Queen Elizabeth Hospital, Woolwich Bereavement Booklet

Help and advice in the rst few days following a death in hospital

A brief guide for bereaved relatives and friends

Queen Elizabeth Hospital

On behalf of staff working here at Queen Elizabeth 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. Bereavement services are a vital part of the service the NHS gives to those in its care and to their bereaved families and friends. Providing a high quality bereavement service which respects the dignity of the person who has died and their families is a key part of effective support for bereaved families.

This is a time of grief and sorrow but it is unfortunately also the time during which a number of matters must be dealt with. These can prove confusing and bewildering and we hope that this booklet will be helpful.

Bereavement Office

The bereavement office is informed of all deaths in Queen Elizabeth Hospital and are able to help bereaved family and friends through the immediate administrative process following the death.

There is a legal process following a death please make sure you contact the bereavement office via telephone before making an appointment to register the death. If you do not do this the registrar of births and deaths may be unable to complete the registration and you will then need to make a second appointment.

To contact the bereavement office regarding the Medical Certificate of Cause of Death please ring 020 8836 4662.

Initially for your first call ring between 10am and 12 noon Monday to Friday.

The bereavement office is open Monday to Friday 8am - 4pm (closed at weekends and bank holidays).

Medical Certificate of Cause of Death

Before a death can be registered at the registry office, a doctor will need to issue a Medical Certificate of Cause of Death (MCCD). The bereavement office organise the completion of the MCCD, medical notes are obtained as they contain the information needed to contact the appropriate doctor(s). Doctors are not always able to attend when requested; some hours may pass before they can attend the bereavement office.

Medical Examiner Service

The Medical Examiner Service consists of Medical Examiners who are supported by Medical Examiner Officers.

A Medical Examiner is an independent consultant, senior doctor or GP who has not been involved in the care of the patient but will look at the admission and circumstances surrounding the death; they also ensure the information contained on the Medical Certificate of Cause of Death (MCCD) is correct and that referrals to the coroner are done in a timely and appropriate manner to avoid delays.

The Medical Examiner or Medical Examiner Officer will contact a designated family member, to explain what has been written on the Medical Certificate of Cause of Death. The Medical Examiner or Officer will not only enquire if you have any concerns regarding the care provided to your relative but also ask about positive experiences. The Medical Examiner Service will feed this back into the Trust, as your feedback enables departments to see what we are doing well and where improvements can be made.

The Medical Examiner or Officer will endeavour to provide answers to any questions you may have.

The Medical Examiner Team are available Monday to Friday 8am – 4pm and can be reached on:

University Hospital Lewisham 0203 192 6045

Queen Elizabeth Hospital Woolwich 0208 836 4626/4627

Senior Medical Examiner 0208 836 6172

Email: lg.medicalexaminerofficelgt@nhs.net

Deaths reported to the Coroner

Legally some deaths are required to be reported to HM coroner. If this happens a doctor will complete a report which is sent electronically to the HM coroner’s office, and the bereavement office will advise you if the death has or will be reported.

There are specific circumstances when a death is required by law to be reported to the coroner. Some examples of such circumstances are:

• The cause of death is unknown

• The death was due to self-harm, violence, trauma or injury

• The death was due to neglect, including self-neglect

• The death was due to an injury or disease attributable to any employment held by the person during the person’s lifetime

• The death was due to the use of a medicinal product, the use of a controlled drug or psychoactive substance

• The death was due to poisoning including by an otherwise benign substance

• The death was due to a person undergoing any treatment or procedure of a medical or similar nature

• The person’s death was unnatural but does not fall within any of the above circumstances

• The registered medical practitioner suspects that the person died while in custody or otherwise state detention

When a death is reported to the office, the coroner will consider the information and do one of three things:

1. Give a doctor permission to issue a Medical Certificate of Cause of Death and then take no further action.

2. Order a post mortem examination. Depending on the results, the coroner will (a) find the death natural and close the case; (b) open an investigation, where further information is obtained from doctors and/or others; or (c) open an inquest, which is a fact-finding court hearing about the circumstances of the death.

