If you have been given this leaflet, you have experienced the death of someone close to you. We are very sorry for your loss and we know that this can be a very difficult and distressing time.
We hope this leaflet will help you to understand what you can expect from Mid Yorkshire Teaching NHS Trust. This leaflet also aims to explain what happens next; including information about how to comment on the care your loved one received and what happens if a death will be looked into by a Coroner. It also provides details of the processes involved if you have any significant concerns about the care we provided and gives you practical advice, support and information.
Contacting us
On the next working day after the death has occurred, please call the Bereavement Office after 10.00 hours:
Pinderfields Hospital
Aberford Road
Wakefield
WF1 4DG
01924 541015 / 541016 / 541017
If you need to contact Wakefield/Pontefract Registry Office contact: 0345 4852888
Our Bereavement Officers will ask you some questions and check your details to ensure they have the correct information required. They will explain what you need to do next and when the Medical Certificate of Cause of Death (MCCD) is likely to be completed.
For Deaths at Dewsbury Hospital:
Dewsbury Registry Office
Dewsbury Town Hall
Wakefield Old Road
Dewsbury
WF12 8DG
01924 324733
We would advise you not to attend the Bereavement Office without first speaking to the Bereavement Officer.
Medical Examiner
Mid Yorkshire Teaching NHS Trust, in line with the new Government reforms around death certification, set up a Medical Examiner office for the Wakefield and North Kirklees District in 2019. The Medical Examiner team comprises senior Consultants from different specialties and General Practitioners who have had no direct involvement in the care of a patient who has died but conduct a review to understand the circumstances surrounding the cause of death, helping to give an independent review.
Although hosted by Mid Yorkshire Teaching NHS Trust, the Medical Examiner’s Office is completely independent from the Trust ensuring an objective and independent review.
The Medical Examiner’s office provides a greater safeguard for you by ensuring all non-coronial deaths are properly scrutinised and, where appropriate, referred to HM Coroner. The Medical Examiner will review your loved one’s medical records and have a discussion with the treating doctors about the care they received and the cause of death that will be documented on the Medical Certificate of Cause of Death (MCCD). The aim is to ensure this cause is accurate and to help you to understand the wording on the MCCD. They will also discuss any concerns and answer any questions you may have about the cause of death and the care they received.
You may receive a call from one of the Medical Examiners or their Medical Examiner Officers to discuss the Medical Certificate in the first days after your loss, answering any questions you may have.
More information about the Medical Examiner’s Service can be found at www.midyorks.nhs.uk/bereavement or by contacting them via email on midyorks.me-office@nhs.net
Medical Certificate of Cause of Death (MCCD)
For you to be able to register the death of your loved one, the hospital will issue a Medical Certificate of Cause of Death (MCCD), unless the death has been reported to HM Coroner. From 9th September 2024, the government has passed legislation which will enable any doctor who has treated your loved one in their lifetime to complete the MCCD after a discussion with the Medical Examiner (if there is no requirement for referral to the coroner) if they feel able to give a cause of death. If the Medical Examiner agrees the cause of death, the Medical Examiner office will send the completed MCCD to the Registrar’s office and the Registrars will arrange a suitable time for you to attend the office and register the death.
The Bereavement Office will help with any questions you may have about the registration process or put you in contact with the Medical Examiner’s Office if your questions relate to the cause of death or care your loved one received. The Bereavement Office will also notify your relative’s GP to inform them of the death.
Registering the death – who can register a death?
Regulations state that only certain people can register a death with the Registrar of Births, Marriages, and Deaths. It can be one of the following:
• A relative of the deceased who was present at the time of death.
• A relative of the deceased in attendance during the last illness.
• A relative of the deceased residing in the same local district.
• A person present at the time of death.
• The person handling the funeral i.e. an executor of the will, solicitor or similar.
• An official from the hospital where the death took place.
What to take to the Registrar
You should take the following:
• The deceased’s birth certificate/passport
• Proof of address i.e. utility bill
• Deed poll if applicable
• NHS medical card or NHS appointment letter showing their NHS medical number
• You will need a credit/debit card to pay £12.50 for each death certificate needed
• Any forms given to you if the death has been referred to the Coroner
Information needed to register a death
Please ensure that you have the correct spellings for all information given to the Registrar.
