The “Attending Practitioner” Myth: Why Any Doctor Who Treated Your Loved One Can Now Sign the MCCD

One of the most frequent causes of distress for grieving families is being told: “The GP can’t sign the death certificate because they haven’t seen your loved one in the last 28 days.”

For years, this was a hard legal fact. It created a “Locum Trap” where families were forced into unnecessary Coroner referrals simply because their regular doctor was on holiday or the patient hadn’t visited the surgery recently.

As of September 9, 2024, this “28-day rule” is officially dead.

Under the new Medical Certificate of Cause of Death Regulations 2024, the criteria for who can sign has been fundamentally redefined. This guide explains the technical shift and how it eliminates one of the biggest bottlenecks in the registration process.

1. The Old Law vs. The New Logic

To understand why this is a “Remarkable” shift for families, we have to look at what changed in the statutory language:

• Pre-Sept 2024: A doctor could only sign the Medical Certificate of Cause of Death (MCCD) if they had “attended” the deceased during their last illness and had seen them either within 14 days of death (extended to 28 days during the pandemic) or after death.
• Post-Sept 2024: The requirement to have seen the patient within a specific timeframe (14 or 28 days) has been abolished.

The new legal standard is simply that the doctor must be an “Attending Practitioner” (AP)—defined as any GMC-registered doctor who attended the deceased during their lifetime.

2. Why This Matters: The End of “The Locum Delay”

Previously, if your parent passed away at home and their specific GP was away, the surgery would often say, “No other doctor can sign because they haven’t seen the patient recently. This must go to the Coroner.”

This triggered a “Defensive Medicine” loop. Coroners were being flooded with natural, expected deaths simply because of a calendar technicality.

The New Reality: If any doctor in the practice has treated the patient for their condition at any point in the past, they are now legally empowered to propose a cause of death. They do not need to have seen the patient in the final weeks, provided they can identify a probable cause of death from the medical records.

3. The Role of “Independent Scrutiny”

You might wonder: If a doctor hasn’t seen the patient for months, isn’t it dangerous for them to sign?

This is why the Medical Examiner (ME) system was introduced. The new law shifts the burden of “accuracy” from the calendar to the Medical Examiner.

1. The Attending Practitioner proposes the cause based on their knowledge of the patient’s history.
2. The Medical Examiner reviews the full medical record to ensure that cause makes clinical sense.
3. This double-check allows for flexibility in who signs without compromising the safety of the system.

4. What to do if you are told “The GP can’t sign”

If you find yourself in a surgery or hospital where staff are citing the “28-day rule,” you are likely dealing with “Legacy Knowledge.” Here is your technical script to resolve the situation:

• The Citation: “Under the Medical Certificate of Cause of Death Regulations 2024, the requirement for a doctor to have seen the patient within 28 days has been removed.”
• The Request: “Can you please check if there is any ‘Attending Practitioner’ in the practice who has treated [Name] during their lifetime? They are now authorized to propose a cause to the Medical Examiner.”
• The Outcome: This usually prompts the surgery to contact their local Medical Examiner’s office, who will confirm the new rules and help the GP process the paperwork.

5. Frequently Asked Questions (FAQ)

Q: What if NO doctor at the surgery ever saw the patient? A: If no doctor attended the patient during their lifetime (e.g., they just moved to the area), then the death must still be referred to the Coroner. However, this is now a rare edge case.

Q: Does the doctor still need to see the body after death? A: No. There is no longer a statutory requirement for a doctor to physically “verify” or “view” the body for the purposes of the MCCD, as the Medical Examiner provides the independent check of the records.

Q: Will this make the process faster? A: Yes. By removing the “28-day bottleneck,” more doctors are available to start the paperwork, preventing cases from being unnecessarily stuck in the Coroner’s queue.

Expert Summary

The “28-day rule” was a blunt instrument that caused thousands of families to suffer through unnecessary inquests. Its removal is a victory for common sense and “Unreasonable Hospitality” in the death registration process.

As an Executor, you no longer need to panic if your loved one’s doctor is on leave. The law now prioritizes clinical knowledge over calendar dates.

Next Step: Once the Attending Practitioner proposes the cause, the next milestone is the Medical Examiner Officer (MEO) call. Use our 72-Hour Limbo Checker to track how your case is moving through this new, simplified relay.