Useful information following a bereavement

We will provide you with information about bereavement support services and practical advice about the things you may need to do following a bereavement. This could include:

• collecting any personal items belonging to the person who has died
• making arrangements to see the person who has died
• collecting the death certificate
• how to register the death

As a family member, partner, friend or carer of someone who has died while in the care of our trust you may have comments, questions or concerns about the care and treatment they received. You may also want to find out more information about the reasons for their death. The staff who were involved in treating the patient before their death should be able to answer your initial questions.

If you think of questions later you can always contact the Patient Advice and Liaison Service (PALS), especially if you would like of the information we have provided explained further.

Let us know if we can be of any help regarding these or other issues. The UK Government website also provides practical information on what to do following a death.

Our Spiritual and Pastoral Care Team can also support the families and carers who have experienced bereavement of a person under the care of the Trust.

The Trust is committed to learning from the deaths of patients under our care and, as such, clinicians routinely undertake reviews of a proportion of health records where a patient has died or where significant concerns have been raised. In addition, reviews may be undertaken if the death is sudden, unexpected, untoward or accidental.

The review enables clinicians to comment on the quality of care provided to someone before their death and to learn, develop and improve the care we provide to our patients and includes looking at each aspect of care and how well it was provided.

If a review identifies significant problems, then the relatives of the deceased will be contacted to let you know what we may have identified and to discuss this further and ask if you have any questions to inform the next steps.

If a review identifies problems with the care provided, which could have contributed to the death, then an investigation will be undertaken. You will be advised of this and offered an opportunity to be involved in the investigation.

In some cases, a patient safety investigation may take place and may involve more care providers than just this Trust. In these circumstances, this will be explained to you, and you will be told which organisation is acting as the lead investigator. You will be kept up to date on the progress of the investigation and be invited to contribute. This includes commenting on drafts of investigation reports.

After the final report has been signed off, the Trust will make arrangements to meet you to further discuss the findings of the investigation. You may find it helpful to get independent advice about taking part in investigations and other options open to you.

Some people will also benefit from having an independent advocate to accompany them to meetings. You are welcome to bring a friend, relative or advocate with you to any meetings.

We know that the death of a loved one is traumatic for families. This can be even more so when concerns have been raised, or when a family is involved in an investigation process. Some families have found that counselling or having someone else to talk to can be very beneficial. You may want to discuss this with your GP, who can refer you to local support. Alternatively, there may be other local or voluntary organisations that provide counselling support, that you would prefer to access.

In certain circumstances external reviews and investigations will be undertaken. These reviews include the death of a patient with a learning disability, or autism or the death of a child or a death from a mental health homicide.

An investigation is a systematic analysis of what happened, how it happened and why.

Investigations draw on evidence (including physical evidence, witness accounts, organisational policies, procedures, guidance, good practice and observation) to identify problems in care or how services are delivered, and to understand how and why those problems occurred.

The process aims to identify changes needed to the care being provided, to reduce the risk of similar events happening in future.

At the start of an investigation the Trust will aim to obtain any comments, concerns, or questions family members may have about the care of the person who has died.

Some deaths need to be referred to the coroner, such as where the cause of death is unknown, or the death occurred in violent or unnatural circumstances. The coroner will decide if an inquest is required. You will be advised if the death of your family member is to be referred to the coroner.

If you have concerns about the treatment provided you can ask the coroner to consider holding an inquest. It is important that you do this as soon as possible after the person has died.

If you would like further information about the inquest process, contact Cornwall's coroner and administration office.

If you are seeking to be involved in an inquest, you may wish to find further independent information, advice or support. There are details of organisations that can advise on the process, including how you can obtain legal representation, in the support and advice tab below.

From 9 September 2024, all deaths in any health setting that are not investigated by a coroner will be reviewed by NHS medical examiners. Medical examiners and officers are senior independent doctors who have not been involved in the care of the person who has died. As part of the changes, there will be a new medical certificate of cause of death.

From 9 September 2024, medical practitioners will be able to complete a certificate if they attended the deceased in their lifetime. This represents a simplification of the current rules, which before 9 September require referral of the case to a coroner for review if the medical practitioner had not seen the patient within the 28 days prior to death or had not seen in person the patient after death.

The role of a medical examiner or officer is currently to scrutinise the care of all patients who die in hospital. From 9 September 2024, this role will be expanded to encompass a review of all deaths not referred to the coroner. They will review the cause of death with the doctors who cared for the deceased person and may contact the next of kin or other relative. This conversation is to ensure that you understand what is written on the death certificate. It is also an opportunity for you to raise any other questions or feedback you have about the care provided.

A family member, or a person nominated by the family, can register the death. A death must be legally registered within 5 days following the death. This period may be extended in certain circumstances, such as when the coroner has been consulted.

The registrar will probably require some, or all, of the information listed below:

• full name of person who has died, including maiden name if applicable
• date and place of birth and death (birth and marriage certificates)
• last known address of the person who has died (proof of address)
• last full-time occupation of the person who has died
• if married, full name, date of birth and occupation of any surviving widow or widower
• details of any occupational pension that the deceased was receiving from public funds (such as Army or Post Office worker)
• NHS medical card (do not worry if you can’t find this)
• passport if the deceased person had one

The registrar’s office may also give you information about a service called Tell Us Once. This is a government initiative which enables bereaved relatives to inform a range of government departments that a death has occurred, either with a single phone call or by using a dedicated, secure website.

The system covers both local and national government departments, including pensions and benefits, tax, council tax, passports, driving licences, blue badges and others. More information can be obtained from the staff at the appropriate register office.

Comments

We would like to hear about your thoughts in relation to the care provided to the person who has died. Receiving this information helps us to continue to do what we do well and to improve where something has not gone as well as we would have hoped, or, expected.

If you would like to comment on the care of the person who has died or have any questions or concerns about the care and treatment the person who died received, contact PALS.

Complaints

We will do our best to respond to any questions or concerns you may have, but there may still be times that you feel you want to make a complaint. In these circumstances, contact our Complaints Team.

National Audit of Care at the end of Life

The quality survey collects information about the care a patient received at the end of their life with the aim to enhance the care we provide.

We understand that it can be very helpful for you to have independent advice.

We have included details below of where you can find support and/or independent specialist advice. These organisations can also help ensure that medical or legal terms or processes are explained to you.

• Care Quality Commission (CQC).
• Parliamentary and Health Service Ombudsman. Call 0345 015 4033.
• Nursing and Midwifery Council.
• General Medical Council.
• GP: Contact your GP practice who may be able to arrange support or counselling.
• Action against Medial Accidents. Call 0845 123 2345.
• Advocacy after Fatal Domestic Abuse. Call 07768 386 922.
• Child Bereavement UK. Call 0800 028 8840.
• Child Death Helpline. Call 0800 282 986.
• Cruse Bereavement Care. Call 0808 808 1677.
• INQUEST. Call 0207 263 1111, option 1
• NHS Cornwall and Isles of Scilly palliative and end of life care information.
• Respond.
• Sands. Call 0808 164 3332.