Plymouth Medical Examiner Service When your loved one
Help for Bereaved Relatives
A practical guide to help you cope with the administrative process in the early days of your bereavement
A practical guide to help you cope with the administrative process in the early days of your bereavement
your loved one dies...
OUR SYMPATHY
Dear relative, carer or friend, we wish to extend to you our deepest sympathy and condolences in your bereavement and, in order to help you during this difficult time, may we offer you some guidance.
The first week of bereavement is a time of grief and sorrow, this is natural. Unfortunately, it is also a period during which a number of matters need to be dealt with.
All of this can prove confusing and bewildering, but we hope this booklet will be of assistance to you.
What to do first
You probably do not want to think about practical arrangements at this time of sorrow, but some things have to be done. It is important that you contact a funeral director as soon as possible so they can start making arrangements on your behalf. You do not need to wait for the Medical Certificate of Cause of Death, however we would advise you not to book a funeral date at this time.
A member of the Medical Examiner Service will contact you by 2:00pm the next working day to introduce themselves and guide you through the process. If we have been unable to contact you by 2:00pm please call 01752 439492 in office hours to speak with us.
When we call, we will ask you for:
• Your full contact details as next of kin
• Whether there will be a cremation or burial
• The name of the funeral director you would like to use
• Some personal history for the deceased we may not always be able to obtain from the hospital/GP records
• Whether you have any concerns about the circumstances of your loved one’s death, or any concerns regarding their recent care and treatment.
Please do not come into the hospital, hospice, or GP Practice to collect the paperwork as it will be emailed directly to the Register Office.
We will arrange for a doctor to complete the paperwork as quickly as possible, but it is a complex legal process that, on some occasions, can take several days; please bear this in mind when making funeral arrangements.
If your loved one has died in Derriford Hospital, please be advised they cannot be released into the care of your appointed funeral director until the process has been completed and a Medical Certificate of Cause of Death issued. The Medical Examiner Service will share your contact details (name, phone number and email address) with your chosen funeral director who will make contact with you at the point your loved one is ready to be released, if the funeral director has not already heard from you directly.
If you need further help, in any way, please do not hesitate to get in touch.
The Medical Examiner Service is available for help or advice by: 01752 439492
Email: plh-tr.medicalexaminerservice@nhs.net
Monday to Friday 9:30am – 12:30pm and 1:00pm – 4:00pm
Please note that all calls will be recorded for training and monitoring purposes.
The Medical Certificate of Cause of Death
The Medical Certificate of Cause of Death is a legal document and cannot be issued by any doctor – only by a doctor who knows the cause of death and attended to the deceased within their lifetime. Our Medical Examiner Team will arrange for this to be issued as quickly as possible.
If the doctor is required to refer a death to the Coroner, this can also cause a delay and in this scenario until the Coroner undertakes their review the Medical Certificate of Cause of Death will not be able to be completed.
The Medical Examiner
Medical Examiners are senior doctors who provide independent scrutiny of causes of death and care provided (except for deaths which must be investigated by the Coroner).
Medical Examiners and their staff (Medical Examiner Officers) offer families and carers of the person who died an opportunity to ask questions or raise concerns about the causes of death, or about the care the person received before their death. This will usually be through a telephone call. Our Medical Examiners carry out an independent review of medical records, and speak with doctors completing the Medical Certificate of Cause of Death. If Medical Examiners detect concerns or issues with care, they pass these on for further investigation for improvements to care and learning from deaths.
You can be confident Medical Examiners and Medical Examiner Officers will provide an independent view. They will never review the cause of death of a person they provided care for.
Once the Medical Examiner is satisfied, the Medical Cause of Death Certificate can be issued, and our Medical Examiner team will telephone you to go through the documentation with you. This review will be completed in a timely manner to avoid any unnecessary delays.
Other questions you may have about the Medical Examiner Service:
Why am I being asked if I have any concerns?
You are being asked if you would like to have a conversation with an independent, specially trained person – the Medical Examiner or a Medical Examiner Officer – about anything that may be worrying you about how the person who died was cared
for. You may simply want to better understand why the person died, including by having medical terminology explained, or you may want to raise something about the care which did not feel right or ideal. This is your opportunity to ask questions and raise concerns.
