IPSWCH BB R11 by bereavementadvice

for relatives and carers

What do I do now?

Bereavement Suite Ipswich Hospital Tel: 01473 704498

Monday to Friday, 8 am – 4 pm answerphone at all other times

Our Sympathy On behalf of staff here at Ipswich hospital we would like to extend our condolences on your bereavement. The NHS cares for many people at the end of their lives and that care does not end when they die. We understand that making arrangements for a funeral can be sad and a little confusing. We would like to do all we can to make things a bit easier for you. This leaflet is designed to give you all the information you will need to make the necessary arrangements. The following is a quick-step guide to help you: 1. The bereavement officer is informed of all deaths at Ipswich hospital. They will aim to call you within 24 hours (Monday to Friday) to help you through the immediate administrative process following death. This will involve a short conversation around your wishes, the medical examiner process and arrangements being made to obtain a medical certificate. If you wish to speak to a bereavement officer before this time please leave a message with your contact details, on 01473 704498 and the bereavement officer will call you following their daily appointments. 2. Once the medical certificate has been completed the bereavement officer will contact you again to confirm the certificate has been issued, and support you through the next steps. To ensure you are not unnecessarily delayed we politely ask you not attend the bereavement office without an appointment. 3. Following making these arrangements with the bereavement officer, you should make an appointment with the appropriate Registrar of Births and Deaths. Details of these are on page 7-8

Contents

Page

Contacting the Bereavement Office and collecting the Medical Cause of Death Certificate................... 1-3 Registering a Death - Important Information.............................. 4-8 Funeral Arrangements..........................................................................................9 Rosemary Suite Visits..............................................................................................9 Tissue Donation........................................................................................................10 Coroner’s Involvement............................................................................... 11-12 Hospital Post Mortem.........................................................................................13 Personal Possessions and Property...........................................................14 Support and Comfort.................................................................................. 14-17 Chaplaincy at Ipswich Hospital...................................................................17 Useful telephone numbers..................................................................... 18-20 Stopping Junk Mail to the recently deceased................................21 Colchester and Ipswich Hospitals Charity..........................................22 Mortuary & Bereavement Services Feedback.................................23 Care in the last days of life.............................................................................24

Contacting the Bereavement Office and collecting the Medical Cause of Death Certificate Please note: Due to unprecedented circumstances there is currently no requirement to attend the hospital and collect the Medical Cause of Death Certificate (MCCD). The Bereavement Officer will call you when the MCCD is ready to be sent to the Registry Office electronically, and explain the next steps to register the death.

Medical Examiner The Medical Examiner is a senior doctor who will discuss the cause of death with the doctor issuing the certificate and the family of the deceased. Providing the Medical Examiner is satisfied there is no requirement to notify the Coroner of the person’s death the certificate can then be released to the family. This additional step may slightly delay releasing the certificate to you. However, the benefit of this system is to ensure the certificate has been completed fully and accurately and provide an opportunity for you to discuss the cause of death with a doctor. This can help prevent delays and/or rejection of the certificate at the Registrar of Births and Deaths and allow you the opportunity to ask questions and understand the cause of death stated on the certificate. Medical Certificate of Cause of Death This is the certificate that you need to take to the Registrar to register the death. The medical certificate has to be completed by a doctor who attended your relative during their stay in hospital. The Bereavement Officer contacts the doctor and arranges the next available appointment for them to meet the Medical Examiner. Following this discussion they are asked to complete the Medical Certificate of Cause of Death promptly. We aim to issue a Medical Certificate of Cause of Death as soon as possible, however these need to be completed by the medical staff who cared for your relative in hospital and unfortunately, due to medical emergencies or urgent clinical issues a delay may occur. A Bereavement Officer will call you when the certificate has been completed.

In some cases the doctor may have to notify the Coroner regarding the death. The Bereavement Officer will inform you if there is likely to be a delay. Please be advised that the Bereavement Officer may not know about potential problems when you contact the office. However, you will be updated immediately that any potential delay becomes apparent. The Bereavement Officer will ask you about the funeral arrangements. We appreciate that you may not have had time to consider these at this time but it is useful for us to know as soon as possible. This ensures all necessary paperwork is completed and no delays are caused in transferring the care of your loved one to your chosen funeral director. For telephone calls made outside office hours, please leave a message with a contact telephone number and we will return your call as soon as possible. Once the doctor has completed the medical certificate one of the Bereavement Officers will contact you to support you through the next steps.

