The death of a loved one is a very difficult time. This booklet aims to provide some helpful and practical advice during the early days of your bereavement.
We offer our condolences at this sad time. If we can be of any further assistance, please do not hesitate to contact us using the number below.
At the back of the booklet there are contact details of some organisations that may be able to offer you further advice and support. The information in this booklet is correct at the time of publication. However, please be aware that some information and details can change after these booklets have been printed, we will always do our best to keep everything as up to date as possible.
Lister Bereavement staff
Bereavement Assistant 01438 284634 an answer phone is available.
The Bereavement Office is open for telephone enquiries and appointments from 9am – 3:30pm Monday to Friday (Closed on Bank Holidays)
Please note: If your call goes through to the voicemail service, it is because we may be talking to another family on the phone. If you leave a message we will return your call as soon as possible.
Additional Contact Details
Lister Hospital main switchboard number 01438 314333
Spiritual & Pastoral Care 01438 285519
Hertfordshire Coroner’s Office 01707 292707
Email: coroner.service@hertfordshire.gov.uk
Medical Examiners Office
medicalexaminer.enh-tr@nhs.net
East & North Herts Charity 01438 285182
Bereavement Services
Email: enh-tr.bereavementservices@nhs.net
WHAT HAS TO BE DONE AFTER A DEATH - AN OVERVIEW
The rest of this booklet explains each stage of the process in more detail.
1. Please telephone the Bereavement Office on the next working day so that we can advise you on what will happen next. We prefer for you to make the first contact with us so that we can advise you at a time that you feel ready to receive the information. If you would prefer to visit the Bereavement Office in person, please call to make an appointment first so that we can ensure the Bereavement Assistant is available.
2. When you speak to the Bereavement Assistant, they will inform you of the process that will need to take place following the death of your loved one. They will ask you the following questions:
• Which funeral director will be appointed?
• Whether arrangements will be made for a cremation or a burial
• Whether you have any concerns regarding your loved one’s stay in hospital
3. You can contact your chosen funeral director to make some provisional arrangements (page 21).
4. We will arrange for a doctor to complete the Medical Certificate of Cause of Death (MCCD), which we will email to the Hertfordshire Registration Service. Your named Medical Examiner Officer (MEO) will telephone you to explain what the doctor has written as the cause of death and answer any questions you may have.
5. The Medical Examiner Officer (MEO) will ask you to telephone the Hertfordshire Register Office on 0300 123 4045 to book an appointment to register the death, or online at www.hertfordshire.gov.uk/registeradeath. You can attend the register office of your choice provided it is in Hertfordshire.
6. If the Coroner is involved, he will review the medical information provided by the doctor and make a decision on whether a post mortem examination is required or if a doctor can issue a Medical Certificate of Cause of Death (page 11).
7. If a post mortem is required you will be designated a Coroner ’s Officer who will inform you of the findings of the post mortem (see page 12).
8. If the coroner is involved, you may only register the death after the Coroner has given permission to do so.
All information relating to the registration office and the Coroner’s processes is correct at the time of publication. The Bereavement Team will advise you of any changes.
DONATING THE BODY, TISSUE OR ORGANS
Tissue and corneal donation may be possible up to 48 hours after death and can benefit many recipients. If this is something that you would like further information on then please speak to a ward nurse or doctor who can contact the Tissue Co-ordinator.
Some people may have previously given their written consent and made arrangements for their body to be used for medical research and teaching purposes. If so, relatives should get in touch with the relevant medical school/anatomy organisation who will then liaise with the hospital staff.
Further information on body donation can be obtained by visiting www.hta.gov.uk
PERSONAL PROPERTY
It is always preferable that you take your loved one’s property home with you at the earliest opportunity; however, we understand that this may not always be possible.
If the property is brought to the Bereavement Office, the bereavement assistant will check through the contents and ask if you would:
• Prefer to collect it from us at the hospital (by appointment only)
• Or, you could ask your chosen Funeral Director to return the belongings to you – most Funeral Directors are happy to provide this service, but occasionally it is not possible.
