Bereavement is never easy and it can be difficult to know what you have to do. This book has been designed to guide you through the practical steps you will need to take over the next few days.
You will also receive our Bereavement Support Guide, which explains some of the adjustments that you will have to face over the coming months, as well as suggesting sources of help and support available to you.
The staff of the University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) are committed to doing all that they can to help you at this time.
Our sincere condolences.
If you have a concern about care
University Hospitals Bristol and Weston NHS Foundation Trust complies with the national guidance on ‘learning from death’ and has a process to review the notes of all deceased patients to assess the standard of care delivered.
If a family member has concerns about the care delivered to their relative/friend, then this can be raised with the Patient Support and Complaints Team on 0117 342 1050 or by writing to the Medical Director, at Trust Headquarters, Marlborough Street, Bristol, BS1 3NU.
We will then make contact with the family member and undertake a review of the notes, and offer a meeting to jointly discuss the findings.
Overview of steps you will need to take
Call the Bereavement Office between 10am and 3pm the next working day
Receive call from Medical Examiner’s Office to confirm cause of death
Receive call from Bereavement Office to confirm Register Office have received MCCD
Book appointment with Register Office
Register the death
Arrange the funeral
Nominated person (sometimes called medical next of kin) or other person acting for the deceased patient
The Trust will communicate with the person recorded in the hospital records as the patient’s nominated contact (sometimes referred to as a medical next of kin) concerning the administration of a patient’s death. This will be the person nominated by the patient to receive information about their medical care, and to provide guidance or advice on the patient’s wishes if they are unable to speak for themself. This may not be a relative of the patient.
If the patient does not have a nominated contact we will try, based on the information available at the time, to communicate with the patient’s closest relative. In some circumstances, the nominated contact and/or closest relative will not be readily identifiable. We will then take steps to contact the person who will take responsibility for registering the death.
It is important at this sad and difficult time, that the nominated contact keeps the person who will register the death and arrange the funeral, other family members, and those close to the deceased, informed of what is happening.
What you will need to do first
Following the death of your relative or friend, you should telephone the Bereavement Office between 10am and 3pm on the next working day.
The team will take some details from you and tell you what to do next. They will call you back to let you know when the necessary administration is complete.
If the death occurred within the following hospitals
• Bristol Royal Infirmary (BRI)
• Bristol Heart Institute (BHI)
• Bristol Haematology and Oncology Centre (BHOC)
• Bristol Eye Hospital (BEH)
• Bristol Dental Hospital (BDH)
Please contact the Bereavement Office on:
0117 342 9048 or 0117 342 9049
Opening hours 10am to 3pm, Monday to Friday
You are advised not to make a funeral date or Register Office appointment until you have spoken to us.
Medical Certificate of Cause of Death (MCCD)
The Medical Certificate of Cause of Death (MCCD) is an important legal document, showing the cause of death.
This has to be signed by the doctor who was responsible for the medical care of your relative or friend while they were in hospital.
Doctors are not always able to complete the paperwork immediately, so it may be several days before the certificate is ready. In some cases, they may need to contact the Coroner’s Office which will delay the paperwork further.
The Role of the Medical Examiner Office
Before the Medical Certificate of the Cause of Death (MCCD) is issued, you will receive a telephone call from the Medical Examiner Office. This is a service that has been introduced to review all deaths in England and Wales. The Medical Examiner Office is staffed by a team of Medical Examiners, supported by Medical Examiner Officers.
A Medical Examiner is an independent doctor who has not been involved in the care of the deceased. They are here to ensure the information written on the MCCD is correct, and that any referrals that need to go to the Coroner are made in a timely fashion to avoid any delays. They scrutinise clinical notes and meet with the doctor who treated the deceased, to discuss the deceased’s care and the cause of death.
The Medical Examiner’s Office will be able to share any feedback to the clinical team or request they review the notes to reflect on the care provided and consider if there is any learning to improve the care of patients in the future. If you have any concerns regarding care or the circumstances surrounding death, this is an opportunity to raise them with an independent service separate from the hospital.
You should receive a call from a Medical Examiner or Medical Examiner Officer in the coming days; they will help you understand the wording used on the MCCD. The MCCD will not be issued until the cause of death has been reviewed by the Medical Examiner Office or the Coroner’s Office.
The Medical Examiner’s Office will make reasonable attempts to contact the deceased’s Next of Kin. If you have any questions and have not been able to speak with a Medical Examiner and would like to, please contact the Bereavement Office on 0117 342 9048/9049 and they will arrange for someone to contact you.