Registering a Death - Important Information Please note: There are currently changes to the registration process due to the COVID-19 Pandemic. The Bereavement Officer will inform you of any changes when they call. Visiting the Registrar The death can be registered at any of the Register Offices in the County (see pages 7-8). What will I need to take to the Registrar? • Medical Cause of Death Certificate • Deceased’s Birth and Marriage/Civil Partnership certificate (if available/applicable) • Deceased’s medical card (NHS Number) • Payment for Certificates • Documents for ‘Tell Us Once’ service (See page 6). The Registrar will need the following information: • Date and place of death (on Medical Certificate of Cause of Death) • Full name of the deceased and maiden name if appropriate • Date and place of birth of the deceased • The deceased’s usual address • Whether or not the deceased was in receipt of a pension from public funds • The deceased’s National Health Service number (this will be shown on the medical card). • If married or in a civil partnership, the full names, date of birth and occupation of the deceased’s spouse, widow/widower or surviving civil partner. 4

It is very important that the information recorded is correct. If any mistake is made, for example in the spelling of a name or an incorrect date of birth, it may cause you considerable inconvenience to have this corrected. You should therefore check the particulars very carefully before you sign. How long will the registration take? Please allow about 30 minutes. What paperwork will be issued following Registration? • A certificate for burial or cremation (also known as the green form) - This form is for you to take to the funeral director so that the funeral can take place. There is no charge for issue of this form. • Standard Death Certificate - A death certificate is a certified copy of the entry in the death register. These will be required for banks, building societies, insurance companies and other financial institutions.

‘Tell Us Once’ Service Tell Us Once is a government initiative which aims to ease the burden of notifying multiple local and central government departments that someone has died. The service, offered as an option at your death registration appointment, will mean that you can ‘tell them once’ and they will, with your permission, share data with the departments and agencies on your behalf. You will need to be ‘next of kin’ or the person dealing with the deceased’s estate to use this service or have permission to do so. The data will be shared with a number of central and local government departments including HM Revenue and Customs, Driver and Vehicle Licensing Agency, Department for Work and Pensions, Identity and Passport Service, housing benefit, blue badge, social care and libraries. What do I need to bring with me? • Deceased’s National Insurance number • Deceased’s surviving husband, wife or civil partner’s National Insurance number if applicable • Next of kin’s name, address and telephone number • Information about any benefits and services the deceased may have been receiving (e.g. state pension, income support, housing benefit, library card etc) • Name and address of person dealing with the deceased’s estate (if different). If applicable: • Driving licence • Passport • Blue badge If you are unable to locate any of this information in time for your appointment, you will still be able to use the service later by telephone. The Registrar will give you a unique reference number and a telephone number to call.

Ipswich Register Office: Tel: 0345 607 2050 St Peter House, 16 Grimwade Street, Ipswich IP4 1LP Opening Hours: Monday to Friday - 9.00am to 4.00pm By appointment only.

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When death has occurred within the Suffolk County Councils region, it may be possible to register a death at the following offices. Please note that the opening days and times may vary from one office to another. To book an appointment please call: 0345 6072060 or visit www.suffolk.gov.uk/births-deaths-and-ceremonies/contact-aregister-office to book online.

• Bury St Edmunds 7 Angel Hill, Bury St Edmunds, IP33 1UZ • Felixstowe The Town Hall, Undercliff Road West, Felixstowe, IP11 2AG • Haverhill The Burton Centre, Camps Road, Haverhill, CB9 8HB • Lowestoft Riverside Business Centre, 1 Riverside Road, Lowestoft NR33 0TQ • Newmarket The Guineas Centre, 63 The Guineas, Newmarket, CB8 8HT • Saxmundham County Offices, Street Farm Road, Saxmundham, IP17 1AL • Stowmarket Milton House, Milton Road South, Stowmarket, IP14 1EZ • Sudbury The Town Hall, Old Market Place, Sudbury, CO10 1TL • Woodbridge 26a Quayside, Woodbridge, IP12 1BH. 8

Funeral Arrangements You should contact your chosen funeral director as soon as possible. They will be able to give you advice on what to do next and help you choose what arrangements you would like to make for the deceased. The mortuary team will wait to hear from your funeral service. Cremation If you are arranging a cremation, please tell the Bereavement Office when they call you. They will arrange for the doctors to complete the necessary paperwork. The funeral director will collect the cremation certificate when they visit the hospital to collect your relative.