IMPORTANT: If there are any property items that went missing/ were misplaced in the ward where your loved one was a patient, please contact that ward directly and speak to the nurse in charge or the matron so this can be investigated.
KEEPSAKES
Keeping mementos of your loved one may give some comfort to you. We can provide you at your request, if appropriate, a lock of hair.
Please inform the bereavement office if you would like a keepsake and we will arrange for it to be taken with your verbal or written consent.
VIEWINGS
Sometimes saying goodbye is an important part of the grieving process. This is a personal choice to be made by you and there will be no pressure on you if you do not wish to do so.
We have a specialised room available for viewings that offers privacy and is of a non-religious or spiritual surrounding but offers you the comfort to spend time with your loved one in a non-medical setting.
Viewings can be arranged by telephone or email with the bereavement & mortuary department during working hours (Mon – Fri, 9am – 3.30pm) and will take place in the bereavement viewing suite where up to 4 immediate family members may attend. Unfortunately we do have to limit viewings to 1 per family.
If you request a viewing the bereavement and mortuary team will need to make initial checks before being able to confirm an appointment time and date, please do not be alarmed by this. This process is so that we can check with the coroner’s office if required and make sure that your loved one is able to be viewed.
Once the bereavement and mortuary team have confirmed the appointment you will be requested to bring with you a form of identification, this can be;
• A passport
• Driving License
• Bank/Credit card
• Other – Please discuss this with the team member who confirms the appointment.
You are welcome to bring in items that you may wish to leave with your loved one, please discuss this with the bereavement and mortuary team, we will ensure that anything left with your loved one stays with them at all times.
SPIRITUAL & PASTORAL CARE
The Spiritual and Pastoral Care Team is available at any time of the day (and at night in an emergency) to offer emotional, spiritual or religious support. Our team includes Chaplains from a variety of faith and belief communities. Currently these are Buddhist, Christian (Anglican, Roman Catholic, Pentecostal) Hindu, Humanist (non-religious), Muslim, and Sikh. The team also have contacts with a variety of people from other faiths and traditions including most other Christian denominations, locally who we can contact for support.
We are here to offer you whatever support we can, whatever you need, whatever your beliefs - whether these are religious or otherwise.
We can
• Sit with you in your pain of loss
• Hear about your loved one and their story
• Listen to what might be of comfort to you
• We can talk about any rites or rituals that may provide comfort
• We can offer prayers or a blessing for your loved one, including a humanist one, if you have no faith.
• And if you ask, we can try and contact your own faith leader in the community for you.
We do not assume to know what you need.
We do not impose our beliefs.
We are here to listen and to serve.
Please contact us on 01438 285519
THE MEDICAL EXAMINER PROCESS
All deaths must be reviewed by a Medical Examiner (ME). This is an independent, senior doctor who was not involved in the care of your loved one. We also have Medical Examiner Officers (MEOs) who coordinate the entire process of ensuring the required certificate of cause of death can be issued. You will have a named Medical Examiner Officer (MEO) who will be your main point of contact throughout the entire process. The bereavement assistant also supports the Medical Examiner Officers (MEOs).
The Medical Examiner (ME) reviews the medical notes and has a discussion with your designated Medical Examiner Officer (MEO) and the doctor(s) responsible for the care of your loved one. This is to ensure that the information entered on the Medical Certificate of Cause of Death (MCCD) is correct and that all information relating to the death is recorded appropriately. The Medical Examiner is NOT the same as the Coroner.
Your designated Medical Examiner Officer (MEO) will ensure you are informed of the cause of death and they will answer any questions you may have about the Medical Examiner process. You will also be asked if you have any concerns regarding your loved one’s care during their final illness. Although they may not be able to answer all of your questions immediately, they will advise you of sources of additional support or information.
Who are Medical Examiners and Medical Examiner Officers?
Since 2019, some senior NHS doctors have received specialist training in order to become Medical Examiners (ME). Alongside their normal working specialities, their job is to give independent advice about causes of death (except for deaths that have been referred directly to the Coroner).