The Coroner
Some deaths have to be reported to the Coroner. The Coroner is an independent judicial officer and is responsible for investigating deaths in circumstances such as:
• all sudden and unexpected deaths
• deaths where the cause is unknown
• unnatural deaths, for example accident or suicide
• deaths that occur during or shortly after an operation
• deaths caused by industrial diseases
• deaths involving a bone fracture
• deaths from acute alcohol poisoning or drug related illnesses
Once information is obtained by the Coroner’s Office from the medical staff, a decision will be made as to whether or not a post mortem is necessary.
In many cases, permission will be given to issue a Medical Certificate of Cause of Death.
However, you should note that the procedure with the Coroner takes at least 3 working days to complete before the certification can be released and in these circumstances an appointment with the Register Office cannot be made until all documentation has been completed and issued.
Coroner’s post mortem
If the Coroner decides a post mortem, also known as an autopsy, is necessary, this will usually take place within a week of the death at the Coroner’s Mortuary in Flax Bourton.
The Coroner’s office will take over responsibility from the Bereavement office and will be responsible for keeping you informed of what is happening and guiding you in the next steps that you should take.
The Coroner does not require the consent of any other person for this to take place. Funeral directors should be advised about the post mortem and are usually happy to proceed with funeral arrangements.
You will be informed by the Coroner’s office when they have sent paperwork to the Register Office so that you can make an appointment to register the death.
The Coroner’s office can be contacted on 01275 461 920. Opening hours: 7.30am to 3.30pm, Monday to Friday.
Coroner’s inquest
In some circumstances the Coroner will proceed to open an inquest.
The purpose of an inquest is to find out 4 facts; who the deceased was, when, where and how they died. They will also record the medical cause of death.
You may be contacted by one of the Coroner’s officers if an inquest has been opened. You may be asked to provide a statement about your loved one. The Trust will also provide the Coroner with statements from those who cared for the patient.
Once the Coroner has considered this evidence, there may be a hearing. This is a fact finding hearing, not to apportion blame, but to answer the aforementioned 4 questions. You will have the opportunity to ask questions.
The Coroner will then record a conclusion, such as natural causes or suicide.
Whilst the aim is for this process to conclude within 6 months of the patient’s death, it can sometimes take longer. You will be kept up to date by the Coroner’s officer.
Patient property
If the deceased patient has property or clothing on the ward which is not taken by relatives at the time of death, the Bereavement Office will discuss arrangements for returning the property to you and for disposing of any unwanted property.
Jewellery (for example wedding rings, earrings) is usually left on the deceased patient unless family request otherwise and will go to the funeral director where it can be removed if requested.
It is important that you agree the arrangements for the return or disposal of patient property with the Bereavement Office. Any property not collected after 4 months will be disposed of without recourse to the Trust.
Visiting the deceased patient
It may be possible to make an appointment to view the deceased patient in the hospital mortuary relatives’ room.
Please telephone the mortuary on 0117 342 7433 between 8.30am and 3.30pm Monday to Friday to arrange this. Outside these times, please ring switchboard on 0117 923 0000 and ask to speak to the on call mortuary team.
Alternatively, you may prefer to wait until the deceased patient is transferred to the funeral director.
In rare cases, for example, due to infection, communicable disease, or forensic evidence, viewing may be restricted.
Tissue donation
Tissue donation can help thousands of people each year.
Donated tissue such as heart valves, bones, and eyes can save or dramatically improve the lives of many people suffering from illness or injury.
Thanks to the generosity of our donors and their families, thousands of people every year receive life-transforming tissue transplants. UHBW works in partnership with NHS Blood and Transplant to support the option of tissue donation.
Almost anyone can be considered as a tissue donor. A specialist nurse from NHS Blood and Transplant may call you, or another family member, to discuss the option of donation from your loved one. The specialist nurse will provide enough information to enable you to make the decision that is right for you.
Throughout the donation, the donor is treated with dignity and respect. After donation our specialist team will ensure the donor retains a natural appearance.
Tissue donation will not delay funeral arrangements.
If you wish to speak to a specialist nurse about tissue donation, please call 0800 432 0559.
Who can register a death?
The following persons are designated by the Births and Deaths Registration Act 1953 as qualified to give information concerning a death in hospital.
• A relative of the deceased, present at the death.
• A relative of the deceased, in attendance during the last illness.
• A relative of the deceased, residing or being in the subdistrict where the death occurred.
• A person present at the death.
• The person causing the disposal of the body, for instance the person dealing with the funeral arrangements.