Surname:
Forenames:
Maiden Name:
Any other previous names: (e.g. if a person has been married more than once)
Any other names: (e.g. usually known as even if not formal name)
Date of Birth:
Place of Birth: (town and county in England and Wales or country if born overseas as the country is known now, not as it may have been at the time of birth, e.g. Bangladesh and not East Pakistan) ...................................................................................................................................................................
Place of Death:
Date of Death:
Usual Address:
Marital Status:
Occupation (or former occupation if retired):
Name/address/occupation of spouse or civil partner (if surviving) or name and occupation (if deceased):
NHS number of deceased (please bring medical card if you have it)
What to tell the Registrar
• The date and place of death.
• The deceased’s last (usual address).
• The deceased’s first names and surname (and the maiden name, if applicable).
• The deceased’s date and place of birth.
• The deceased’s occupation and the name and occupation of husband/wife (if applicable).
• Whether the deceased was getting a pension or allowance from public funds.
• Whether the deceased was married.
What documents will be provided
The Registrar will issue:
• A Certificate for Burial or Cremation (known as the Green Form) which is electronically sent to the Local Bereavement Services Office in the area where the funeral is to take place.
• A Certified Copy of an entry Certificate (death certificate) can be purchased for a statutory fee. This is needed for any bank/ pensions claims, insurance policies, and other financial matters.
• You will be offered the “Tell Us Once” service to inform central, local and government departments.
“Tell Us Once” Service
Your local Registration Service offer a service called Tell Us Once; they can help you inform the people who need to know. The Tell Us Once service aims to reduce the number of local and central government departments that you have to notify when you have had a bereavement.
The service is optional but most people who register a death choose to use Tell Us Once.
Who they can give information to on your behalf:
• Department for Work and Pensions
• HM Revenue and Customs
• HM Passport Office
• DVLA
• War Pensions Scheme
If you ask they can also contact:
• Housing Benefit Office
• Council Tax and Council Tax Benefit Office
• Collection of payments for council services
• Libraries
• Electoral Services
• Blue Badges
• Adult and Children’s Services
All information you give them will be kept securely.
For further information visit: www.gov.uk/after-a-death/organisations-you-need-to-contact-and tell-us-once
Who do I need to inform of the death?
Please be aware that some of these will be covered as part of the Tell Us Once service.
The local Social Services Department of the Council, if the deceased was getting mealson-wheels, home help, day centre care or had an appliance or piece of equipment issued by the department
The Inland Revenue
The local Council Housing Department if the deceased was living in a Council House
The local Council Tax Office and/or Business Rates Office
The local Council Housing Benefit Section if the deceased was getting Housing Benefit and/or Council Tax Benefit
Any other Hospital the person was attending
The landlord, if the deceased was living in rented accommodation; or the mortgage provider if the house is mortgaged
The deceased’s G.P. practice
Any employer and trade union
The deceased’s bank(s) and/or building society(s)
The car insurance company. (NB; if you are insured to drive the car under the deceased person’s name, you will cease to be legally insured)
The deceased’s water, gas, electricity and telephone suppliers
The Post Office, so that they can redirect the deceased’s mail to the person who will be responsible for the Estate
Any company or personal pension provider
Any home and/or contents insurance company (to ensure cover continues where necessary)
Any life insurance company with which the deceased had a policy
The teacher, employer or college of any closely-related child or young person (if a parent, brother, sister, grandparent or close friend has died)
It may be appropriate to contact a minister of religion or representative of your faith community
Things to send back
q Passport to the Passport Office
q Driving Licence to the Driver and Vehicle Licensing Agency, Longview Road, Swansea, SA6 7JL
q The registration documents of a car, for the change of ownership to be recorded
q Any National Insurance papers to the relevant office
q Any NHS equipment such as wheelchairs, hearing aids and artificial limbs
q Membership cards of clubs and associations - claiming refund due
q TV licence for a refund
q Bus pass
q Library books and tickets
q Season ticket - claim any refund due
Stop:
q Milk, papers and anything else delivered on a regular basis to the house
q Email address
q Online subscriptions
Understanding what happened
As a family member, partner, friend or carer of someone who has died while in the care of Mid Yorkshire Teaching NHS 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 your loved one should be able to answer your initial questions. However, please do not worry if you are not ready to ask these questions straight away, or if you think of questions later – you will still have the opportunity to raise these with us when you are ready.
It is also important for us to know if you do not understand any of the information we provide. Please tell us if we need to explain things more fully.