Medical Examiners (ME’s) look at the relevant medical records and discuss the causes of death with the attending doctor, a doctor who was involved in the care of your loved one, and who will complete the Medical Certificate of Cause of Death (MCCD).
The Medical Examiner (ME) will provide an independent view as they will only review cases where they have not provided care for your loved one.
During the independent review, if the Medical Examiner (ME) finds issues with care that needs further investigation, they will refer these to someone who can do this. This is usually an internal investigation within the hospital.
Medical Examiner Officers (MEO’s) are specially trained Administrative staff who coordinate the entire process. They offer families and carers an opportunity to raise questions or concerns about the causes of death, or about the care their loved one received before their death. They can explain what the medical language means and make it easier to understand.
Each family is assigned a Medical Examiner Officer (MEO) who will remain their point of contact.
Coroners
When the Medical Examiner (ME) identifies a case that requires a referral to the Coroner, it is the Coroner who investigates the death independently and not the Medical Examiner.
Why am I being asked if I have any concerns?
A discussion with the Medical Examiner Officer (MEO) provides you with an opportunity to have an open and honest conversation with someone who was not involved in providing care to your loved one. Any worries or concerns you may have can be discussed and the Medical Examiner Officer (MEO) will be able to help you identify whether you need to make a direct complaint or whether they can provide your feedback and concerns to the team/ward responsible.
The Medical Examiner Officer (MEO) is here to listen to your concerns and questions and provide answers if possible. If issues are found they will be passed onto the appropriate people to be investigated. If this is the case the Medical Examiner Officer (MEO) will explain this process to you.
If there is a requirement for further investigation, unless the death has been referred to the Coroners, this will not cause a delay in the death certification process.
As well as answering your questions, any feedback or concerns received can help the NHS provide better care for loved ones in the future.
Can I ask the Medical Examiner Office to talk to someone else if it’s too difficult for me to speak with them?
Yes of course, the Medical Examiner Officer (MEO) will ask you who you would like us to speak to instead, or you can let the bereavement assistant know during your initial call following the death of your love one. Your first point of contact can also make the initial call to the bereavement office on your behalf if you feel you are unable to do this.
We understand that this is a difficult time for you and speaking to the Medical Examiner office is your choice. Will funeral plans or release of your relative take longer?
The Medical Examiner office will make every effort to avoid any delays and work with families to meet the legal requirements for registering deaths.
What can I do if I have questions or concerns about the Medical Examiner process?
If you are not satisfied with the information provided by the Medical Examiner office, we suggest you discuss this with your appointed Medical Examiner Officer (MEO) first.
If you are still not satisfied, you can also contact the Patient Advice and Liaison Service (PALS) where staff will be happy to listen to your concerns and ask the appropriate member of the Trust staff to contact you to talk through your concerns as quickly as possible.
COMMENTS, QUESTIONS OR CONCERNS
As a family member, partner, friend or carer of someone who has died while in the care of East and North Hertfordshire 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.
Your questions or concerns can be discussed with the Bereavement Assistant during your initial contact, which will be passed to the assigned Medical Examiner Officer (MEO) to discuss with the Medical Examiner (ME) and qualifying doctor.
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 through the Medical Examiner Office or Bereavement Assistant or our Patient Advice and Liaison Service (PALS).
Telephone: 01438 285811 or email: pals.enh-tr@nhs.net.
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.
MEDICAL CERTIFICATE OF CAUSE OF DEATH (MCCD)
This is the certificate written by the hospital doctor and is emailed to the Registrar by the Medical Examiner’s Office.
To enable a MCCD to be completed, Medical Examiner Officers (MEO’s) must follow a standard procedure. Please be aware that this process may take a few working days, depending upon the circumstances.
The Medical Examiner Officer (MEO) will contact a doctor involved in the care of your loved one and ask them to come and complete the MCCD. Doctors are not always able to attend immediately when requested but you will be kept informed of any unavoidable delays.
On completion of the MCCD, your Medical Examiner Officer (MEO) will email it to the Hertfordshire Registration Service and will call you to confirm this has been done.
