Keeping care continuous: End-of-life certification over the holiday period

In the run up to the Christmas and New Year break, it is important we plan our cover arrangements so we continue to provide high-quality care for our enrolled populations.  

One aspect of this is the provision of death and cremation certificates during the holiday breaks.  

When we have people who are in rest homes or under palliative care on our books, it is an important part of the care plan to inform whānau of what happens when a person dies.  

Who will they call and when?  

If the person or service covering your holiday does not know, or has not cared for the person, they must view the body in person before they can provide a medical cause of death certificate (MCCD) and / or a cremation certificate.  

The person covering your break must also be able to access the medical records in order to be able to complete the MCCD.  

One way to address this is to plan ahead for these people. Discuss their case with the person covering you, before you go away. Ideally, ask the person covering you to speak to the patient or their whānau in a "warm handover" that means they are then able to honestly affirm they were involved in their care before the death.  

The cremation certificate usually requires the viewing of a body after death. 

How will the person or service covering you achieve this?  

Current legislation (valid officially until 31 December 2025, but we expect this to be extended) allows for GPs/NPs to provide a cremation certificate following a video viewing of the body in one very restricted circumstance.  

Video can be used when the person is known to the provider before they die and: 

• the death occurs in rest homes, residential care facilities, and other long-term in-patient facilities; and
• the death is not unexpected; and
• where the medical history and current conditions of the deceased are known by a medical or nurse practitioner.

You must also have a "trusted source" (usually a registered nurse) able to provide a reasonable level of assurance of the cause of death to verify the identity of the deceased, and that the deceased died of natural causes. You must record the identity, contact details, and position of the trusted source.  

When completing the certificate there is an option to select “the deceased was not examined after death as per the Minister's residential care facility exemption”. 

This exemption does not apply to deaths in public hospitals, hospices, private homes, or other settings and where a medical practitioner does not know the medical history of the individual.

Certifying practitioners are still required to view the body of a person who dies outside of a residential care facility in order to issue a cremation certificate. 

For more information see Te Whatu Ora's website.