Rosemary Suite Visits Visiting your loved one after their death may help and can be easily arranged for you. These appointments can be made by the bereavement officer, or by calling the mortuary directly on 01473 703580. Visiting hours are 13:00 to 16:00 by appointment. If you wish to visit in the evenings or at the weekend please contact the hospital switchboard team. They will connect you to the on call member of the mortuary team to arrange a mutually convenient time to visit.

The mortuary has a separate ‘Rosemary Suite’, this comprises of a visitors room, side room with seating and a reflection garden. It is situated adjacent to the mortuary and is suitable and open to all religions and denominations. If you have parked on site whilst visiting your loved one, please inform a member of mortuary or bereavement staff of your number plate. They will cancel any parking fees for this period.

Tissue Donation At time of writing there are proposed law changes in England. From 20th May 2020, tissue and organ donation in England will move to an ‘opt out’ system. This means that all adults in England will be considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate or are in one of the excluded groups. Further information available at www.nhsbt.nhs.uk

Coroner’s Involvement Under certain circumstances the involvement of the Coroner may be necessary. Some examples of such circumstances are: • All sudden and unexplained deaths • Where the cause of death is unknown and a doctor cannot issue a certificate • Any deaths through unnatural or suspicious causes. Examples of these would cover accidents, suicides, violence, poisoning etc. • If the death occurred whilst the patient was undergoing a medical operation or was under the effect of anaesthetic • A custodial death whilst under arrest, detained in prison under the Mental Health Act • If the death was caused by industrial disease The Coroner for Suffolk is an independent judicial officer who enquires into those deaths that fall within the above circumstances, within the County of Suffolk. The Coroner’s Officers are independent representatives and work to the guidance of the Coroner. The Coroner’s Officers will be contacted in any of the above circumstances and the Coroner will as part of the investigation, decide one of two things: • That NO post mortem is necessary. The doctor will issue a Medical Certificate of the Cause of Death (MCCD). • A post mortem examination will have to be undertaken to ascertain the cause of death. The Coroner’s Officers will speak with the next of kin in each case as part of their enquiries. They will endeavour to contact the next of kin within 2-3 working days of the death being referred by the doctor. 11

Post mortem Relatives will be informed if a post mortem is necessary. The Coroner is legally empowered to request this, irrespective of religious belief, consent is therefore not required. If you have any concerns you can discuss these with the Coroner’s Officer. A post mortem is usually carried out within five working days of the death being referred to the Coroner. It is a surgical examination to find out more accurately the cause of death. Following the outcome, the Coroner’s Officer will be in touch and will inform you of the result. They may ask which funeral directors you intend using and whether a burial or cremation is to be arranged. Inquest If the death is by unnatural causes or there is need for further enquiry following the post mortem the Coroner’s Officer will open an inquest into the medical cause and circumstances surrounding the death. The Coroner’s Officer will explain the details to you at the time, specific to the case, but the inquest will usually be adjourned and re-opened at a later date. In this situation an Interim Certificate of Fact of Death will be issued by the Coroner to the next of kin until the inquest is over and the death can be registered. The Coroner’s Officer will issue an Order of Burial Form or Certificate Form E so that the funeral can take place. In some circumstances the body may be required for further examination, but if not the funeral can take place before the inquest.

After the inquest the Coroner will send the Coroner’s Certificate of After Inquest (Form 99) to the Registrar allowing the death to be formally registered and the full death certificate to be issued accordingly.

Hospital Post Mortem Although the Coroner may not require a post mortem examination, a hospital doctor may ask your permission to perform a post mortem. This can help doctors to understand the reason why the death occurred. The findings may also help in the treatment of other patients in the future. A member of the medical staff will approach the next of kin for permission to do this and they will be asked to sign a hospital post mortem consent form. The doctor and the Bereavement Team will explain the form and the process. It gives you complete control as to how the post mortem is performed. You are within your rights to refuse consent to this request. Should you give consent for a post mortem the results of the post mortem examination may be obtained from the clinician requesting the post mortem. By consenting to this examination, you are still able to collect the Medical Cause of Death Certificate, register the death and make the funeral arrangements without any delay.