3. Open an inquest without a post mortem examination.

If the coroner has decided that the hospital doctor can issue the Medical Certificate of Cause of Death the coroner will issue a document (form 100A) which will be sent to the registrar of births and deaths. Once this has been issued the bereavement office will contact you regarding the Medical Certificate of Cause of Death.

If a post mortem is necessary the coroner’s officer will explain why. Following the post mortem, if the death is natural you will be informed of the cause of death and when documentation will be sent directly to the Registrar of birth and deaths. If an investigation or inquest is required either with or without a post mortem the coroner’s officer will inform you.

In some instances when an inquest, which is a formal public enquiry into the cause and circumstances of a death, is necessary the death cannot be registered until after the inquest, but the coroner can give you an interim death certificate. When the inquest is over the coroner will tell the registrar of births and deaths what to put in the register and send the relevant paperwork to the registrar.

A coroner’s officer assigned will contact a designated family member to discuss the death and keep you informed of the coroner’s decision. The coroner’s officer is responsible for guiding and helping you through the process.

Whilst the bereavement office staff will be able to provide you with information relating to the procedures following a death it is not possible for them to influence any processes where the offices of HM coroner are involved.

Contact details of HM Coroner’s Office for this area is:

Inner South London Coroners Office, 1 Tennis Street, Southwark, SE1 1YD.

Telephone number 020 7525 4200

Website

www.innersouthlondoncoroner.org.uk

You can still contact a funeral director of your choice to start making arrangements for the funeral, however please do not make any final arrangements until the coroners office have advised you to do so.

Investigations

In a small percentage of cases, there may be concerns that the death could be related to a patient safety incident. A patient safety incident is any unintended or unexpected incident, which would have, or did, lead to harm for one or more patients receiving healthcare.

Where there is a concern that a patient safety incident may have contributed to a patient’s death, a safety investigation will be undertaken. The purpose of a safety investigation is to find out what happened and why. This is to identify any potential learning and to reduce the risk of something similar happening to any other patients in the future.

If an investigation is to be held, we will inform you and explain the process to you. We will also ask you about how, and when, you would like to be involved. We will explain how we will include you in setting the terms of reference (the topics that will be looked at) for the investigation. Investigations may be carried out internally or by external investigators, depending on the circumstances.

In some cases, an investigation may involve more care providers than just Lewisham and Greenwich NHS Trust. For example, your loved one may have received care from several organisations (that have raised potential concern). In these circumstances, this will be explained to you, and you will be told which organisation is acting as the lead investigator. You will be kept up to date on the progress of the investigation and be invited to contribute. This includes commenting on drafts of investigation reports before they are signed off. Your comments should be incorporated in the reports. After the final report has been signed off, the Trust will make arrangements to meet you to further discuss the findings of the investigation.

Where the death of a patient is associated with an unexpected or unintended incident during a patient’s care, staff must follow the Duty of Candour Regulation/Policy.

Registration

The death must be registered with the registrar of births and deaths within five days (if it has not been reported to the Coroner). However, if for any reason you are unable to attend the district where the death occurred, please contact your local registry office for advice regarding the registration.

Please be aware that registering the death at a location other than that of the district/borough of death you will encounter a delay to the process.

You can arrange this appointment yourself, the details for the registrar office can be found below.

The Royal Borough of Greenwich Woolwich

Town Hall

Wellington Street

Woolwich SE18 6PW

To make an appointment please telephone 020 8921 5015/5016.

Opening times are Monday to Friday 9am – 5pm.

Woolwich Ferr y

There are signposted car parks close to the Town Hall. There is pay and display along Wellington Street, surrounding roads are parking meters.

Town Hall and Public Hall FRANCES STREET

YROTISOPER R O A D

CHARLTON PARK LANE HA-HAROAD

Queen Elizabeth Hospital STADIUM ROAD WOOLWICHNEWROAD

NIGHTINGALE PLACE WOOLWICH COMMON GRAND DEPOT RD B210 ARTILLARY PLACE

Directions to the Register Office at Woolwich Town Hall NHS MARKETST POLYTECHNIC ST A117 PIER ROAD

Buses to and from hospital: 161, 178, 244, 291, 386, 469

Woolwich Arsenal DLR and Train Station

Who can register the death?