If you are registered in the hospital as the nominated contact or next of kin but are not a direct relative of the deceased person, it is important that you declare this information to the Register Office when you are in contact with them as it may affect your ability to legally register the death.
Registering a death
When the Bereavement Office have completed all the necessary administration and sent the MCCD to the Registrar, they will let you know so that you can contact Bristol Register Office to register the death. An appointment can be made either online at www.bristol.gov.uk or by calling 0117 922 2800.
This appointment will be a face-to-face meeting to complete the registration and issue both the death certificate and the green form. The green form enables your chosen funeral director to proceed with arrangements.
They will also tell you how to purchase death certificates. The certificates cost £12.50 each and will be sent to you by post once you have purchased them. Payment can be made by card, cheque or cash.
The Registrar will ask you to provide the following information about the deceased:
• The date and place of death
• Full name, surname and maiden name if appropriate
• Date and place of birth
• Occupation
• Their usual address
• If the deceased was married, the date of birth of the surviving widow or widower
• Whether the deceased was receiving a pension or allowance from public funds.
This information should be given to the best of your ability. Your name will go on the death certificate as the informant.
is:
If there has been a Coroner’s post mortem, you will be told by the Coroner’s Office when you may make the appointment.
The Old Council House, Cor n Street, Bristol, BS1 1JG
The nearest Register Office to the hospital is: Bristol Register Office, The Old Council House, Corn Street, Bristol BS1 1JG.
Saturday 9.45am to 11.45am (by special arrangement only)
Bereavement Office, A409, Bristol Royal Infirmary, BS2 8HW
Bristol Register Office,
The Old Council House, Corn Street, Bristol BS1 1JG
Opening hours of the Register Office
Monday, Tuesday, Thursday and Friday 9am to 4pm, Wednesday 10am to 4pm and 5pm to 7pm. Saturday 9.45am to 11.45am (by special arrangement only).
Telephone 0117 922 2800
Phones are answered Monday to Friday 9am to 4pm.
There is also a Register Office at Southmead Hospital. Opening hours are Monday to Thursday 1.30pm to 4pm, Friday 2pm to 4pm. You will be issued the green form, however the death certificate will be posted from Bristol and may delay the funeral. Please make clear which office you require when you telephone for an appointment.
It is possible to make a declaration of someone’s death at any Register Office in England and Wales. The information is forwarded to the Register Office in Bristol which will post death certificates to you. This will delay registration and may delay funerals. You will need to contact Bristol Register Office who will help facilitate this.
The death certificate
This is a certified copy of the entry in the register of deaths. Each one costs £12.50, for which you will need to pay the Registrar by card, cheque or cash. You will need to consider how many certificates you require as banks, building societies and insurance companies require certified copies (otherwise known as originals). Additional copies can be ordered at any time in the future. The Registrar will also give you a certificate for burial or cremation (known as the green form). This will be required by your funeral director.
Organisations you need to contact
Tell Us Once
You will need to report the death to various organisations and government departments. Bristol City Council runs a service called Tell Us Once, which will help you to contact these. In doing so you will not have to pay for extra death certificates for each organisation they contact. There is a cost in providing the certificate to organisations who are not contacted by the council.
If you wish to use this service, inform the Registrar when you attend the Register Office and the options will be explained to you.
You will be able to access this service by telephone or online once you have registered the death.
If you choose not to use the Tell Us Once service you will need to report the death to various organisations and government departments.
The following are organisations which may be appropriate to notify.
Local councils
• Housing Benefit Office
• Council Tax
• Collection of payment for council services
• Libraries
• Electoral Services
• Blue Badges
• Adult Services
• Children’s Services
• Council Housing Department for Work and Pensions (DWP)
• Pension, Disability and Carers’ Service
• Jobcentre Plus
• Overseas Health Team
Revenue and Customs
• Child Benefit
• Child Tax Credit and Working Tax Credit
• Personal Taxation
Identity and Passport Service
• Driver and Vehicle Licensing Agency
• Ministry of Defence
• Service Personnel and Veterans Agency
• War Pensions Scheme
People, apart from close family and friends, you might need to inform
Type
Healthcare providers, i.e. optician, dentist, GP
Bank or building society, credit card providers
Premium bonds, long term savings companies (ISAs)
Anyone holding money for the deceased
Social services such as home help or care
Previous/current place of work (occupational pension), trade unions
Solicitor
Executor of the estate (Will)
Insurance companies (car, home, life insurance)
Residential or nursing home
Landlord or housing agency
Mortgage company
Utility companies (water, electric, gas, phone, internet, TV licence, internet)
Hire purchase companies
Post Office (to redirect mail)
Cancel any upcoming appointments
Transport (to day centres or clubs)
Deliveries (milk, food boxes, newspapers)
Return any borrowed equipment (medical or social)
Religious organisations (faith leaders)
Stop any junk mail
Done
Arranging a funeral
Before going ahead with any arrangements, it is advisable to check whether the deceased person left a Will and any instructions for the funeral.