Personal Possessions and Property Items of jewellery, in particular wedding rings, are generally left with the patient unless you have instructed ward staff to do otherwise. Any property that is left with the patient will be carefully packed in a sealed bag by the nursing staff who cared for the patient. If you do not have the opportunity to collect from the nursing staff, this will accompany the patient to the mortuary. These bags will remain sealed and handed to the funeral service. If you wish to collect the property before this time please call the bereavement or mortuary staff who will be able to advise.

Support and Comfort When someone close to us dies, whether the death was expected or more sudden, the sense of shock and loss can be overwhelming. Often there is a sense of numbness, unreality and disbelief. This feeling can often last for several weeks or even months as reality gradually dawns. Grief can often be a deeply painful and confusing process. Life will never be quite the same again and it will take time to feel on some sort of even keel. Although you will never forget the person who has died or the meaning of the relationship you shared, most people find that over a period of time the memory carries less pain and a new perspective on life can gradually be realised.

For some this may happen quite quickly, but is not unusual for a few years to pass before you establish a new sense of purpose. Generally the intensity of your loss will subside during this time. For some people the loss can be a great relief and there can be a sense of release, for whatever reason. Everyone’s experience of grief and loss is as unique as every relationship. However, there are some common feelings which can be experienced, not necessarily in any order. These might be: • shock • anger • sadness and sudden tearfulness • guilt • intense loneliness

• pining • panic - How will I cope? What does the future hold? • erratic sleeping and moods • appetite changes

These feelings often come and go and can linger for two or three years. Sometimes they can resolve in quite a short space of time. Grief is a painful process that gradually eases as we adapt to a life very much changed by the absence of our loved one. It is also important to remember that children grieve, although this may not always be as obvious as when adults do. Some dos and don’ts • Do give yourself permission to express your grief in your own way, not how others tell you. • Do be involved with practical matters, but do let others help. • Do seek help if you begin to feel concerned about yourself (or a family member). • Do try to eat and look after yourself generally. • Do rest if you feel tired, this is normal.

• Do begin to notify banks, building societies, utility companies etc. • Don’t be embarrassed or concerned about being tearful or needing to talk about your loss. • Don’t make any major changes in your life. Support Remember, although painful, it is normal to grieve and it is often family and friends who provide the support and comfort needed at this time. If you become concerned about how your grief is affecting you there are various avenues available. Many people find their GP helpful and there may be a counsellor attached to your surgery if you feel the need to discuss concerns. Your local church or faith group may be able to offer support. Cruse is a national organisation with local branches which offers support and guidance after bereavement and you will find numbers for Cruse at the end of this booklet. A few other phone numbers and websites are included in this booklet, including details for the Bereavement Advice Centre which has a more comprehensive list. You may also find that your funeral director’s brochure has useful information and contact details. Death following cancer If the death has occurred as a result of cancer, the Oncology Department offers a support service with a dedicated bereavement line. Please telephone 01473 704902. In addition to providing short-term counselling, information about support available to bereaved children can be provided. 16

Financial and other practical concerns If you have practical or financial concerns, and don’t know who to contact, telephone the Citizens Advice Bureau (CAB) on 0300 3301 151 for information.

Chaplaincy at Ipswich Hospital The chaplains are available to support anyone who has been bereaved. You do not need to be religious to speak with a chaplain. If you would like to talk about your loved one who has died, or your feelings of grief and loss the chaplains are available to listen and to support you. The chaplains can also accompany you on visits to the Rosemary Suite, assist if you have practical questions about death and funerals, and help provide specific faith and belief advice or support at your request. The chaplains are on site Monday to Friday from 8am-4pm. Outside of these hours the chaplains provide an on-call service. You can contact the chaplains by calling 01473 704100. If the chaplains are not immediately available to take your call you can leave a message on their secure answerphone, or call the hospital switchboard on 01473 712233 and ask to speak to the on-call chaplain. You can also email the chaplains on chaplaincy@esneft.nhs.uk Please do make contact with the chaplains if you feel they can help and support you in any way.