THE CORONER
Coroners are independent judicial officers who inquire into deaths, which appear to be of an unknown cause or have occurred suddenly, if the deceased underwent surgery or if they had any recent falls or injuries which has contributed to their death.
ISSUE OF THE MEDICAL CERTIFICATE UNDER THE CORONER’S AUTHORISATION
A referral to the Coroner does not necessarily mean a post mortem will be required.
If the person who has died had any recent operations or significant injuries that contributed to their death it MUST be reported to the Coroner. If the treating doctor(s) can give a clear cause of death then the Coroner may allow the doctor to issue the Medical Certificate of Cause of Death. This is at the discretion of the Coroner’s Office though, depending on the circumstances leading to the death.
In these cases, a delay of a few working days is usually incurred whilst the Coroner looks at the circumstances. The Coroner’s Officer will advise when the Coroner has given permission for you to call the Register Office to book an appointment to register the death.
CORONER’S POST MORTEM
A referral for a post mortem is made when the cause of death cannot be given by the doctor or Medical Examiner. When doctors are unable to issue a Medical Certificate of Cause of Death they are required to inform the Coroner. The Coroner will decide if a post mortem will take place.
The Coroner does not require consent from the next of kin for this and it is part of a legal process.
The Coroner’s Officer, a representative of the Coroner, will keep you informed throughout the process of when the post mortem will take place and when you are going to be able to register the death.
The Coroner’s office can be contacted on 01707 292 707 or via email: coroner.service@hertfordshire.gov.uk
REGISTERING THE DEATH
All deaths which occur in Hertfordshire must be registered with the Hertfordshire Registration Service, even if the deceased lived in another county.
To register the death, the doctor must have first issued the Medical Certificate of Cause of Death (MCCD) which will be sent to the Medical Examiner. Once reviewed, the MCCD will be emailed to the register office if there is no coronial involvement. The Medical Examiner will inform you when this paperwork has been sent. You will then be able to book an appointment to visit one of the Register Offices in Hertfordshire (listed on pages 17-19).
To book an appointment online or obtain further information, please follow this link: www.hertfordshire.gov.uk/registeradeath
When you book on line you will be able to pre-pay for death certificates. The certificates will be issued during the appointment.
THE DEATH CERTIFICATE
Death certificates are certified copies of the original death registration entry. You will need to consider how many certificates you require as many companies such as banks, building societies and insurance companies may require original copies of the certificate. There is a fee of £12.50 per death certificate. The death certificates will be issued to you during the registration appointment.
Information required for registering the death:
• Date and place of death
• Deceased’s full name and maiden name if applicable
• Deceased’s date and place of birth
• Deceased’s usual address
• Deceased’s occupation
• Spouse’s name, DOB and occupation if applicable
THE GREEN FORM
The green form (or Form 9) is required by the funeral director in order to proceed with the burial or cremation.
This form will be issued by the registrar during the registration appointment. The registrar can email this form to the funeral director, or you can take the original green form with you from the appointment. It is important that this form is received by the funeral director as quickly as possible.
TELL US ONCE SERVICE
The Tell Us Once service, set up by the Department for Work and Pensions, is a government service which will notify local and central government departments of the death. During the registration appointment, the registrar will provide you with a unique reference number for you to access the Tell Us Once Service. You cannot use this service without this reference number.
If you decide to use the Tell Us Once service, the following departments and organisations will be notified.
Council Services
• Council housing
• Housing and council tax benefit
• Council tax
• Libraries
• Blue badges
• Adult social care (including attendance allowance)
• Collection of payments for council services
• Electoral services
Government Organisations
• Department for Work and Pensions
• HM Revenue and Customs (HMRC)
• HM Passport Office
• Driver and Vehicle Licensing Agency (DVLA)
• Ministry of Defence, Service Personnel and Veterans Agency
There is no charge for using the Tell Us Once service. The information that is given will be treated securely and confidentially. The organisations that are contacted will use the information to update records, end services, benefits and credits provided as appropriate, or to start up services. They may use the information in other ways, but only as the law allows.