If you are not the next of kin (nearest relative) or executor, you should check with them that you have the authority to proceed.
Most funeral directors are members of one of 2 trade associations:
• National Association of Funeral Directors (NAFD)
• Society of Allied and Independent Funeral Directors (SAIF)
Member firms must provide you with a price list on request and cannot exceed any written quotation they give you without your permission.
Most people would probably require the funeral director to provide the following services as a minimum:
• make all necessary arrangements
• provide appropriate staff
• provide a suitable coffin
• transfer the deceased from the place of death to the funeral director
• care for the deceased prior to the funeral
• provide a hearse to the nearest cemetery or crematorium
• arrange for burial or cremation as appropriate
Embalming, viewing of the deceased, or providing a limousine for mourners are optional extras. Discuss these fully with your funeral director and make sure you receive an itemised written quotation.
Funeral costs for the same services may vary considerably from one funeral director to another.
It is advisable to get more than one quote to compare costs and services. Funeral directors should provide detailed price lists for you to take away.
Disbursements are fees paid to others, for example doctors (for cremation forms), a minister, newspaper announcements, flowers and crematorium. Ask the funeral director for a written quotation detailing all these fees.
In addition, it should be remembered:
• when you arrange a funeral, you are responsible for paying the bill
• funeral payments are recoverable from the deceased person’s estate and banks are obliged to release money to pay for funeral costs when requested.
If you receive certain benefits from the Department for Work and Pensions you may be entitled to some assistance towards the funeral expenses of your relative. For further information please contact the nearest Jobcentre Plus Centre.
A bereavement payment or bereavement allowance may be made in certain circumstances if you are the partner or spouse of someone who died whilst employed.
These are dependent upon National Insurance contributions and other conditions. Please contact Jobcentre Plus to find out more.
Useful hospital contacts
Bereavement Office
0117 342 9048 or 0117 342 9049
Patient Support and Complaints Team
0117 342 1050
PSCT@uhbw.nhs.uk
Patient Support and Complaints Team
University Hospitals Bristol and Weston NHS Foundation Trust, Welcome Centre, Queen Building, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW
Other hospital services
The opportunity is available for you to return to the ward setting to meet with the ward manager or those involved in caring for your relative to discuss any issues you may have should you feel the need either currently or in the future.
RNS publications would like to thank the sponsors and advertisers without whom this publication would not be possible.
University Hospitals Bristol and Weston (UHBW) does not endorse any of the products or services included in this leaflet pack. UHBW have not financially gained from these adverts.
As well as providing clinical care, our Trust has an important role in research. This allows us to discover new and improved ways of treating patients. While under our care, you may be invited to take part in research. To find out more please visit: www.uhbw.nhs.uk
Help us prevent the spread of infection in hospital. Please make sure your hands are clean. Wash and dry them thoroughly/use the gel provided. If you have been unwell in the last 48 hours please consider whether your visit is essential.
Smoking is the primary cause of preventable illness and premature death. For support in stopping smoking contact NHS Smokefree on 0300 123 1044.
Drinkline is the national alcohol helpline. If you’re worried about your own or someone else’s drinking, you can call this free helpline in complete confidence. Drinkline on 0300 123 1110.
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The Hospital would like to thank RNS Publications for publishing this information and the following pages contain some features from services o ering their help at this time.
Whilst the Hospital is grateful of their support it does not endorse or recommend any of the services that they provide.
STOPPING JUNK MAIL
It is distressing to deal with a bereavement and unsolicited mail can be insensitive and destructive during a grieving process.
By scanning the below QR code on your phone or visiting www.stopmail.co.uk, we are able to securely share this information with mailing organisations and under the Data Protection Act the information will not be used for any other purpose.
Other benefits reduce the possibility of identity fraud, such as assumed identity and you will only have to supply the information once.
MEANINGFUL FUNERALS FOR NON-RELIGIOUS PEOPLE
If your loved one wasn’t religious, a humanist funeral is an authentic and memorable way to celebrate their unique life. Our funerals are personal and heartfelt non-religious ceremonies, led by a professional, trusted humanist celebrant.