• A relative of the deceased

• The person who is arranging the funeral

• A person present at the death

What the Registrar will ask you about the person who has died:

• the person’s full name at the time of death

• any names previously used, eg maiden name

• the person’s date and place of birth

• their last address

• their occupation

• the full name, date of birth and occupation of a surviving or late spouse or civil partner

• whether they were getting a State Pension or any other benefits

You will need to take with you the Medical Cause of Death Certificate and if possible birth / marriage / civil partnership certificates.

After registration has been completed

What the registrar will give you:

• Certificate for burial or cremation (known as the green form). This is the form that will be required by your chosen funeral director to allow the funeral to go ahead.

• Copies of the Death Certificate

Copies of the death certificates are required when settling the deceased’s estate, it is advisable to purchase more than one certificate as they are often required for sorting out financial affairs such as insurance policies, pension claims or other purposes. There is a fee for each certificate.

Tell Us Once service

Tell Us Once is a free service offered by HM Government. It enables you to report a death only once, telling central and local government services securely and confidentially without you having to inform them individually.

Many services can be notified and these include:

• The local council

• HM Revenue and Customs (HMRC)

• Department for Work and Pensions (DWP)

• Passport Office

• Driver and Vehicle Licensing Agency (DVLA)

• Public Sector or Armed Forces Pension Schemes

After you have registered the death the registrar will provide you with a unique Tell Us Once reference number, which will enable you to access the service online or via their telephone service.

Viewing the deceased

We request that family members wishing to visit the deceased attend together and arrive at the arranged time.

Mortuary staff can arrange a time for you to visit the deceased at the hospital. Please ring 020 8836 5686 for further directions. The mortuary is open Monday to Friday 8am - 4pm, excluding weekend and bank holidays.

Patient’s property

This will be given to you on the ward if you were present at the time of death. If this is not the case please contact the Cashier’s Office on 020 8836 4667 Mon-Fri 9am-4pm (excluding weekends and bank holidays).

Body Donation

Some people have previously made arrangements for their body to be used for medical teaching purposes by one of the London anatomy organisations. If so, relatives should contact the relevant organisation and also inform the bereavement office.

Chaplaincy and Spiritual Care

How can we help?

The experience of being bereaved may evoke many different emotions and you may feel that you would like someone to talk to in confidence.

The chaplaincy and spiritual care team offers spiritual care to bereaved people. They offer support to all patients, relatives and carers whatever their faith or belief, religious or non-religious. Chaplains provide a supportive, non-judgemental, confidential listening ear to all.

They have good links with world faiths and other groups, and they aim to get an appropriate person to support you whether religious or non-religious.

Is there somewhere for prayer and reflection?

You may need time for reflection in a place that is peaceful and quiet. The chapel and prayer room is located on the ground floor of the hospital close to the main entrance. It is open to everyone, whatever your faith or belief. It is open each day until early evening.

How do I contact a chaplain?

If you would like to talk to a chaplain, please call extension 6831 from inside the hospital or 020 8836 6831 from outside the hospital. The chaplaincy office is on the ground floor of the hospital next to the chapel and prayer room.

Funeral Directors

It is a common misconception that you cannot contact the funeral director until the death has been registered. You do not have to wait until you have registered the death before contacting a funeral director. The organising of a funeral can be carried out as soon after death as you feel comfortable.

Your chosen funeral director will need the Certificate of Burial or Cremation (also known as the green form), which the registrar will give you. If the death has been referred to the coroner the funeral director will liaise with the coroner’s office for you.

You may wish to approach more than one funeral director to get an estimate of their costs before making your choice; you will find that your chosen funeral director will be able to guide you in every detail in making funeral arrangements.

Your chosen funeral director will be able to act on your behalf; they will contact the hospital mortuary to arrange collection of the deceased and any necessary documentation.

There are no universal standards applying to funeral directors but some are members of a professional organisation operating under a code of conduct.

The National Association of Funeral Directors (NAFD) and the Society of Allied and Independent Funeral Directors (SAIF) are two examples of these.

Funeral director’s addresses and telephone numbers can be obtained from the internet, local telephone directories or in the back of this booklet. The bereavement office is not able to recommend any funeral directors.