Medical Examiners and Medical Examiner Officers will discuss your feedback, questions and concerns. If they consider any issues with care need further investigation, they will refer these to someone who can do this work.
As well as answering your questions, talking to a Medical Examiner helps the NHS provide better care for other patients and carers in future; for example, by identifying ways in which patient and family care could be improved.
Can I ask the Medical Examiner to talk to someone else if it’s too difficult for me to talk to them?
Yes, of course. The Medical Examiner or Medical Examiner Officer may contact you to ask who you would like them to talk to instead, or you can let the medical team know if you would like someone other than you to be the first point of contact. The Medical Examiner or their office will usually phone you before the Medical Certificate of Cause of Death is completed – but we can arrange another way of contacting you if you let us know what you prefer.
What questions will I be asked?
The Medical Examiner or Medical Examiner Officer will explain what is written on the Medical Certificate of Cause of Death and why, and check if you have any questions or concerns. They will also discuss the Medical Examiner’s review and ask if you have any concerns or questions about the care the person received before their death. This is the best time for you to ask any questions and raise anything that concerns you.
What if I don’t want to talk to the Medical Examiner or Medical Examiner Officer, or I don’t want to tell them about my concerns?
We understand this is likely to be a difficult time for you and it is your choice whether you talk to a Medical Examiner or not. If you are not sure, you can contact the Medical Examiner’s Office on 01752 439492 and ask for more information before deciding if you want to go ahead – they are trained to help bereaved people and will be very understanding.
Medical Examiners and Medical Examiner Officers provide an independent view, so if you can, we encourage you to talk to them. They can explain things to you and are specially trained to answer your questions. If Medical Examiners find any potential issues, they will be able to raise these with the people who were responsible for the care of the person who died or refer the issues to someone who can investigate further.
What will happen if something was not right?
The Medical Examiner and Medical Examiner Officer are here to listen to your concerns and answer your questions and, if necessary, contact someone who can investigate further. Medical Examiners will not investigate further themselves, as they must complete their work in the time before the death has to be registered by law.
Will funeral plans or release of the body take longer?
Medical Examiners make every effort to avoid any delays and work with families and carers of the person who died to meet the legal requirements for registering deaths, and will try to be flexible, for example where urgent release of the body is expected due to faith requirements.
Arranging the funeral
Most funeral directors are available seven days a week. If you wish, they can visit your home to advise you on the necessary arrangements.
Paying for the funeral can be a worry. Costs for funerals can vary considerably from one funeral director to another so don’t be afraid to discuss options and costs with several funeral directors before making a choice. Many local funeral directors can offer options such as direct cremation or basic funeral plans to help families manage costs.
Paying for the funeral
Funeral costs are normally recoverable from the deceased’s estate, but the person organising the funeral will be responsible for paying the bill. It is advisable to check where the money will come from before you make arrangements. Many people now purchase their funeral in advance through a pre-purchased funeral plan. You may need to check if this has been arranged.
Many funeral directors require payment before probate is granted, so ensure you discuss payment from an early stage. Where probate is being requested, many banks and building societies will release money to pay for the funeral before probate is granted but not all.
Where payment for the funeral is difficult, you may be entitled to help with the funeral costs through the Social Fund. There is now a One-Stop contact number at the Department for Work and Pensions (DWP) (0800 731 0469) which will cancel all DWP benefits, as well as help you establish if you are eligible for help towards costs (a funeral grant) and advise on your eligibility for other benefits.
There is a time limit for claiming bereavement benefits and a funeral grant so it is important to contact them as soon as possible. Funeral grants have a maximum threshold and not everyone is given the full amount. It is essential to consider this when organising the funeral to prevent running up large costs.
You can begin to make your funeral arrangements as soon as you feel able. Before you agree a funeral date you will need to check with the Medical Examiner Office whether there may be a delay with the paperwork, which may happen if there needs to be a post mortem or an inquest. Once you have registered the death you can confirm a date for the funeral.