Solicitors
If the deceased made a Will, consult the solicitors who hold it, to see what the deceased’s funeral wishes were. The Will should also disclose the names of the executors or the persons legally entitled to deal with the deceased’s estate. Your solicitors will assist you with the administration of the estate and any questions relating to taxation that may arise.
In case of a Pandemic
When a pandemic occurs some of the information in the Bereavement Booklet will not apply.
• The appointment with the registrar will be done by telephone.
• Personal items of the deceased will be stored securely. Information will be given to the relatives at the time of death by the ward or bereavement office.
Practical information, support arrangements and counselling
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 view the deceased in the mortuary if asked
• collecting the death certificate
• how to register the death
Please let us know if we can be of any help regarding these or other issues. The gov.uk website (www.gov.uk/after-a-death) also provides practical information on what to do following a death.
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. Some examples of organisations that may be able to help you are at the back of this booklet.
Your feelings
Grieving
Grieving is a natural process that can take place after any kind of loss. When someone we love dies we can be left with overpowering feelings, which have to run their course. There are a whole succession of different feelings that can take some time to go through and must not be hurried. Although people are all individuals, the order in which they go through these feelings is very similar.
For some time following the death of someone who is close, most people feel totally stunned. A feeling of disbelief is common, even if the death has been expected (say after a long period of illness). This feeling of numbness can actually be a help in dealing with the various practical arrangements that have to be made, but this detachment from reality can become a problem if it goes on for too long.
To overcome this feeling of numbness for some people it can help to see the person who has died. It is not until the funeral that the reality of what has happened finally sinks in. Although it may be distressing to attend the funeral or to see the body, it is important to say goodbye to the ones we loved.
It is often the case for people who did not do this to experience a great feeling of regret for years to come. After the feeling of numbness has gone, it is often replaced for a sense of agitation and a yearning for the person who has died. This can affect the bereaved in their everyday life, it may be difficult to relax, concentrate or sleep properly.
Some people experience disturbing dreams, others feel they see their loved one everywhere they go and especially in the places that they used to spend time together. It is also quite usual to feel angry at the time, maybe towards the person who has left them. Another common feeling is guilt. It is likely that the bereaved will go over in their mind all the things that they had wished that they had said or done. In some cases they may even consider what they could have done to have prevented the death. Of course death is usually beyond the control of anyone and they must be reminded of this.
There is a list of care associations who can help support you through your grieving at the back of this booklet.
The do’s and don’ts of grief
We are all individuals and have our own particular ways of grieving but the “do’s and don’ts” listed below offer some practical advice which may help;
• Don’t hide your feelings; try to bring out into the open whatever you are feeling. This is central to grieving.
• Don’t rush into having the funeral right away (unless it is the practice of your culture) and don’t be persuaded to have an expensive funeral unless you or the deceased really want it.
• Don’t make any major life changes while you are still grieving. Give yourself lots of time to think about changes you may wish to make and discuss these plans with others.
• Don’t neglect yourself. Try to eat well and get plenty of rest.
• Don’t enter into any financial or legal arrangements unless you fully understand them.
• Don’t hurry yourself to overcome your grief. There is no fixed time that it takes to get over bereavement.
• Don’t let others rush you into anything before you are ready, but remember that sometimes you may not know whether you are ready for something unless you give it a try.
• Don’t turn to drugs, smoking or alcohol to stop yourself feeling the pain of grief.
• Do express your feelings as much as possible.
• Do talk through what has happened with someone you trust (eg your family, a close friend, and an appropriate support group).
• Do contact one of the voluntary or hospital organisations (telephone numbers of which are contained within this leaflet) if you would like someone to talk to – they are there to help.
• Do take good care of yourself; get lots of rest, eat well and give yourself lots of time to grieve.
• Do begin to make longer-term plans for the future so that you will always have something to look forward to BUT remember; Don’t rush into any big life changes.
• Do choose a funeral director you like and trust.
• Do contact your doctor if you feel unwell or would like the doctor to refer you to someone to talk to.
• Do keep in touch with friends and family – remember that most people feel honoured to be asked to help. However, many people feel awkward and embarrassed about offering their help, so it may be left up to you to ask for it, even though this may be difficult for you.
Guilt is often experienced, if a sense of relief is felt after the person dies, particularly after a distressing illness. This feeling of relief is perfectly natural and very common, and is nothing to feel guilty about.
These strong confusing feelings can be felt for quite a while following someone’s death and are generally followed by periods of sadness and depression.
