Bringing Matters to Rest Report

• New analysis from Co-op Funeralcare reveals that bereaved families in England are still facing funeral delays more than a year after the introduction of a death certification process which introduced extra reviews by independent senior doctors. [1]

• Whilst the Department of Health and Social Care recently stated that the Medical Certificate of Cause of Death (MCCD) should be approved “within 24 hours”, only a minority (18%) of Medical Examiner offices hit this target. [2]

• More than a quarter of cases (26.62%) were approved more than five days after death, according to further FOI data obtained from NHS trusts.

• The broad scope of the Medical Examiner system means there is less focus on ensuring dignified care of the deceased and a timely funeral for the deceased, which is leading to these problems.

• Co-op Funeralcare is, therefore, calling on the government to improve the system to put care for the deceased and their families at the heart of the death registration system by removing unnecessary delays, regardless of location.

Co-op Funeralcare, the UK’s leading funeral provider, is calling on the government to make urgent improvements to the current death certification system, warning that its analysis shows bereaved families are facing a funeral delay postcode lottery.

The member-owned organisation’s findings form part of its ‘Bringing matters to rest’ report, which suggests that, more than a year after Medical Examiners were introduced to the death certification process in September 2024, waiting times for MCCDs are stagnating and even increasing, with significant geographical variation. [3]

Whilst there is now no statutory timeframe for Medical Examiners to approve the MCCD, the Department of Health and Social Care recently recommended that MCCD should be approved “within 24 hours”, particularly in straightforward cases.

Yet, Freedom of Information data obtained by Co-op Funeralcare from NHS England suggests that no more than 18% of Medical Examiner offices have ever consistently met this target. Between October and December 2025, just 13 out of 125 offices approved MCCDs within an average of 24 hours of a death being referred to them. [4]

What’s more, across the full reporting period, more than a quarter of cases (26.62%) were approved more than five days after death, according to further FOI data obtained from NHS trusts. [5]

The findings also highlight clear regional disparities, reinforcing that these delays vary significantly depending on location and are essentially a postcode lottery:

• 39% of cases in the South East of England exceeded five days.
• 37% of cases in the North East & Yorkshire exceeded five days.
• In some regions, fewer than one in five cases exceeded five days, underlining the stark inconsistency.

At a local level, performance varies even more widely. The trust reporting the longest amount of time for approval was South Tyneside and Sunderland NHS Foundation Trust, where four in five (82%) MCCDs were approved more than five days after death.

Other trusts also reported consistently high proportions of MCCDs taking more than five days to approve, including:

• Maidstone and Tunbridge Wells NHS Trust (67%).
• East Kent Hospitals University NHS Foundation Trust (55%).
• County Durham and Darlington NHS Foundation Trust (69%).
• Sheffield Teaching Hospitals NHS Foundation Trust (51%).
• Mid Yorkshire Teaching NHS Trust (49%).

Prior to the reforms, there was a statutory timeframe of five days between death and death registration. However, under the new system, there is no such timeframe between death and the Medical Examiner approving the MCCD, it’s only after this point that the death must be registered within five days.

This means that there is no enforced time limit for Medical Examiners to approve the MCCD, which is a vital step in registering the death. As such, there is greater uncertainty not only for the funeral sector, but also for bereaved families who are unsure when they will be able obtain the death registration and subsequently confirm funeral arrangements.

This is due to the fact that burials or cremations cannot take place until the death is registered and as a result funerals have to be delayed, which creates added uncertainty for bereaved families at an already distressing time.

While the NHS trust FOI data shows a clear and sustained increase in approval time, the findings do not attribute the issue solely to Medical Examiners or the reforms themselves. A range of factors can influence the time taken to issue an MCCD, including referrals from community doctors, referrals to coroners and delays in communication.

Overall, the evidence suggests the system is under significant strain: under-resourced, fragile under pressure, and contributing to widening regional inequalities.

It also appears that these problems have occurred due to the broad scope of the Medical Examiner system which includes independent scrutiny of deaths and improving patient care and clinical standards. While important, these goals as currently operated are undermining the objective of ensuring dignified care and a timely funeral for the deceased.

As the nation’s leading funeral provider that's delivered expert care for the deceased for generations, Co-op Funeralcare is calling on the government to improve the system to prevent bereaved families facing funeral delays.

Michael Pengelly, Head of Client Operations at Co-op Funeralcare, said:

“At Co-op Funeralcare, we believe timely funerals are an important part of providing dignified care for the deceased, and we are committed to ensuring that bereaved families can lay their loved ones to rest within an appropriate and respectful timeframe.

“Our findings highlight the real and growing impact that delays in the death certification process are having on bereaved families across England. At an already difficult time, families are being left waiting longer to make funeral arrangements and say goodbye to their loved ones, often with little certainty around timings.

“While the Medical Examiner reforms were introduced with important intentions to strengthen safeguards, our data shows the system is currently under significant strain. The wide variation in delays between regions and trusts risks creating an unacceptable postcode lottery, where grieving families’ experiences depend on where their loved one dies.

“As experts in caring for the deceased, we want to work alongside clinical experts and the government to re-examine the current system to ensure that families can arrange a funeral promptly and with dignity, regardless of location, so that they can get the closure they need.”

Andrew Judd, CEO of The National Association of Funeral Directors (NAFD), said:

“NAFD members represented across England and Wales, including Co-op Funeralcare, have consistently reported significant delays across the entire death management pathway.

“NAFD members have also reported considerable regional variation in the length of time taken to complete Medical Examiner scrutiny, and inconsistent approaches to communication with Funeral Directors and the bereaved families they serve.

“We would like to see a comprehensive review of the entire journey from death to the funeral, with a clear focus on improving the experience for people dealing with grief at every stage.

“Funerals matter. They are a vital part of the grieving process, and people only get one chance to say goodbye. When funerals are delayed unnecessarily, it compounds distress at an already painful time.”

Notes:

1. Data collated by Co-op Funeralcare from FOI requests from NHS trusts, ONS statistics, and internal business data from October 2024 to December 2025.

2. In answer to a parliamentary question raised by MP Darren Paffey on death certification, Preet Kaur Gil of the Department of Health and Social Care stated on Monday 8 June 2026 that: “Medical Examiners and their officers are expected to complete their work without unreasonable delay and for straight-forward cases this should normally be completed within 24 hours.”

3. New process for death certification: Medical Examiners now oversee the issuance of the MCCD, in addition to those medical practitioners who originally record the death. The MCCD must then be sent to registrars before a death can be formally registered, delaying key stages of funeral planning, including processes such as embalming.

4. NHS England data covers every Medical Examiner office in the country. It includes averages, but not volumes.

5. FOI data from NHS trusts covers around two-thirds of Medical Examiner offices per region, so it does not cover 100% of Medical Examiner offices. It includes both volume and averages.