Burial
Most churches have set fees for burials of which your funeral director can advise you. The costs may be higher for the burial of someone who lived outside the parish. Most non-denominational cemeteries are owned by either local authorities or private companies, so fees may vary.
Cremation
No one can be cremated until the cause of death is definitely known. The funeral director will advise you of the process. Ashes can be scattered in a garden of remembrance or in a favourite spot – permission for this may have to be granted, or they can be buried in a church yard or cemetery.
The Coroner
The Coroner is a legal qualified (solicitor or barrister) judicial office holder responsible for investigating some deaths.
A death may be reported to the Coroner by either the doctor or the registrar of deaths. There are a number of reasons why a death might be referred to the Coroner.
For example:
• if the cause of death is uncertain
• if the death was sudden or violent or caused by an accident
• when death might be due to an industrial injury or disease
• if the death occurred while the patient was undergoing an operation or was under the effect of an anaesthetic
• if a death occurred following an accident or fall.
If the Coroner does not wish to carry out a post mortem or hold an inquest, the attending practitioner will be required to issue a Medical Certificate of Cause of Death which will be reviewed by a Medical Examiner.
Further information about the role of the Coroner can be found here:
The Plymouth, Torbay and South Devon Coroner’s Office can be contacted on: 01752 487402
Monday to Thursday 7:30am – 12:30pm and 1:00pm – 3:30pm Friday 7:30am – 12:30pm and 1:00pm – 3:00pm
Registering the death
The Medical Certificate of Cause of Death will be sent by email to the Register Office within the district that your loved one died.
If this is within the Plymouth area, the Medical Examiner Service will provide them with your contact details. The Plymouth Register Office will then contact you by telephone and arrange an appointment for you to go to the Register Office in Plymouth to complete the registration process.
If your loved one died elsewhere in Devon, or in Cornwall, then you will be asked by the Medical Examiner Service at the time the Medical Certificate of Cause of Death is sent to the Register Office, to phone either the Devon or Cornwall Registration Service 24 hours later to make an appointment to attend a Register Office within the respective area to complete the registration process.
Who can register the death?
The person registering the death is called an informant. There is a preferential order laid down in legislation as to who the informant can be. The order is as follows:
1. Family member related by birth, marriage, civil partnership, adoption, who was present at the death
2. Family member related by birth, marriage, civil partnership, adoption
3. Someone present at the death – this can be a partner (if 1 or 2 are not available)
4. Hospital or residential care home manager
5. Person instructing the funeral director
What
information
is required to register the death?
There is specific information you will need in order to register the death, details of this can be found on page 15 of this booklet.
It is advisable to prepare this information in advance of the appointment with them as once information has been recorded in the register, it cannot easily be corrected and you may be asked by the registrar to confirm some details.
Please make sure you are legally able to register the death before you go to the Register Office. This can be confirmed by Register Office staff.
If you need any help or advice please telephone the Register Office and a registrar will gladly give you further information.
Plymouth Registration Service 01752 268331
Monday to Friday 9:00am - 5:00pm Friday 09.00am - 4.30pm
The Medical Certificate for the Cause of Death from the Medical Examiner Service or certificate from the Coroner.
The medical card or National Health Service number belonging to the deceased. (This is provided by the Medical Examiner Service to the Register Office)
Address including postcode........................................................
If the deceased was married, the date of birth of the surviving spouse ....................................................................................................
The reference number of any pension paid out of public funds apart from state retirement pension.......................................................
This information you have given to the registrar will form the entry in the register of deaths. You can buy certified copies of the entry
at the time of registration. Payment is taken over the phone when the appointment is booked or you can purchase online once the death has been registered. There is no option to make payment during your appointment.
The registrar will provide you with:
A green form will be emailed to the funeral director unless the Coroner has already sent their own form
People to inform
There are various people, companies and other interested parties who need to be informed of the death, especially if the deceased lived alone. The Register Office facilitates a “Tell Us Once” service which can inform the following:
• DWP Benefits and Pensions
• HMRC Tax Office
• Passport Agency - to cancel a passport
• Driver and Vehicle Licencing Agency - to cancel a driving licence
• Veterans’ Agency - War Pension
And Local Authority Services, such as:
• Council Tax
• Electoral Services
• Blue Badge Department
• Bus Passes
• Housing Benefit
• Library Services
• Adult Social Services
Tell Us Once is comprised of 2 parts:
Capture – The Registrar logs basic details about the deceased with the Department for Work and Pensions (DWP). Once captured a unique reference number (URN) is created and given to you; this is used for next part of the process called Enrichment.