Grief can be sparked off many months after the death by things that bring back memories. It can be difficult for other people to understand or cope with someone who bursts into tears for no apparent reason. Some people who can’t deal with this tend to stay away at the time when they are needed most of all. It is best to return to a normal life as soon as possible and to resume normal activities.
For the bereaved partner there are constant reminders of their loneliness seeing other couples together, and from the images seen on television of happy families. All of this can make it difficult to adjust to a new, single lifestyle.
As time passes, the pain of early bereavement begins to fade. The depression lessens and it’s possible to think about other things again. The different stages of mourning tend to overlap and can show themselves in various ways.
There is no standard way of grieving as we have our own individual ways of dealing with all of life’s trials, not least the loss of someone we love.
Your doctor can help
If you feel the need for medical attention to help you through your bereavement, there is help available and you should not hesitate to contact your family doctor.
Bereavement can turn our world upside-down and is one of the most painful experiences we have to endure. In some instances sleepless nights can go on indefinitely, which can be a serious problem. The doctor may be able to prescribe something to help.
Grief in children and teenagers
Children generally do not understand the meaning of death until they are about three or four years old. However, young children can still experience grief following the death of a person they were close to. Young children may need to be reminded the person who has died will not come back again, but that they can still remember the person who has died.
Older children may understand what death means, but can struggle to understand their own emotions. They can also worry that they or other people they love will die.
Teenagers can find it harder to cope than younger children. They may cope in ways that are difficult for you to deal with, such as refusing to talk or getting angry.
If possible, it can be helpful for a trusted person to explain to a child what has happened in a way that they understand.
Some examples of organisations that may be able to help you are at the back of this booklet.
Friends and relatives can help:
• Generally by spending time with the person who has been bereaved.
• Being close to others can be a great source of comfort. It is not always necessary to say anything, just being there is enough.
• It is important that a bereaved person is able to talk and cry with someone without being told to pull himself/herself together.
• It can also be difficult for people to understand why the bereaved keep covering the same ground, talking and apparently becoming distressed about the same things over and over again. However, this is an important part of the healing process and should really be encouraged.
• Not mentioning the name of the person who has died (for fear of upsetting them), can lead to a sense of isolation and can add to the grief of the bereaved.
Stopping Junk Mail to the recently deceased
If someone you know has died, the amount of unwanted marketing post being sent to them can be greatly reduced which helps to stop painful daily reminders.
By registering with the free service www.stopmail.co.uk the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks. If you cannot access the internet you can call 0808 168 9607, where you will be asked for very simple information that will take only a few minutes to complete. Alternatively, ask the bereavement team for a leaflet that can be returned in the post.
This free of charge service provided by the Bereavement Support Network will actively reduce the unwanted marketing mail but also can help reduce the likelihood of identity theft following the death of someone close. The information is not used for any other purpose and you only have to complete this once. Additionally to Stop Mail a comparable service can also be accessed from the Bereavement Register or Deceased Preference Service if you would prefer to use them.
Choosing a Funeral Director
You don’t have to wait until the Medical Certificate of Cause of Death is issued. In some cases it may not be possible for the hospital doctor to issue a Medical Certificate of Cause of Death (i.e. if the death is referred to the Coroner and a further investigation is needed).
When choosing a Funeral Director you should feel comfortable and confident with them. You can ask any Funeral Director for an estimated cost before making a commitment to use their services. It is reasonable to seek estimates from more than one company.
The Funeral Director needs to know and discuss with you:
• The name, age and religion of the deceased
• The place of death and name of the doctor who has signed the MCCD
• Any particular requests left by the deceased
• If burial or cremation is required
• The style of coffin
• The type of service, hymns, cars, flowers, newspaper notices etc you would like
Burial or Cremation
The cost for both Burial and Cremation may vary. Please discuss this with your Funeral Director.
Cremation - If you choose cremation, an additional form is required to be completed by a doctor, the doctor will receive a fee, which your chosen Funeral Director will have factored into the total cost of the funeral. From the 9th September 2024 doctors will no longer need to complete the additional cremation form. Please contact your Funeral Director if you have any further enquiries regarding this. Local Authorities govern costs of cremation.
Ashes can be buried in the churchyard or cemetery or they can be kept or scattered (although in some places, consent may be required to do so).
Burial - Your family may already have reserved a burial plot for which you will have a deed or grant. This will show the plot number of the existing grave. You will need to take this document to your Funeral Director. If you do not have a reserved/family plot then your Funeral Director will advise and assist you on the availability of a new plot. Some churchyards are no longer open for burials because there are no more vacant plots.