Help with funeral costs and bereavement payments

If you are finding it difficult to pay for a funeral that you have to arrange, you may be entitled to receive a funeral expenses payment from the Department for Work and Pensions providing you receive certain benefits. Information can be found via www.gov.uk/funeral-payments

You may also be entitled to a bereavement support payment (BSP) if your husband, wife or civil partner died in the last 21 months. Information can be found via www.gov.uk/bereavementsupport-payment

Information about the above payments along with additional information about other benefits, tax and state pension can be accessed via www.gov.uk/when-someone-dies or telephone the bereavement service helpline 0800 731 0469.

Who to inform of the death

There are various people, companies and other interested parties that need to be informed such as:

• Post Office/Building Society or Bank

• Social Security to cancel any pension, allowances or benefits

• Employer

• Solicitor/Accountant

• Pension or Life Insurance providers

• Insurance companies (car, house etc.)

• Inland Revenue

• Credit Card company

• Social Services

• Landlord/Housing Association or local housing department

• GP and any other hospital the deceased may have been attending

• TV Licensing

Wills and Probate

If the person who died left a Will they may have asked an executor to deal with the estate. If the person did not name an executor or leave a Will then sometimes an administrator will be needed to deal with the estate.

If the Will is held at a solicitor’s you should make contact with them to inform them of the death.

You may be able to deal with the estate without probate; you should contact the relevant organisations, for example those holding money or property to enquire.

Information about probate, if it is required and applying for probate can be found via www.gov.uk/applying-for-probate or by telephoning the probate call centre on 0300 303 0648.

Further Information

After a few days you may find that you have a number of questions that you would like to ask about the death of your relative, or their care whilst in hospital; staff will try to help you as much as they can.

If you have questions about the medical condition or treatment received by your relative, it is important that they are answered by a professional with the relevant expertise. If this is the situation, please contact the secretary of the consultant responsible for your relative’s medical care. Some relatives find it helpful to do this two or three weeks after their relative has died when they feel more able to deal with their bereavement.

If the questions are about general care of your relative whilst in the hospital, you should contact the manager of the ward or department concerned.

The Patient Advice and Liaison Service (PALS) are also there to support and assist you with any concerns you may have.

They can be contacted on 020 8836 4592 or email pals.qeht@nhs.net

Access to Health Records

If you have any questions about access to the medical records, then please contact the medical records department on 020 3192 6114 (University Hospital Lewisham) or 020 8836 5539/5540 (Queen Elizabeth Hospital).

www.lewishamandgreenwich.nhs.uk/access-to-medical-records

Grief and emotions

Grief is a personal experience; the experience of loss can be upsetting physically, emotionally and socially. Reactions to grief are quite natural; it is important to remember this is not an illness.

You may find that you feel quite numb to begin with. It may be difficult to eat or sleep; you may lose energy, feel cold, strained, run down and as though nothing seems real. These are natural bodily reactions to shock and trauma.

At first it can be very difficult to believe that someone has died. You may feel an intense longing to be with them. A common experience is to feel that they are still physically with you.

It is important to talk about the person who has died, especially important to include children and young people, as they will be experiencing similar feelings.

Your memories of the deceased - good and bad, are important. You may well find feelings of guilt and anger coming out. It can feel very disloyal to be angry with the one who has died and left you, but many people go through this experience. It may be that there is a conflict within your religious beliefs.

Very often people want to help you but feel awkward and many avoid you or feel unable to talk to you. If you feel able, let them know that you need them and their support. Remember that to express your feelings of grief is both painful and healing. Crying can be helpful.

There will be difficulties ahead; perhaps many months or years after the person has died, especially around special dates. When someone close to you has died it is really important for you to share your feelings with people you can trust.

Government website

The government website www.gov.uk contains a wealth of information on a wide range of subjects which you may find useful such as:

• Intestacy

• Find out who is entitled to a share of someone’s property, possessions and money if they die without making a Will

• Inheritance Tax

• How to pay inheritance tax: get a reference number, payment methods; use the deceased’s bank account, National Savings and Investments, government stock

• Telling DVLA about a bereavement

• What you need to tell DVLA if someone who was a driver has died

• Valuing the estate of someone who’s died

• When someone dies, you need to find out the value of the estate to see if inheritance tax is due - valuing the estate, reliefs, gifts, joint assets, stocks and shares, trusts and deductions

• Department for Work and Pensions (DWP)

• Provides benefits and services for a wide range of people Telephone 0800 731 0469

Stopping unwanted mail

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.