Visit www.gov.uk/tell-us-once for more information.
If you have any nursing or occupational therapy equipment that needs to be returned, (such as hospital bed, mattress, toilet or bath equipment etc) please call the above number to arrange collection.
Mobility Aids
If you have any walking aids such as a frame, rollator or elbow crutches they can all be returned to Lister Hospital regardless of where they were issued.
Wheelchair Service (0333 234 0303)
If you have a wheelchair and/or wheelchair cushion that were provided by the Wheelchair Service please call the above number to let them know it is ready for return. Please also call HES on 01707 292555 who will arrange the collection.
ARRANGING A FUNERAL
You can begin to make funeral arrangements as soon as you feel able. In some circumstances your loved one may have already made a pre-paid plan, if this is the case you will need to speak to the required funeral directors to advise them of the death so that they can review the plan to see what was arranged.
If there is no plan in place you will need to consider the type of funeral that you think your loved one would have wanted. This can be a burial or cremation, with or without a religious or a nonreligious ceremony. Please consider any faith cultures that may need to be followed.
Funeral directors are responsible for managing the funeral arrangements and will be able to provide advice on the practicalities. We would suggest that you check that the funeral directors belong to a trade association as this requires them to provide a list about the services and prices.
Things to consider are;
• Location of the funeral directors premises - some will charge extra mileage if the location of the deceased is outside a specified area.
• The services provided - ensure that they will be able to cover your requirements.
• Cost - it is understandable that while trying to cope with the grief and loss your attention may be more focused on arranging and providing an appropriate funeral, please make sure that you are aware of the costs involved in each requirement.
• Recommendations - If you’ve used a funeral directors before and they have provided a service that you were happy with it’s not unusual that you enlist the same company. If however this is your first time making funeral arrangements you may wish to ask friends and family for recommendations. You can also check reviews online.
FINANCIAL HELP
If you are arranging a funeral you will be responsible for paying the bill, so check where the money will come from first.
If you are finding it difficult to pay for a funeral that you have to arrange, you may be able to get funeral expenses providing you or your partner are in receipt of one of the following.
• You get certain benefits or tax credits
• You meet the rules on your relationship with the deceased
• You’re arranging a funeral in the UK, the European Economic Area (EEA) or Switzerland
More information can be found at www.gov.uk/funeral-payments/eligibility
WIDOWED PARENT’S ALLOWANCE
You might be able to claim Widowed Parent’s Allowance if you’re widowed under State Pension age and have at least one dependent child.
You may also be able to claim if you’re pregnant and your husband has died, or you’re pregnant after fertility treatment and your civil partner has died.
You can get Widowed Parent’s Allowance until you stop being entitled to Child Benefit.
More information and how to apply can be found at www.gov.uk/widowed-parents-allowance
CHANGE IN CIRCUMSTANCE AND BENEFITS
The sudden loss of a family member that contributes to the household income can add extra stress at an already stressful time.
If you are in receipt of any benefits please check that any claims are in your name only, if these are not you will need to update the relevant departments of the change of circumstances. If the claim is in the name of the deceased you may need to make a new application, if you need help in completing the applications or are unsure of your entitlement Citizen Advice, Age Concern or Herts Help will be able to help with completing the application forms, completing a benefits review and may also be able to provide immediate support in a financial crisis.
Probate is the legal process for the distribution of the deceased’s estate; you will need to establish if there is a Will in place, this maybe at home, a solicitors, with a family member or friend.
If there is a Will in place this may advise on the deceased’s wishes and how they would like the estate resolved. This will be the responsibility of the executor(s) and information on how to do this can be found at www.gov.uk/probate-estate or they may wish to speak to a solicitor.
When there is no will in place, they are said to have died intestate and different rules apply.
Further information and guidance can be found at www.gov.uk/ inheritssomeone-dies-without-will
COPING WITH GRIEF
It can be hard to accept death and you may feel overwhelmed and confused by the emotions you are unable to control. Even an expected death is often still a great shock when the person dies. Part of the grieving process is trying to make sense of something that may seem senseless.