Early Release Burials
As a bereavement service we cater to the needs and wishes of those who require an urgent body release for cultural, religious and personal beliefs. If you wish for further information please feel free to contact the bereavement department on Tel: 01924 541015 or Email: myh-tr.bereavementmidyorks@nhs.net
Learning from lives and deaths – People with a learning disability and autistic people (LeDeR)
All deaths of people with a learning disability or autistic people (aged 4 and over) will be referred into the LeDeR programme. The programme aims to improve care, reduce health inequalities and prevent people dying early by reviewing information about the health and social care support people with a learning disability or autistic people received during their life.
An initial review of the death will take place, and as part of the process the local reviewer will speak to family members, friends, professionals and anyone else involved in supporting the person who has died. This is to find out more about their life and the circumstances leading to their death. Families can be involved as little or as much as they would like throughout the review process.
Reviews of deaths in our care
Case note reviews (or case record reviews) are carried out in different circumstances. Firstly, case note reviews are routinely carried out in NHS trusts on a proportion of all their deaths to learn, develop and improve healthcare, as well as when a problem in care may be suspected.
A clinician (usually a doctor), who was not directly involved in the care your loved one received, will look carefully at their case notes. They will look at each aspect of their care and how well it was provided. When a routine review finds any issues with a patient’s care, we contact their family to discuss this further.
Secondly, we also carry out case note reviews when a significant concern is raised with us about the care we provided to a patient. We consider a ‘significant concern’ to mean:
(a) any concerns raised by the family that cannot be answered at the time; or
(b) anything that is not answered to the family’s satisfaction or which does not reassure them.
This may happen when a death is sudden, unexpected, untoward or accidental. When a significant concern has been raised, we will undertake a case note review for your loved one and share our findings with you.
Aside from case note reviews, there are specific processes and procedures that trusts need to follow if your loved one had a learning disability, is a child, died in a maternity setting or as a result of a mental health related homicide. If this is the case, we will provide you with the relevant details on these processes.
Investigations
In a small percentage of cases, there may be concerns that the death could be related to a patient safety incident. A patient safety incident is any unintended or unexpected incident, which could have, or did, lead to harm for one or more patients receiving health-care. Where there is a concern that a patient safety incident may have contributed to a patient’s death, a safety investigation will be undertaken. The purpose of a safety investigation is to find out what happened and why. This is to identify any potential learning and to reduce the risk of something similar happening to any other patients in the future.
If an investigation is to be held, we will inform you and explain the process to you. We will also ask you about how, and when, you would like to be involved. We will explain how we will include you in setting the terms of reference (the topics that will be looked at) for the investigation. Investigations may be carried out internally or by external investigators, depending on the circumstances.
In some cases, an investigation may involve more care providers than just Mid Yorkshire Teaching NHS Trust. For example, your loved one may have received care from several organisations (that have raised potential concern). 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 before they are signed off. Your comments should be incorporated in the 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, etc. Please see details of independent organisations that may be able to help, later in this leaflet. You are welcome to bring a friend, relative or advocate with you to any meetings.
Where the death of a patient is associated with an unexpected or unintended incident during a patient’s care, staff must follow the Duty of Candour Regulation/Policy. The charity AvMA (Action Against Medical Accidents) has produced information for families on Duty of Candour which is endorsed by the Care Quality Commission.
Coroners’ inquests
Some deaths are referred to the coroner, for example where the cause of death is unknown, or the death occurred in violent or unnatural circumstances. When a death is referred to the coroner they may request a post mortem examination. The coroner will decide whether an inquest is required, to establish the cause of the death. An inquest is a ‘fact finding’ exercise which normally aims to determine the circumstances of someone’s death.
The Medical Examiner Officer will inform you if we have to refer the death to the coroner. If we do not refer a death to the coroner, but you have concerns about the treatment provided, you can ask the Medical Examiner to refer the death to the coroner to consider holding an inquest. It is important to do this as soon as possible after your loved one has died, as delays in requesting an inquest may mean that opportunities for the coroner to hold a post mortem are lost.
If you would like to contact the Coroner’s Officers:
If you are seeking or 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, at the back of this booklet.
Providing feedback, raising concerns and/or making a complaint
Providing feedback: We want to hear your thoughts about your loved one’s care. Receiving feedback from families helps us to understand (i) the things we are doing right and need to continue; and (ii) the things we need to improve.
