Bereavement: Information and guidance following your bereavement

This information aims to help you at this difficult time

Firstly, the hospital staff would like to offer their condolences to you, your family and friends.

This booklet is provided to help guide you through the arrangements that need to be made over the coming days and weeks.

It has been designed to provide you with information and advice on the issues to be addressed immediately following a death. It also gives guidance on who can help, and where further information can be obtained. It explains how to register the death and arrange the funeral.

Practical advice on what needs to be done

What needs to be done first?

On the first working day after your loved one has died, please contact the Bereavement Care Office on 01223 217537. The office is open from 08:00 (8am) until 16:00 (4pm) Monday to Friday excluding bank holidays and weekends. If there is no answer, please leave a message on the answerphone with your name and number; a member of the team will call you back as soon as we can. When we first speak to you we will take a contact name and number which we will then use for all further contact. Please tell us, if you are able to, whether you want a cremation or burial as additional paperwork might need to be completed by the hospital doctors.

Bereavement Care

The role of the bereavement co-ordinator is to support with information, liaising with the ward team to obtain the Medical Certificate of Cause of Death (MCCD) and assisting relatives and carers with registration of the death. Once the paperwork has been issued, we will be in contact with you to inform you of the next steps.

Contacting a funeral director

You can appoint a funeral director at any time so that you can begin to organise the funeral. We advise that you do not arrange a date for the funeral until you have been informed that you can register the death. Once you have registered you will be given a green form to take to your funeral director. This form is needed to finalise all the arrangements especially if the person who has died is to be cremated.

Deceased patient property

Please telephone the ward directly to arrange to collect any valuables or property.

The Medical Examiner

The Medical Examiner’s service is aimed at providing an independent review of all deaths. The service supports the ward teams in establishing the cause of death for the death certificate and ensuring that appropriate referrals are made to the Coroner. The Medical Examiners are Consultants who already work within the Trust and they are supported by Medical Examiner Officers and an administrator. An important part of the team’s role is in supporting you and your family in understanding what has been written on the death certificate and encouraging you to ask any questions you might have. The nominated person will be phoned to explain the content of the death certificate.

The Woodland Suite

Appointments to see your loved one whilst they remain in the hospital are managed by the mortuary team. If you wish to see your loved one, the mortuary staff can make you or other members of your family an appointment in the Woodland Suite. Please call the Mortuary on 01223 217106, Monday to Friday between 08:00 (8am) and 16:00 (4pm). Outside these times, please call the Contact Centre on 01223 245151 and ask to speak with the on-call mortuary technician.

The Coroner

It can be routine to refer certain deaths to the Coroner, in cases where, for example, the death is sudden, unexpected, due to an accident, or where the cause of death is unknown or unclear. In those circumstances, the hospital doctor will refer the death to the Coroner and you will then be contacted by a Coroner’s Officer who will provide further information on how the investigation into the death is progressing. Sometimes, the Coroner might decide that a post-mortem examination is necessary to establish the cause of death. Where this happens, the Coroner does not need to seek permission from relatives in order to proceed.

Where an investigation or inquest is triggered (usually after a post-mortem examination has taken place, but not always), the Coroner will issue an Interim Death Certificate and advise you on what the next steps are, together with their timescale. Where a death has been referred to the Coroner, the Bereavement Care team will ensure that we provide them with the next of kin’s contact name and number that we hold in our records. The Bereavement Care Team is not informed of progress with Coroner’s cases. We will provide you with the Coroner’s contact details so you can liaise with their officers directly.

Hospital post-mortem examination

This is usually performed at the request of the doctors who have been caring for the patient, or sometimes by the relatives, who may wish to learn more about the cause of death or the illness and use this knowledge to help other patients. All the details will be explained to you. Please be assured that a hospital voluntary post-mortem cannot take place without the explicit written consent of the next of kin.

How to register the death

Where is the death registered?

You have to register the death in the Registration District where it occurred. In Cambridgeshire there are register offices in Cambridge, Ely, Huntingdon, March and Wisbech.

Appointments

In order to enable you to make an appointment to register the death of your loved one, the Bereavement Care team will scan a copy of the Medical Cause of Death Certificate and send it to Registrations. Once this has been done, one of the team will ring you to give you the information you need to enable you to register the death. Appointments are available Monday to Friday 09:00 (9am) to 15:30 (3.30pm). You can either go online 24/7 to book via Cambridgeshire County Council (opens in a new tab) or call 0345 045 1363 (lines open 08:00 (8am) to 18:00 (6pm) Monday to Friday and 09:00 (9am) to 13:00 (1pm) Saturday, excluding bank holidays).

Who can register the death?

• A relative (this does not include common law partners or domestic partners) of the deceased.
• A person who was present at the time of death (the person who was present at the time of death does not need to be a relative).
• A person who is arranging the funeral (this does not have to be a family member).

What you will need to tell the Registrar

• The person's full name at time of death and any names previously used, including maiden surname.
• The person's date and place of birth (town and county if born in the UK and country if born abroad).
• Their home address.
• Their occupation.
• The full name, date of birth and occupation of their surviving (or deceased) spouse or civil partner.
• Whether they were getting a state pension or any other state benefit.