Useful telephone numbers Unfortunately we cannot include every helpline available, but below are a few numbers you may find useful. We have provided local numbers where possible. An initial contact can often point you in the direction of support closer to home if you live outside Ipswich. Some of the numbers are national help and information lines. Local Ipswich Hospital Advice and Complaints Service 01473 703797 Ipswich Hospital Cancer Bereavement Support 01473 704902 Ipswich Citizens Advice Bureau 0300 3301 151 Ipswich and Suffolk Coastal Cruse and Young Cruse 01473 230888 47 St Helen’s Street, Ipswich IP4 2JL Samaritans 116 123

National The Good Grief Trust www.thegoodgrieftrust.org Age UK 0800 169 6565 or www.ageuk.org.uk Bereavement Advice Centre 0800 634 9494 or www.bereavementadvice.org Bereavement Support Network (STOPMAIL) To remove the name and address of someone who has died from databases and mailing lists. 0808 168 9607 or www.stopmail.co.uk Compassionate Friends A national helpline for anyone affected by the death of a child at any age. 0345 123 2304 or www.tcf.org.uk Cruse National Helpline 0808 808 1677 or www.cruse.org.uk Lesbian and Gay Bereavement Helpline 020 7833 1674 Tuesdays 7.30pm - 9.30pm www.londonfriend.org.uk Miscarriage Association 01924 200799 or www.miscarriageassociation.org.uk RoadPeace National charity for road traffic victims for those bereaved by road death. 0845 4500 355 or www.roadpeace.org Sands - Stillbirth and Neonatal Death Society 0808 164 3332 or www.sands.org.uk

WAY Widowed and Young For those widowed under the age of 50. www.widowedandyoung.org.uk Survivors of Bereavement by Suicide 0300 111 5065 or www.uksobs.org In the event of a death caused through violence, information about specialised support can be obtained from: Victim Support 0808 168 9111 or www.victimsupport.org.uk Support after Murder and Manslaughter 0121 472 2912 or www.samm.org.uk We would like to offer our condolences at this difficult time. Concerns or complaints If you have any concerns or worries about your care please contact the department responsible. However, if you are unable to resolve your concerns or wish to make a formal complaint, please contact the PALS (Patient Advice and Liaison Service), on 01473 704781 - or ask any member of staff for a leaflet, which will describe how you may make a complaint.

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.

IN MEMORY OF YOUR LOVED ONE Please accept our sincere condolences at this sad time. We are grateful to you for taking the time to read about your hospital’s charity which helps make improvements for patients and staff. GIFTS IN MEMORY If you are arranging a funeral and would like to ask for a donation to benefit a ward or department instead of floral tributes, our funeral collection envelopes will make it easier and can be designated for a particular ward or department. Envelopes can be ordered from Colchester & Ipswich Hospitals Charity. SUPPORTING YOUR HOSPITAL Colchester & Ipswich Hospitals Charity gives grants to wards and departments for special equipment, to enhance care and improve the environment for patients across east Suffolk and north Essex. For advice about writing funeral notices and orders of service to ensure donations reach the ward or department of your choice or to make a donation please contact Colchester & Ipswich Hospitals Charity. T: 0300 770 1369 E: charity@esneft.nhs.uk W: colchesteripswichcharity.org.uk Registered charity number 1048827

Mortuary & Bereavement Services Feedback As a Trust we welcome feedback on the service we provide and therefore we would appreciate your comments, good or bad, as they can help us improve our service. ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ...........................................................................................................................................................................

Please return to: The Bereavement Service Manager Ipswich Hospital (S617) Heath Road Ipswich IP4 5DP

Care in the last days of life Your feedback helps to improve care at the end of life for our patients.

Please complete our online ‘care in the last days of life’ survey at forms.office.com/r/09Ai26eaaH or use the QR code above, There are also paper copies available via the bereavement team. Thank you

Reference: Ipswich Hospital Bereavement Booklet Publication date: December 2021 Review date: December 2023

The Hospital would like to thank RNS Publications for publishing this information and the following pages contain some features from local services offering 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.

Remember Someone Special with Memory Space Memory Space is a place where you can keep photos and share stories about a loved one, while raising money for Mind in their memory. By fundraising for us with Memory Space in your loved one’s honour, you’ll help create a kinder society – one where everyone who is struggling can talk openly about their mental health and get the support they need, when they need it. In this way, some good can come from a place of loss.

Call us on 020 8215 2243 or visit mind.org.uk/memory-space

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