Raising concerns: It is very important to us that you feel able to ask any questions or raise any concerns regarding the care your loved one received. In the first instance, the team that cared for your loved one should be able to respond to this. However, if you would prefer to speak to someone who was not directly involved in your loved one’s care, our Patient Advice and Liaison Service (PALS) team will be able to help.
Making a complaint: We will do our best to respond to any questions or concerns that you have. Additionally you can raise concerns as a complaint, at any point. If you do this we will ensure that we respond, in an accessible format (followed by a response in writing where appropriate to your needs), to the issues you have raised.
The NHS Complaints Regulations state a complaint must be made within 12 months of the incident happening or within 12 months of you realising you have something to complain about.
However, if you have a reason for not complaining to us sooner we will review your complaint and decide whether it would still be possible to fairly and reasonably investigate.
If we decide not to investigate in these circumstances, you can contact the Parliamentary and Health Service Ombudsman (PHSO).
Please note you do not have to wait until an investigation is complete before you complain – both processes can be carried out at the same time. For example, a complaint can trigger an investigation if it brings to light problems in the care that were not previously known about. However, if both the complaint and investigation are looking at similar issues, we may not be able to respond to the complaint until the associated investigation is complete.
If you are not happy with the response to a complaint, you have the right to refer the case to the Parliamentary and Health Service Ombudsman. PHSO has produced ‘My expectations for raising concerns and complaints for users of health services’. It sets out what you should expect from the complaints process: www.ombudsman.org.uk/publications/my-expectations-raisingconcerns-and-complaints
Please see the frequently asked questions at the back of this booklet for more information on what to do if you are not happy with the responses you receive from us.
Access to Healthcare Records
Personal representatives of patients are entitled to access their health records under the Access to Health Records Act 1990 where a request is made to access the Medical Records of a deceased patient.
Enquiries about access to health records can be made by contacting the Access to Records Department and asking for an application form to be posted to you.
Their contact details are:
Access to Records Department
Mid Yorkshire Teaching NHS Trust
Pinderfields Hospital
Aberford Road
Wakefield
WF1 4DG
Tel: 01924 543697 / 543700
Email: midyorks.accesstorecords@nhs.net
Alternatively, an applicant may send their request by letter rather than using the Trust’s request form, as long as the letter contains enough information to identify the correct patient record and confirms what information is required.
Independent information, advice and advocacy
If you raise any concerns about the treatment we gave your loved one, we will provide you with information and support; and do our best to answer the questions you have. However, we understand that it can be very helpful for you to have independent advice. We have included details on the following pages of where you can find independent specialist advice to support an investigation into your concerns. These organisations can also help ensure that medical or legal terms are explained to you.
Some of the independent organisations may be able to find you an ‘advocate’ if you need support when attending meetings. They may also direct you to other advocacy organisations that have more experience of working with certain groups of people, such as people with learning disabilities, mental health issues, or other specialist needs.
The list on the following pages does not include every organisation but the ones listed should either be able to help you themselves, or refer you to other specialist organisations best suited to addressing your needs. In addition all local authorities (councils) should provide an independent health complaints advocacy service, which is independent of the trust, that people can access free of charge. If you would like to use this service, please contact them on the details provided at the back of this booklet.
We may also be able to provide you with details of other organisations and services that provide local support, and if relevant we would be happy to talk these through with you.
• Touchstone: Provides advocacy services in Kirklees to support people who have a concern or complaint about an NHS Service. www.touchstonesupport.org.uk
• Healthwatch Wakefield: Provides advocacy services in Wakefield to support people who have a concern or complaint about an NHS Service. www.healthwatchwakefield.co.uk/nhs-complaints-advocacy 01924 787379
• Independent Complaints Advocacy Team (ICAT): Provides advocacy services in Bradford to support people who have a concern or complaint about NHS Services. www.bradford.gov.uk/health/health-advice-and-support/ independent-complaints-advocacy-team 01274 770118
• Cloverleaf Advocacy: Provides advocacy services to people with mental health needs, learning disabilities, older people, people with physical and sensory impairment, and carers. This includes people in hospitals, secure mental health units and residential homes. www.cloverleaf-advocacy.co.uk 01924 454875
• Citizens Advice Bureau:
National organisations
• Action against Medical Accidents (‘AvMA’): An independent national charity that specialises in advising people who have been affected by lapses in patient safety (‘medical accidents’). It offers free advice on NHS investigations; complaints; inquests; health professional regulation and legal action regarding clinical negligence. Most advice is provided via its helpline or in writing but individual ‘advocacy’ may also be arranged. It can also refer to other specialist sources of advice, support and advocacy or specialist solicitors where appropriate. www.avma.org.uk 0845 123 2352
• Advocacy after Fatal Domestic Abuse: Specialises in guiding families through inquiries including domestic homicide reviews and mental health reviews, and assists with and represents on inquests, Independent Office for Police Conduct (IPOC) inquiries and other reviews. www.aafda.org.uk 07768386 922
• Child Bereavement UK: Supports families and educates professionals when a baby or child of any age dies or is facing bereavement. This includes supporting adults to support a bereaved child or young person. All support is free, confidential, has no time limit, and includes face to face sessions and booked telephone support. www.childbereavementuk.org 0800 028 8840.