Grief can have emotional and physical symptoms and can appear to come in waves washing over you without warning. One minute, life may feel as if it were back to normal, and the next, you may find yourself in tears.
When to ask for help
Although the pain of grief is part of living, the emotional adjustment after such a major life event is a process that may continue for some time and is uniquely individual.
It’s natural to feel impatient or to worry about others who don’t seem to be managing their grief well, so if you are concerned it can be helpful to seek advice.
The list below offers some examples of behaviour and symptoms that may be supported by seeking professional help.
• Difficult thoughts and feelings become increasingly more intense
• Loss of interest in everyday activity
• Depression and/or anxiety which intrudes on normal activities
• Loss of interest in health and personal care
• Avoidance of memories of the deceased
• Need to be excessively busy for a prolonged period of time
• Self-enforced isolation and an inability to be with other people
• Thoughts of self harm and or suicide
Grief is a natural, albeit uncomfortable process. Everyone grieves differently and you will grieve in your own way.
COUNSELLING AND BEREAVEMENT SUPPORT SERVICE
Counselling gives you a confidential and safe space to help you share and better understand how you are feeling. Many people find that talking to someone other than family or friends can be helpful, there are many different ways to take part in counselling to suit your needs, these can be;
• An individual face to face appointment
• By telephone
• Online
• Or in a group setting
We would always suggest that you speak to your GP if you feel that you may need some support so that they can determine what would best suit your needs. However we also understand that this can be difficult so there are lots of charities that will be able to provide support, below are just a few;
Cruse Bereavement Care
Promotes the wellbeing of bereaved people, to help you understand your grief and cope with your loss.
support and friendship for bereaved parents and their families by those similarly bereaved. Email: helpline@tcf.org.uk www.tcf.org.uk
WAY (Widowed and Young)
Provides a self-help social and support network for men and women widowed up to the age of 50, and their children. Email: enquiries@widowedandyoung.org.uk www.widowedandyoung.org.uk
CHILDREN AND YOUNG PEOPLE
The death of someone close can have a big impact on a child or young person. However with the right support and information they will be able to understand what has happened and learn how to cope with the loss.
It is important to remember that children will notice changes to their world and can sense when something is wrong or if an adult is stressed or upset. Parents and carers can help their children by providing age appropriate information; this will result in questions being asked and feelings being expressed. It is important that you have enough support and your child is supported when they are outside of the home, so while it may be an uncomfortable conversation we would advise that you inform the nursery/school or college so that they can also make sure any support is available should your child need it.
Children 0-11 years
• Try to continue with regular activities as far as possible. This can help children feel secure
• Children often see-saw in and out of grief, needing time to have fun as well as be sad
• Talk to the children using simple straightforward language
• Give the children as much information as they ask for
• Answer questions about death as honestly as you can
• Encourage children to talk about how they are feeling
• Children often need help retaining their memoriesshare memories and stories with them
• It is ok for your child to know that you are feeling sad.
Young people 12 years +
• Bereaved teenagers and young people often don’t want to talk to parents, preferring to talk to friends
• They may need to grieve privately and may be reluctant to display feelings openly
• They may take their lead from the way the adults around them behave
• They may channel their feelings into new behaviour
• They may be more likely to talk and cry with friends
WHO YOU SHOULD INFORM
Financial Organisations
General insurance companies for home, car, travel or medical
Private pension providers
Life insurance companies
Banks and building societies
Mortgage provider
Hire purchase or loan companies
Credit card providers and any store cards
Utilities and household contacts
Use Tell Us Once Service to inform DWP, DVLA, HMRC, HM Passport Office / Blue Badge
Landlord or local authority if they rented a property
Any private organisation/agency providing home help
Utility companies if accounts were in the deceased’s name
Royal Mail – if mail needs re-directing
TV/internet companies with which the deceased had subscriptions
Mobile phone contract provider
When you contact any of the above organisations, ask to be directed to their bereavement department so that you get to speak to the right person who can help you.
Reference: Lister Hospital Bereavement Book Review Date: October 2026
Publication Date: October 2024
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.
