When someone dies, their GP surgery is usually one of the very first calls to make. If the death happened at home, the GP (or an out-of-hours doctor) may need to attend to verify the death. Even for hospital deaths, the surgery should be told promptly so that the patient’s records are updated and any ongoing services – appointments, repeat prescriptions, online access – are closed down.
But the GP surgery is only the starting point. The NHS is a collection of separate services, and death notification does not flow automatically between them. This guide covers the full picture: the Medical Certificate of Cause of Death, how to notify the surgery, what Tell Us Once does and does not handle, and the specific steps needed for the NHS app, organ donor registration, prescription prepayment certificates, and outstanding hospital appointments.
If you are working through everything that needs to be done, our notification checklist tool can help you build a personalised list of organisations to contact.
The Medical Certificate of Cause of Death
Before a death can be formally registered, a Medical Certificate of Cause of Death (MCCD) must be issued. This is a legal document that records the medical cause of death, and without it the registrar cannot register the death – which in turn means the funeral cannot proceed.
Who issues the MCCD
The MCCD is completed by the attending practitioner – a doctor who provided care to the deceased during their lifetime. That could be their GP, a hospital doctor, or a hospice doctor. Since September 2024, England and Wales introduced a new requirement: before the MCCD is sent to the registrar, it must be independently reviewed and approved by a medical examiner (a senior NHS doctor not involved in the patient’s care). The medical examiner scrutinises the cause of death and offers bereaved families the opportunity to ask questions or raise concerns about the care provided.
Scotland operates a different system: the Certification of Death (Scotland) Act 2011 introduced independent review by Medical Reviewers, but on a random sampling basis rather than for every death.
Deaths at home
If the death occurred at home, the GP or out-of-hours doctor attends to verify the death and, if the cause is known, begins the MCCD process. You should call the surgery during opening hours, or NHS 111 outside them. Once the medical examiner has approved the MCCD, it is sent directly to the registrar – and the 5-day statutory window to register the death begins.
Deaths in hospital
If the death happened in hospital, the hospital’s doctors complete the MCCD and the hospital’s medical examiner oversees the process. The hospital will usually notify the GP separately, but it is worth contacting the surgery yourself to confirm they have been informed.
Coroner referrals
Some deaths must be referred to the coroner – for example, unexpected deaths, deaths where the cause is unclear, or where the deceased had not seen a doctor recently. In these cases, no MCCD is issued until the coroner’s investigation concludes, and the registration process is paused until then. The coroner’s office will keep the family informed.
Notifying the GP surgery
How to notify
Phone the surgery directly. There is no national helpline for this, no online form, and the surgery cannot action a notification by email – GP systems require telephone contact for security reasons. You will need the full name and date of birth of the deceased, and ideally their NHS number if you have it.
When you call, explain that you are reporting the death of a patient. The receptionist will note the details and flag the record. The surgery will then:
- Close the patient’s GP record and deregister them from the practice
- Cancel any upcoming GP appointments
- Stop repeat prescription requests
- Alert any district nurses or community health teams who were visiting
- Pass relevant details to the medical examiner if the MCCD process has not already begun
When to call
Call as soon as practically possible after the death. If the death happened at home during surgery hours, this is often the first call you make. For hospital deaths, call within a day or two. You do not need to wait until after the funeral, or until you have the death certificate in hand.
Scotland and Northern Ireland
The process of notifying the GP surgery is the same across the UK. Scotland’s death certification is handled via Healthcare Improvement Scotland rather than the medical examiner system used in England and Wales, but from the family’s perspective the steps are identical: call the surgery and let them know.
Tell Us Once and NHS services
Tell Us Once is the free government service that lets you notify multiple government departments in one step. You access it when you register the death at the register office.
Tell Us Once notifies: HMRC, DWP, DVLA, the Passport Office, the local council, Veterans UK, Social Security Scotland (where applicable), and a range of public sector pension schemes – including NHS Pensions.
What Tell Us Once does NOT do for NHS services:
- It does not notify the GP surgery
- It does not close the NHS app or NHS login account
- It does not cancel a prescription prepayment certificate
- It does not remove the deceased from hospital waiting lists
The NHS Organ Donor Register is a partial exception – Tell Us Once does notify NHSBT (NHS Blood and Transplant) as part of its standard process. But given that NHS transplant teams check the register at the point any potential donation is assessed, families should also make sure they know the deceased’s recorded wishes.
The practical upshot: Tell Us Once is a valuable step, but it handles the government administration side of death notification, not the clinical NHS side. The steps below all need to be done separately.
Closing the NHS app account
The NHS app allows people to book GP appointments, view their health records, request repeat prescriptions, and manage their organ donation decision. If the deceased had an NHS login, their account does not close automatically on death.
To close it, you can contact NHS login support via the NHS website or call 0345 604 2683. You will need to confirm the identity of the account holder and the fact of the death. NHS login may request a copy of the death certificate.
A few things to be aware of:
- Logging in with the deceased’s credentials is not the right approach. Their NHS login is personal and tied to their identity verification. Instead, contact support to request closure.
- Health records are not deleted when the account closes. NHS records are retained after death under the NHS Records Management Code of Practice. In England, GP records are retained for a minimum of 10 years after death. Records are not the same as the app account – closing the account does not destroy the records.
- Family members cannot transfer or inherit access to a deceased person’s health records through the app. Access to records after death is governed by the Access to Health Records Act 1990, which allows the deceased’s personal representative (executor) to apply through the GP practice.