• Department for Work and Pensions: www.gov.uk/government/ organisations/department-for-work-pensions
• Child Death Helpline: Provides a freephone helpline for anyone affected by a child’s death, from pre-birth to the death of an adult child, however recently or long ago and whatever the circumstances of the death and uses a translation service to support those for whom English is not a first language. Volunteers who staff the helpline are all bereaved parents, although supported and trained by professionals. www.childdeathhelpline.org.uk 0800 282 986
• Cruse Bereavement Care: Offers free confidential support for adults and children when someone dies. Contact us by telephone, email or face-to-face. www.cruse.org.uk 0808 808 1677
• Hundred Families: Offers support, information and practical advice for families bereaved by people with mental health problems, including information on health service investigations. www.hundredfamilies.org
• INQUEST: Provides free and independent advice to bereaved families on investigations, inquests and other legal processes following a death in custody and detention. This includes deaths in mental health settings. Further information is available on its website including a link to ‘The INQUEST Handbook: A Guide for Bereaved Families, Friends and Advisors’. www.inquest.org.uk 020 726 31111 option 1
• National Survivor User Network: Is developing a network of mental health service users and survivors to strengthen user voice and campaign for improvements. It also has a useful page of links to user groups and organisations that offer counselling and support. www.nsun.org.uk
• Royal Voluntary Service: 0845 6080122
• Miscarriage Association: 01924 200799
• Patients Association: Provides advice, support and guidance to family members with a national helpline providing specialist information, advice and signposting. This does not include medical or legal advice. It can also help you make a complaint to the CQC. www.patients-association.org.uk 0800 345 7115
• Respond: Supports people with learning disabilities and their families and supporters to lessen the effect of trauma and abuse, through psychotherapy, advocacy and campaigning. www.respond.org.uk
• Sands: Supports those affected by the death of a baby before, during and shortly after birth, providing a bereavement support helpline, a network of support groups, an online forum and message board. www.sands.org.uk 0808 164 3332
• Support after Suicide Partnership: Provides helpful resources for those bereaved by suicide and signposting to local support groups and organisations. www.supportaftersuicide.org.uk
• Samaritans: 116 123 (National)
• Terrence Higgins Trust (HIV/AIDS): 439 Caledonian Road, London N7 9BG. 0808 8021221 (Monday to Friday, 10am to 6pm)
What should I do if I have concerns about my relative/friend’s treatment contributing to their death?
Please speak to the staff involved in the treatment of your loved one; or the Patient Advice and Liaison Service (PALS). If necessary, you can ask for an investigation. You can also make a formal complaint, either to the trust directly or to the relevant Integrated Care Board (ICB) – please see below for more information.
Who orders a post mortem or inquest?
In some cases we refer deaths to the coroner and in some cases the coroner may then order a post mortem to find out how the person died. Legally, a post mortem must be carried out if the cause of death is potentially unnatural or unknown. The coroner knows this can be a very difficult situation for families and will only carry out a post mortem after careful consideration. A family can appeal this in writing to the coroner, giving their reasons, and should let the coroner know they intend to do this as soon as possible. However, a coroner makes the final decision, and if necessary, can order a post mortem even when a family does not agree. Please note that the body of your loved one will not be released for burial until it is completed, although a coroner will do their best to minimise any delay to funeral arrangements. You speak directly to the local coroner’s office about having a post mortem and/or inquest.
What should I do if I think the treatment was negligent and deserving of compensation?