Support and Help

Greenwich & Bexley Bereavement Help Point

• We can help anyone living in Greenwich or Bexley who needs advice or support.

healthwatchgreenwich.co.uk Telephone 020 8320 5833

Cruse Bereavement Care

• Provides a nationwide service of bereavement counselling advice, information and social contact.

www.cruse.org.uk

National helpline: 0808 808 1677

Greenwich branch: 020 8850 0505

Bexley branch: 020 8304 5245

• Support for young people.

www.hopeagain.org.uk Telephone 0808 808 1677

Samaritans

• 24 hour helpline for help and support on any matter.

www.samaritans.org Telephone 116 123

Bereavement Support Network

• A national organisation offering advice on all aspects of bereavement.

www.bereavementsupport.co.uk Telephone 0808 168 9607

WAY Widowed and Young

• For under 50s

www.widowedandyoung.org.uk

Age UK

• For information and advice on a range of subjects

www.ageuk.org.uk Telephone 0800 055 6112

The Compassionate Friends

• Supporting bereaved parents and their families after the death of a child.

www.tcf.org.uk Telephone 0345 123 2304

Winston’s Wish

• National charity helping bereaved children.

www.winstonswish.org Telephone 0808 802 0021

SSAFA

• National charity for helping serving and ex-serving men, women and their families in need.

www.ssafa.org.uk Telephone 0800 260 6767

MIND

• National leading mental health charity supporting individuals in times of bereavement.

www.mind.org.uk National Telephone: 0300 123 3393

The Silver Line

• Helpline for older people offering free, confidential information, friendship and advice.

www.thesilverline.org.uk

Telephone: 0800 470 8090

Counselling Directory

• A comprehensive database of UK counsellors, with information of their training and experience. A free confidential service.

www.counselling-directory.org.uk

The Coroners Court Support Service

• The Coroners Courts Support Service is a registered charity whose volunteers give emotional and practical support to families and other witnesses attending Inquests.

www.coronerscourtssupportservice.org.uk

Telephone: 0300 111 2141

Way Up

• Self-help group and support network for people widowed in their 50s and 60s.

www.way-up.co.uk

London Friend

• Supporting the lesbian, gay, bisexual and transgender (LGBT) community

www.londonfriend.org.uk

LGBT Bereavement helpline Telephone: 0300 330 0630

Macmillan Cancer Support

• For practical support and advice.

www.macmillan.org.uk Support Line Tel: 0808 808 00 00

Sudden

• If you have been bereaved as a result of COVID-19, take a look at Sudden, a charity who support those who have been suddenly bereaved.

www.sudden.org

The Loss Foundation

• Offering specific support, including online support groups, to those who have lost loved ones through COVID-19.

www.thelossfoundation.org/our-response-to-coronavirus

The Good Grief Trust

• Run by bereaved for the bereaved. Please email hello@thegoodgrieftrust.org or visit www.thegoodgrieftrust.org

Reference:

Queen Elizabeth Hospital Bereavement Booklet

Review date: March 2026

Publication date: March 2024

The information contained within this booklet has been prepared by the bereavement office and contains general advice, which we hope will be useful. We do not accept any liability from its use. We aim to ensure that this information is as up to date and accurate as possible, but please be aware that certain areas (such as contact details) are subject to change from time to time.

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.

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.

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Our experienced and friendly team are available 24 hours a day by telephone or you can arrange a home visit.

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• Prepaid Funeral Plans

• Probate

• International Repatriation

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Belvedere: 01322 517 570

Sidcup: 020 8023 7519

www.ashdownfuneralservices.co.uk

This publication has been jointly developed between ourselves and the hospital. We hope that it has been or will be of help at this time and we welcome any comments or suggestions that you may have.

Please contact us either by phone, email or by post. 01253

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