NHS organ donor registration
England operates an opt-out system for organ donation: anyone who has not recorded a decision is considered to have agreed to donate, unless they are in an excluded group (such as those who lack mental capacity, or are under 18). Wales has a similar system. Scotland introduced opt-out in 2021. Northern Ireland retains opt-in.
When someone dies and donation is medically possible, the NHS transplant team checks the NHS Organ Donor Register before any decision is made. The family is always consulted, regardless of what is recorded on the register. If the family’s wishes conflict with a registered decision, transplant teams take this into account – so it is worth making sure that the deceased’s wishes, wherever recorded, are known to the family.
Tell Us Once notifies NHSBT (NHS Blood and Transplant) as part of the death notification process. This updates the register to reflect the death. Families do not need to take any separate action on the organ donor register itself – though if you are unsure what the deceased had recorded, you can contact NHSBT on 0300 123 23 23 (available 24/7) to discuss this.
If the deceased had managed their organ donation decision through the NHS app, that decision remains on the register even after the account is closed.
Prescription prepayment certificates
A Prescription Prepayment Certificate (PPC) is a certificate that covers all of a person’s NHS prescription charges for a set period, regardless of how many items they need. It costs £32.05 for three months or £114.50 for 12 months (2025–26 prices). Anyone who takes three or more prescription items in three months typically saves money with a PPC.
When the holder dies, the PPC becomes invalid. A partial refund may be available depending on when the death occurred:
- Full refund: if the holder died during the first month of the certificate, or entered hospital or a hospice in the first month and subsequently died
- Partial refund: if the death occurred during months 2–11 of a 12-month PPC, or month 2 of a 3-month PPC
- No refund: if the death occurred during the final month of the PPC
To claim, send a copy of the death certificate (or interim death certificate) and a covering letter to the NHS Business Services Authority. The letter should include the PPC holder’s full name and address, and the contact details of whoever is claiming the refund.
You can submit by:
- Email: nhsbsa.ppc1@nhsbsa.nhs.uk
- Post: Policy Refunds, NHSBSA, Bridge House, 152 Pilgrim Street, Newcastle upon Tyne, NE1 6SN
- Online contact form: via nhsbsa.nhs.uk
- Phone: 0300 330 1343
Claims must be made within 24 months of the date of death. If the deceased had a standing order to renew the PPC automatically, cancel this through their bank as part of the general financial administration.
Hospital appointments and waiting lists
If the deceased had any outstanding hospital outpatient appointments, referrals, or waiting list positions, these do not automatically cancel. Hospital systems do not always communicate with each other, and a GP record closure does not cascade through the hospital network.
Contact each hospital directly, using the appointment letter or booking reference to identify the relevant department. For most appointments, a phone call to the outpatient bookings team at the relevant hospital is all that is needed.
If you are unsure which hospitals or consultants were involved, the GP surgery may be able to help – they hold referral records. The Patient Advice and Liaison Service (PALS) at each hospital trust can also help you navigate who to contact if you are not sure where to start.
Tips and things to watch out for
Security prevents email notification. GP surgeries cannot process a death notification by email. You must phone the surgery. This is a deliberate policy – patient records are sensitive, and email is not considered a secure enough channel for this kind of notification.
NHS records persist after death. Closing an NHS app account, deregistering from the surgery, and cancelling a PPC all relate to active NHS services. The underlying health record is kept separately and is not deleted. Under the NHS Records Management Code of Practice, GP records in England are retained for a minimum of 10 years after death. These records may be relevant if questions arise later about the deceased’s care – for example, if a medical negligence claim is being considered, or a coroner’s investigation requires review of clinical history.
No account transfer for medical records. There is no mechanism to transfer or inherit a deceased person’s online GP access. If you need to access their health records for legal or administrative reasons, the correct route is through the Access to Health Records Act 1990: the executor or personal representative can apply to the GP practice in writing.
Scotland uses different records management codes. The retention periods above apply to England. Scotland has separate NHS records management guidance. If the deceased was registered with a GP in Scotland, contact NHS National Services Scotland or the specific health board for guidance on retention periods.
Coroner involvement changes the MCCD timeline. If the death is referred to the coroner, the standard MCCD process does not apply. No MCCD is issued until the coroner closes the investigation, which can take weeks or longer. This delays death registration and, in turn, probate. The coroner’s office will advise you on next steps.
Summary
| Service | How to notify | Tell Us Once? | Notes |
|---|---|---|---|
| GP surgery | Phone the surgery directly | No – notify separately | Needed for MCCD process |
| NHS Spine (central records) | Automatic via GP system | Partial | Updated when GP closes record |
| NHS Organ Donor Register | Via Tell Us Once (NHSBT) | Yes | Transplant teams also check register at time of death |
| NHS app account | nhs.uk or 0345 604 2683 | No | Separate step; records not deleted |
| Prescription prepayment | NHSBSA – 0300 330 1343 | No | Refund may be available |
| Hospital appointments | Contact each hospital directly | No | Cancel outstanding bookings |
The GP surgery and MCCD come first. Everything else can follow once the immediate steps around death verification and registration are underway.
For a full list of organisations to notify, including banks, utilities, insurance, and government services, use our who do I need to notify? checklist tool.
Related guides: How to notify the DWP | How to notify HMRC | Tell Us Once explained | What to do after someone dies