Useful documents and information regarding the deceased

You might find it helpful to have some of these documents to check the details you are giving to the registrar when you are registering the death:

• passports
• birth certificates
• marriage or civil partnership certificates
• utility bills
• change of name deeds
• NHS medical card

Registration

The Registrar will ask for confirmation of the spelling of names and any accents during the registration. At the end they will read back the information given and double check spellings before completing the registration. Please check the details very carefully as once the register page is completed any correction requested to a death entry will have to be accompanied by a non-refundable fee of £75 or £90 (depending on whether the correction can be done locally or has to be referred to the General Register Office). Any correction application must be made in the district where the event occurred.

Documents supplied following Registration

A Green Certificate for Notification of Burial or Cremation

Once you have registered need to take this form to your nominated funeral director so that the funeral can take place.

A Death Certificate

You will need a debit or credit card in your name to pay for each death certificate required. Each death certificate is currently £11 (price correct as of June 2022).

Tell Us Once service

Tell Us Once is a service that lets you report a death to most government organisations in one go. After you register the death, you must use the service within 28 days. You will be given a special reference number and the details of how to use the service.

Tell Us Once will notify:

• HM Revenue and Customs (HMRC) – to deal with personal tax (you need to contact HMRC separately for business taxes, like VAT)
• Department for Work and Pensions (DWP) – to cancel benefits, for example Income Support
• Passport Office – to cancel a British passport
• Driver and Vehicle Licensing Agency (DVLA) – to cancel a licence and remove the person as the keeper of up to five vehicles (contact DVLA separately if you keep or sell a vehicle)
• the local council – to cancel Housing Benefit, Council Tax Reduction (sometimes called Council Tax Support), a Blue Badge, inform council housing services and remove the person from the electoral register
• Veterans UK – to cancel Armed Forces Compensation Scheme payments

HM Revenue and Customs (HMRC) and the Department for Work and Pensions (DWP) will contact you about the tax, benefits and entitlements of the person who died.

Tell Us Once will also contact some public sector pension schemes so that they cancel future pension payments.

Checklist of things which might need to be done in the first few days and weeks

The UK government website (opens in a new tab) has a checklist of what to do when someone dies (opens in a new tab).

• Register the death except where the death has been referred to the Coroner, when you will need permission from the Coroner.
• Choose a funeral director and begin funeral arrangements.
• Tell government departments about the death (Tell Us Once service).
• Find the Will – there might be a copy with a solicitor.
• Notify the person’s landlord and other organisations. Organisations might include:
  • housing associations or council housing offices
  • banks, mortgage providers
  • employers
  • utility providers
  • insurers and creditors
• Deal with their estate (check if you need to apply for probate).
• Inform the GP.
• Return the person’s passport and driving licence.

Grief and symptoms of grieving

Bereavement, grief and loss causes many different symptoms and can affect someone in many different ways. There is no right or wrong way to feel. Some of the common symptoms include:

• Shock, numbness or confusion – this is usually the first reaction to loss, and people often talk about "being in a daze" or being on “automatic pilot”. You might not remember what people are saying to you and the reality of death might not have fully sunk in.
• Overwhelming sadness, or despair with lots of crying.
• Tiredness or exhaustion.
• Anger – towards the person you’ve lost or the reason for your loss.
• Guilt – for example, guilt about feeling angry, about something you said or did not say, or not being able to stop your loved one dying.
• Loneliness or isolation.

These feelings might appear unexpectedly and not be there all the time.

Ways of coping with loss

• Talk about your feelings with a friend, family member or counsellor.
• Allow yourself to grieve and to feel how you are feeling.
• Don’t try to do everything at once, set small achievable targets.
• Get enough sleep, eat a well-balanced diet and exercise regularly.

The Bereavement Care Follow-up Service

As a hospital, we realise that the death of a loved one can raise many questions for the bereaved. If not addressed, this can add to the distress that you experience. The Bereavement Care Follow-up Service was developed by Addenbrooke’s with the aim of providing support and help to those grieving, by offering an opportunity to talk with the consultant in charge of their loved one’s care. This service is provided for the families of all adults who die in Addenbrooke’s Hospital. For the families of those who die in the hospital aged 16 or under, similar help and support is offered by the child and family support counsellors.

Five weeks after the death of a patient, a letter is sent to the next of kin or the named contact inviting them and any other family members to a follow-up meeting. This is an opportunity to speak to either the consultant or the ward manager, depending on the nature of your questions, involved in your loved one’s care. The letter you will receive has a reply slip attached to it, and you can respond either by using the slip or by phoning the number on the letter. You will then be contacted to see how we might best be able to help in answering any questions you might have. These meetings are currently held by Zoom or telephone call. One of the Bereavement Care Follow-up team will also be at the meeting to make sure all your questions are answered.

We are here to help you at this difficult time, so please do not hesitate to reply to the letter. Even if you are unsure about how we might help, if we possibly can, we will.

Contacts and further information

If you have been bereaved at Addenbrooke’s Hospital or The Rosie Hospital, bereavement care is provided by the Bereavement Care Service located at Addenbrooke’s Hospital.

Bereavement Care Service

Box 136, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ 01223 217537, Email the Bereavement Care Service

Bereavement Care Follow-up Service

Box 105a, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ 01223 256076, Email the Bereavement Care Follow-up Service

Patient Advice and Liaison Service (PALS)

Box 53, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ 01223 216756, Email PALS