Neither patient safety investigations nor complaints will establish liability or deal with compensation, but they can help you decide what to do next. You may wish to seek independent advice from Action against Medical Accidents (see the section on ‘Independent information, advice and advocacy’). They can put you in touch with a specialist lawyer if appropriate. Please note: There is a three-year limitation period for taking legal action.
What should I do if I think individual health professionals’ poor practice contributed to the death and remains a risk to other patients?
Lapses in patient safety are almost always due to system failures rather than individuals. However, you may be concerned that individual health professionals contributed to the death of your loved one and remain a risk. If this is the case, you can raise your concerns with us or go directly to one of the independent health professional regulators listed on page 32-33.
Where can I get independent advice and support about raising concerns?
Please see the section on independent information, advice and advocacy, which details a range of organisations. Other local organisations may also be able to help.
Other organisations that may be of help:
• Integrated Care Board (ICB): Integrated Care Boards pay for and monitor services provided by NHS Trusts. Complaints can be made to the relevant ICB instead of the trust, if you prefer. Please ask us for contact details of the relevant ICB or visit www.nhs.uk/nhs-services/find-your-local-integrated-care-board/
• Parliamentary and Health Service Ombudsman (PHSO): The PHSO make final decisions on complaints that have not been resolved by the NHS in England and UK government departments. They share findings from their casework to help parliament scrutinise public service providers. They also share their findings more widely to help drive improvements in public services and complaint handling. If you are not satisfied with the response to a complaint, you can ask the PHSO to investigate. www.ombudsman.org.uk 0345 015 4033
• Care Quality Commission (CQC): The CQC is the regulator for health and social care in England. The CQC is interested in hearing about concerns as general intelligence on the quality of services, but please note that they do not investigate individual complaints. Visit: www.cqc.org.uk
• National Reporting and Learning System (NRLS): Members of the public can report patient safety incidents to the NRLS. This is a database of incidents administered by NHS Improvement, which is used to identify patient safety issues that need to be addressed. Please note though that reports are not investigated or responded to. www.england.nhs.uk/patient-safety/report-patient-safety-incident
• NHS England – Specialised Services: Specialised services support people with a range of rare and complex conditions. They often involve treatments provided to patients with rare cancers, genetic disorders or complex medical or surgical conditions. Unlike most healthcare, which is planned and arranged locally, specialised services are planned nationally
and regionally by NHS England. If you wish to raise a concern regarding any specialised services commissioned in your area, please contact NHS England’s contact centre in the first instance. Email: england.contactus@nhs.net or telephone 0300 311 22 33
• Nursing and Midwifery Council (NMC): The NMC is the nursing and midwifery regulator for England, Wales, Scotland and Northern Ireland. It has a Public Support Service that puts patients, families and the public at the centre of their work. More information can be found within the ‘Concerns about nurses or midwives’ section on their website: www.nmc.org.uk
• General Medical Council (GMC): The GMC maintains the official register of medical practitioners within the United Kingdom. Its statutory purpose is to protect, promote and maintain the health and safety of the public. It controls entry to the register, and suspends or removes members when necessary. Its website includes a guide for patients and the public which will help you decide which organisation is best placed to help you. More information can be found within the ‘Concerns’ section at: www.gmc-uk.org
• Healthcare Safety Investigations Branch (HSIB): HSIB’s purpose is to improve safety through effective and independent investigations that don’t apportion blame or liability. HSIB’s investigations are for patient safety learning purposes. Anyone can share cases with HSIB for potential investigation (but an investigation is not guaranteed). www.hsib.org.uk
This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request. Please contact: PALS on: 01924 542972 or via email on: myh-tr.palsmidyorks@nhs.net
Acknowledgement and thanks
The NHS is very grateful to everyone who has contributed to the development of this information. In particular, they would like to thank all of the families who very kindly shared their experiences, expertise and feedback to help develop this resource.
This information has been produced in parallel with ‘Learning from Deaths - Guidance for NHS trusts on working with bereaved families and carers’, which can be found at (www.england.nhs.uk/ get-involved/get-involved/how/nhs-citizen/working-with-families-andcarers-to-learn-from-deaths)
Future updates to this information
Please note that this information will be updated in the future as a result of expected new guidance and processes.
Ref: Mid Yorkshire Teaching NHS Trust (D&DGH)
Print date: September 2024
Review date: September 2026
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.
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You may need help, support or advice on what to do when someone dies in relation to probate.
We offer free guidance and advice on the legal and financial aspects of bereavement including your responsibilities and whether probate is required.
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