Enrichment - You will need to telephone the Tell Us Once telephone line which is provided by the Department for Work and Pensions, or use the GOV.UK website to notify local and central Government departments of the death. You must provide the unique reference number provided by the Registrar. If you do not have this number then you will not be able to use the service and would need to notify all departments separately.
Please note, you must use the service within 28 days of getting your unique reference number.
Other people that will need to be contacted by you are:
• Local Social Services if meals on wheels, home help, day centre transport were used
• Any other hospital the person was attending
• Any employer or trade union
• A child’s or young person’s teacher, employer or college, should be informed if a parent, brother, sister, grandparent or close friend has died
• Car insurance company. People driving a car insured in the deceased’s name are not legally insured
• Local offices of gas, electricity, telephone company, Royal Mail deliveries, local newsagents and milkman
• Professional organisations
• Private landlord
If there was any NHS equipment being used it will need to be returned to either the hospital or health centre from where it came.
When someone dies
The death of someone close to you is a devastating experience and can bring about stronger emotions than most people have ever felt before.
Even if you have known that your loved one was dying there is still a sense of shock when the death occurs. You may feel cold, numb, empty and unreal for a time. Following this you may experience such emotions as anger, panic, guilt and sadness. This may also be accompanied by periods of restlessness, especially at night when it is difficult to sleep. You may also react by becoming irritable or critical of yourself and others which can lead to feelings of despair. All these are natural reactions to bereavement and are not a sign that you cannot cope anymore. You will obviously want to ensure that the necessary arrangements are efficiently organised, but also with dignity and respect for the person you have lost.
You may wish to organise things by yourself, but if not, why not consider the help of relatives or a close and trusted friend? Very often relatives or close friends of the family want to help and share the burden.
During this time you will need the support of others. Do not be afraid to speak about your feelings to someone. This is often a difficult time for family and friends too. They may be afraid to speak about your loved one for fear of upsetting you.
It may be necessary for you to take the first step, let them know you want to talk and would like their support.
If your loved one died in hospital, the Hospital Chaplain is happy to see you and can put you in touch with a minister of your own denomination. You can contact the Hospital Chaplain on 01752 245255.
Grief is a very individual process and we can each react differently so do not feel that you should necessarily experience feelings exactly as described. What is important is that you allow yourself time to grieve and come to terms with your loss in whatever way is right for you.
In time, the pain will ease and you will find yourself being able to remember your loved one without becoming distressed. This is a good sign, and a clear indication that you are beginning to come to terms with your loss.
Your doctor can help Bereavement can turn our world upside down and is one of the most painful experiences we have to endure. Most of the time bereavement is something that we all go through without the need for medical attention. On occasion you or your family may need additional support, there is help available and you should contact your family doctor.
University Hospitals Plymouth NHS Trust
(Hospitals located at the following sites: Derriford, Mount Gould, South Hams, Tavistock)
Clothing and valuables
Please be advised that any property, other than valuables, left with the ward, will be disposed of, if not collected, within one month.
Sir Jules Thorne Viewing Suite at Derriford Hospital
It may help to see your loved one after they have died. It may be possible to arrange through the Medical Examiner Service for the next of kin or immediate family of a person who has died at Derriford Hospital, to see them in the hospital’s viewing suite. Most funeral directors are also able to facilitate viewings in the funeral director’s Chapel of Rest.
If you wish to see your loved one in the hospital’s viewing suite it is important to make an appointment first. To do this you can make the necessary arrangements with the Medical Examiner Service on 01752 439492 out of hours by telephoning 01752 202082 (main switchboard) who will contact the oncall manager to make these arrangements for you.
