coroner (for more details on what the coroner does):

  • an accident or injury
  • an industrial disease
  • during a surgical operation
  • before recovery from an anaesthetic
  • if the cause of death is unknown
  • the death was sudden and unexplained, for instance, a sudden infant death (cot death).

The coroner may be the only person who can certify the cause of death. The doctor will write on the Formal Notice that the death has been referred to the coroner.

If the doctor treating the deceased had not seen him or her, either after death or within 14 days before death, the death must be reported to the coroner.

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If the organs or body are to be donated

You will have to act quickly if it was the wish of the deceased or the nearest relative to donate the organs for transplant, or the whole body for medical teaching purposes.

The usual procedure is to approach the next of kin to make sure they do not object to organ donation.

If the death was in a hospital or similar institution, the head of that institution is lawfully in possession of the body. They may honour the deceased’s request, in writing or orally before two witnesses, for the body to be given for medical research, if there is no reason to think the request withdrawn.

If the death has to be reported to the coroner, the coroner’s consent may be necessary before the organs or body can be donated. A medical certificate must be issued before any organs can be removed or the body used.

It is usual for kidneys, and essential for heart, lungs, liver and pancreas, to be removed from donors:

  • who have been certified to be brain stem dead
  • and whose breathing, and hence heartbeat, are maintained by a ventilator in a hospital intensive care unit.

Kidneys can, very rarely, be removed up to an hour after heart death. Other organs can be removed up to the following times after heart death:

  • the corneas (from the eyes) – up to 24 hours
  • skin – up to 24 hours
  • bone – up to 36 hours
  • Heart valves – up to 72 hours.

The doctor attending will advise on procedure. After organ donation, the body is released to the relatives.

 

The coroner

The coroner is a doctor or lawyer responsible for investigating deaths in the following situations:

  • the deceased was not attended by a doctor during the last illness or the doctor treating the deceased had not seen him or her either after death or within the 14 days before death
  • the death was violent or unnatural or occurred under suspicious circumstances
  • the cause of death is not known or is uncertain
  • the death occurred while the patient was undergoing an operation or did not recover from the anaesthetic
  • the death was caused by an industrial disease
  • the death occurred in prison or in police custody.

If you want advice or information about a death which has been reported to the coroner, contact the coroner’s office. You can get the address from the police station or, if death was in hospital, the hospital official dealing with deaths.

Coroner's post-mortem

The coroner may arrange for a post-mortem examination of the body. The consent of the relatives is not needed, but they are entitled to be represented at the examination by a doctor. When relatives have told the coroner they wish to be represented, the coroner will, if at all practicable, tell them when and where the examination will be.

If the death occurs in hospital, the coroner will arrange for the examination to be carried out by a pathologist other than one employed at or connected with that hospital, if a relative asks the coroner to do so and if it does not cause an undue delay.

The removal of a body from the place of death to the mortuary for post-mortem examination will usually be paid for by the coroner. The relatives may choose the funeral director.

However, in some areas a funeral director will be appointed by the coroner to remove the body from the place of death to the hospital mortuary. The relatives can then choose a funeral director to carry out the funeral, once the coroner has released the body.

If the post-mortem shows that death was due to natural causes, the coroner may issue a notification known as Pink Form B (form 100) which gives the cause of death so that the death can be registered. The coroner usually sends the form direct to the registrar but may give it to you to deliver.

If the body is to be cremated the coroner will give you the Certificate for Cremation (form E) which allows cremation to take place.

Inquest

An inquest is an enquiry into the medical cause and circumstances of a death. It is held in public, sometimes with a jury. It is up to the coroner how to organise the enquiry in a way to best serve the public interest and the interests of the relatives.

The coroner will hold an inquest if the death was:

  • violent or unnatural
  • or caused by a reportable industrial disease
  • or the death occurred in prison
  • or if the cause of death remains uncertain after post-mortem examination.

Coroners hold inquests in these circumstances even if the death occurred abroad (and the body is returned to Britain). If a body is lost (usually at sea) a coroner can hold an inquest by order of the Secretary of State if death is likely to have occurred in or near a coroner’s jurisdiction.

If an inquest is held, the coroner must inform the following people:

  • the married partner of the deceased
  • the nearest relative (if different)
  • And the personal representative (if different from above).

Relatives can attend an inquest and ask questions of witnesses but they may only ask questions about the medical cause and circumstances of the death.

It may be important to have a lawyer to represent you if the death was caused by a road accident, or an accident at work, or other circumstances which could lead to a claim for compensation. You cannot get legal aid for this. If the enquiries take some time, ask the coroner to give you a letter confirming the death. You can use this letter for social security and National Insurance (NI) purposes.

The coroner may give you an Order for Burial (form 101) or a Certificate for Cremation (form E) so that the funeral can take place. This may be done before the inquest is completed, provided the body is not required for further examination. The coroner will also send a Certificate after Inquest (form 99 (rev)), stating the cause of death, to the registrar. This allows the death to be registered.

Moving a body out of England or Wales

Only the coroner can give permission for a body to be moved out of England or Wales. This permission has to be obtained at least 4 days before the body is to be moved (although the coroner may be able to give permission sooner) so that any necessary enquiries may be carried out. Afterwards you will be given a Removal Notice (form 104), part of which is sent to the registrar after the funeral. Permission must be obtained whenever the funeral is to take place outside England or Wales.

This procedure applies in all cases where the body is to be moved out of England or Wales, not just where a death was reported to the coroner.

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The initial arrangements

You will need to decide: 

  • where the body is to rest while awaiting the funeral
  • the time and place of the funeral 
  • how much you intend to spend on the funeral 
  • whether to have a funeral service 
  • whether to have flowers, or to make any donations to a named charity
  • whether to put a notice in the newspapers
  •  
  • whether to order a website or online obituary
  • Whether the body should be buried or cremated. 

 

When registering a death

You will usually get a

From

If the death is not referred to a coroner

Medical Certificate

the doctor

In all cases

Formal Notice

the doctor

If a baby is stillborn

Medical Certificate of Stillbirth

the doctor or midwife

If the death is referred to a coroner but there is no inquest

Notification by the Coroner (Pink Form B/ form 100)

the coroner (this is usually sent direct to the registrar, but you may be asked to deliver it)

If there is an inquest and the body is to be buried

Order for Burial (form 101)

the coroner

If there is a post-mortem or an inquest and the body is to be cremated

Certificate for Cremation (form E)

the coroner

If the body is to be moved out of England or Wales

Removal Notice (form 104)

the coroner

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