Please note that if your loved one’s death has been referred to the Coroner, then the Medical Examiner Service is required to seek the Coroner’s permission before a viewing can be arranged. It will be the Coroner’s decision as to whether a viewing can take place in the hospital viewing suite.
Hospital post mortem
The doctor who has written the Medical Certificate of Cause of Death may ask for permission from the family, for a post mortem examination to assist in medical knowledge and teaching.
You are free to decide whether to grant permission for this. If you do agree to a post mortem, you will be asked to sign a consent form.
If it is difficult for doctors to establish the cause of death, it may be necessary to involve the Coroner. The Coroner does not need to ask for permission if he decides a post mortem is necessary.
Tissue donation
If at this difficult time you feel able to consider tissue donation, it may be helpful to know that:
• Heart valves and eyes (corneas) can be donated up to 2448 hours following death
• Agreeing to tissue donation is not expected - it is an option. However, you may be contacted by a donor transplant coordinator if your relative was on the Organ Donor Register
• The family can consent on behalf of the patient
• It is not necessary to have a Donor Card
The decision to donate is of course very personal, so if you want to discuss this further, please speak to the ward staff or contact the on-call transplant co-ordinator via the switchboard 01752 202082.
Patient Advice & Liaison Service (PALS)
PALS is about listening, learning and working with you to improve your health service. Should you wish to discuss any aspect of the care your loved one received please contact PALS Monday to Friday 9:30am – 12:30pm and 1:00pm - 4:00pm on: Telephone: 01752 439884
Email: plh-tr.PALS@nhs.net
Learning from deaths in hospital
At University Hospitals Plymouth, all deaths in hospital are reviewed. These reviews are carried out to ensure that as an organisation we continually learn, develop, and improve the care we provide, both when concerns are raised and also when things have gone well. The Department of Health has provided guidance to all hospitals, giving certain criteria where an additional, more detailed review should be considered, or where concerns have been raised regarding the care provided either by Healthcare Professionals or the patient’s family, friends, and carers.
If it is felt a more detailed review should be considered, the Mortality and Clinical Harm Team within the hospital will coordinate this review process. A clinician who was not directly involved in the care your loved one received, will look carefully at their case notes, reviewing each aspect of their care, looking at how well it was provided and taking into account any concerns raised.
It is very important that relatives, friends, and carers are involved in the review process; therefore, when a request for a more detailed review is passed to our team, we will make contact with you to discuss this further. We will confirm your preferred level of involvement and the contact you wish to receive from us both during and once the review for your loved one is completed. If you decide you do not wish to be involved this will not affect the way the review is carried out and you are able to contact us at any time, should you change your decision.
There is no need for you to contact the Mortality & Clinical Harm Team as we will contact you should the decision be made that an additional review is required. However, should you have any questions or concerns the team can be contacted via:
The family member / loved one, who is responsible for making the funeral arrangements will need to let the nursing team in the inpatient unit know the details as soon as possible.
You can call 01752 401172 and ask for the inpatient unit nursing team if you are making these arrangements from home.
The nursing team will then liaise with the chosen funeral directors to arrange for collection of your loved one.
Patient property
Any property that was left behind after your loved one’s death, will be kept safe until such a time as you feel ready to pick them up. Just call us on the number above to let us know when you, or someone else will be coming so that we can get it ready. If you decide you don’t need any of it, then just call us and let us know and we will be happy to handle this for you. If after 3 months we have not heard from you, we will try to contact you to clarify your wishes. Unfortunately, we are unable to hold the property for longer than 6 months. After this time has elapsed, we will donate the property to St Luke’s charity unless you indicate otherwise.
Bereavement support
After approximately 2 weeks, a letter will be sent to the primary contact from the St Luke’s Hospice Social Care Team, offering bereavement counselling to family / friends. If you feel you need support before then, please call 01752 401172 and ask to speak to the Social Care Team, or if you are happy to email them, then call the number and ask for their email address. Our thoughts are with you.
Customer Services Department
Should you wish to discuss any aspect of the care your loved one received please contact: 01752 435201
Many of us need help to deal with grief or feel the need for extra support. This help is available and many people gain support from seeking it. The following individuals and organisations may be useful.
Support
• The Bereavement Counselling Service (SW) 01752 349769
www.bcsplymouth.co.uk
• Bereavement Support Network 0808 168 9607
www.bereavementsupport.co.uk
• Cruse For help with emotional and practical problems 0300 330 5466 www.cruse.org.uk
• Jeremiah’s Journey
Support for bereaved children and their families 01752 424348
www.jeremiahsjourney.org.uk
• Samaritans 116 123 www.samaritans.org
• St Luke’s Hospice www.stlukes-hospice.org.uk
• The Good Grief Trust www.thegoodgrieftrust.org
• Probate Registry
0300 123 1072
• Bereavement Advice Centre 0800 258 5556
www.bereavementadvice.org
Remember…
Grief is a very individual process. Each of us reacts differently so please don’t worry if your grief doesn’t follow a general pattern. It is a time consuming, exhausting and isolating experience. But it can help to remember that millions of people have survived grief and in time you will too.
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 Medical Examiner 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.
After the funeral
Settling the deceased person’s estate can be confusing, time consuming and distressing. If you have been named as executor in the will, it is your responsibility to see that the person’s wishes, as you understand them, are carried out.
This will include payment of funeral expenses, debts and taxes, as well as the disposal of their possessions and other assets.
If it seems likely to be complex it may be worth using solicitors and accountants to help you. Fees will be charged for these services, usually by the hour. This money will come out of the estate. Make it clear precisely what work your solicitors or accountants are required to do. While the estate is being sorted out, immediate access to funds can sometimes be difficult, but a solicitor may be able to arrange alternative financial support. Alternatively, you can contact the Citizens Advice Bureau for free advice.
Life then begins to return to normal for most people, except close relatives and friends who could find the process of adjustment to their loss more difficult. Try to avoid making hasty decisions, especially if you now find yourself living alone.
Remembering
Everyone will have their own ways to remember the person who has died. Talk about them, mention their name as often as you can and put the emphasis on the good things that happened when they were alive. Members of the family or close friends might appreciate a photograph or a small keepsake as a reminder.
Most important of all will be your own memories.
Miss me, but let me go
When I come to the end of the road, And the sun has set for me, I want no rites in a gloom filled room Why cry for a soul set free. Miss me a little - but not too long. And not with your head bowed low. Remember the love that we once shared Miss me - but let me go. For this is a journey that we all must take, And each must go alone. It’s all a part of the Master’s plan, A step on the road to home. When you are lonely, and sick of heart, Go to the friends we know, And bury your sorrows in doing good deeds. Miss me - but let me go. Anon
Death is nothing at all. I have only slipped away into the next room. I am I, and you are you. Whatever we were to each other that we are still.
Call me by my old familiar name, speak to me in the easy way which you always used. Put no difference in your tone; wear no forced air of solemnity or sorrow.
Laugh as we always laughed at the little jokes we enjoyed together. Play, smile, think of me, pray for me. Let my name be ever the household word that it always was. Let it be spoken without effort, without the ghost of a shadow on it.
Life means all that it ever meant. It is the same as it ever was; there is absolutely unbroken continuity. What is death but a negligible accident? Why should I be out of mind because I am out of sight.
I am waiting for you for an interval, somewhere very near just around the corner. All is well.
Henry Scott Holland (1847 - 1918)
This booklet has been produced in consultation with the Register Office and local funeral directors. We hope you find it helpful. If you have any comments or suggestions on how we may improve it please let us know. Contact the Medical Examiner Office on 01752 439492 or write to us at the Medical Examiner Office, Level 07, Derriford Hospital, Plymouth PL6 8DH.
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.
Ref: D-26/PS/AR/ help for bereaved relatives
For Review: November 2026
Published: November 2024
STOPPING JUNK MAIL
It is distressing to deal with a bereavement and unsolicited mail can be insensitive and destructive during a grieving process.
By scanning the below QR code on your phone or visiting www.stopmail.co.uk, we are able to securely share this information with mailing organisations and under the Data Protection Act the information will not be used for any other purpose.
Other benefits reduce the possibility of identity fraud, such as assumed identity and you will only have to supply the information once.
