Singleton Hospital BB R24 English Version by bereavementadvice

Bwrdd lechyd Prifysgol Bae Abertawe Swansea Bay University Health Board

With Sincere Condolences Information & Support for

Information & Support for your Bereavement your Bereavement

‘Memories are the loveliest thing, they last from day to day, They can’t get lost, they don’t wear out, and can’t be given away’

Anonymous

Published by RNS Publications © Tel: 01253 832400 R24 (SIN)

Help when you need it... There are many things you will need to do during the days and weeks following the death of your relative or friend, and this booklet aims to guide you and help you navigate these difficult times. At Swansea Bay University Health Board, we have a dedicated Care After Death Service, and the team are on hand to support you with all practical matters, such as death certification, and can also help you to find the right support during your bereavement if you feel you need it. The Care After Death Team are available to contact 6 days a week, Monday to Friday 9.00am to 6.00pm, and Saturday 9.00am to 12.00pm. The team can be contacted on 01792 703114 Or by email - SBU.CADC@wales.nhs.uk Please get in touch if you need anything at all during your bereavement or if you have any questions about the information provided in this booklet - the team can help you in the initial days, weeks, months or at any point in the future should you need it. Once again, on behalf of Swansea Bay University Health Board, we extend to you our most sincere and heartfelt condolences.

Contents Page Pages First Steps

If your relative or friend has died in any of our hospitals

If your relative or friend has died at home, or in the community

The Role of the Medical Examiner

The Role of the Coroner

Hospital Post Mortem

Registering a Death

Tell Us Once Service

Visiting your relative or friend at the Mortuary

Grieving and Support

Further Support

Bereavement Services Feedback

First Steps If your relative or friend has died in any of our HospitalsThe Care After Death Team will support and assist with the necessary paperwork and liaise with other people who are usually involved following a death, such as the Registrar, Medical Examiner or Coroner’s Office. You will find more information about these services further on in this booklet. In the first instance, please contact the Care After Death Team on 01792 703114 and they will explain what happens next with regards the Medical Certificate of Cause of Death, sometimes called a ‘Death Certificate’ or ‘Medical Certificate’ The Team will ask you • Some identifying questions to ascertain who the patient is • Your name, contact details and relationship to the patient • Establish if you are the person who will be responsible for Registration of Death and arranging the Funeral • The name of the Funeral Director you wish to use, if you have decided • Whether the deceased will be for Burial or Cremation You will be able to ask the Team any questions you may have and they will be able to support you. You can call the team as many times as you like, and they will keep in contact with you to keep you updated on the progress of the paperwork. They can also advise you on your relative/ friend’s belongings if needed. Any time someone we love dies we can often feel overwhelmed and you may feel like it is difficult to cope with how you are feeling. If you feel this way, the Care After Death Team can help to find you the right support during your bereavement, so please talk to the team if you think this would help you. You may also come and talk to a member of the team face to face. If you wish to do this, please call us and we can arrange an appointment for you.

If your relative or friend has died at home, or in the community Depending on the circumstances, it would usually be the patient’s GP who completes the Medical Certificate of Cause of Death when a person dies at home or in a residential/care home. If you know who your relative/ friend’s GP is, you can contact them for an update on the paperwork. If the death is sudden or unexpected, the Coroner’s Office may be involved. The GP or the Police (if in attendance) may be able to advise you on this, and there is further information about the role of the Coroner further on in this booklet. However, the Care After Death Service can help you in either circumstance, if you feel you need any support. You can contact them on - 01792 703114. They can liaise with the GP or Coroner on your behalf, and keep you updated with the progress of the paperwork, as well as liaise with other people who are usually involved following a death, such as the Registrar or Medical Examiner. You will find more information about these services further on in this booklet. The Team will ask you • Some identifying questions to ascertain who the patient is • Your name, contact details and relationship to the patient • Some details about the circumstances of your relative/friend’s death, to ascertain if the Coroner is involved • Establish if you are the person who will be responsible for Registration of Death and arranging the Funeral • The name of the Funeral Director you wish to use, if you have decided • Whether the deceased will be for Burial or Cremation

You will be able to ask the Team any questions you may have and they will be able to support you. You can call the team as many times as you like, and they will keep in contact with you to keep you updated on the progress of the paperwork if they are supporting you with this. Any time someone we love dies we can often feel overwhelmed and you may feel like it is difficult to cope with how you are feeling, especially if the death was sudden or unexpected. If you feel this way, the Care After Death Team can help to find you the right support during your bereavement, so please talk to the team if you think this would help you. You may also come and talk to a member of the team face to face. If you wish to do this, please call us and we can arrange an appointment for you.

The role of the Medical Examiner In line with Government requirements and changes to death certification reforms, Swansea Bay Health Board is working closely with the Medical Examiner Service. A Medical Examiner is a senior, independent doctor not involved in the care of the patient, who provides an independent scrutiny of each death, for any patient where a Medical Cause of Death Certificate is going to be issued. This can be either a death in hospital or in the community. The Medical Examiner Service allows the Cause of Death to be more accurately identified, and the circumstances surrounding the death to be more objectively assessed. The Medical Examiner Service has a Team of Medical Examiner Officers, who will contact you in the days following the death of your relative/ friend. They will discuss with you the Cause of Death, and listen to your views on the care provided. They can answer any questions you may have about the cause of death and the circumstances of the death. Sometimes, a referral to the Coroner may be needed, and this is not something to worry about. If this happens, the Medical Examiner Officer will discuss with you why this may be the case, and you may also need to speak with the Coroner’s Officers too. There is more information about the Coroner in this booklet, and the Care After Death Team can also help you to navigate this process. Once your discussion with the Medical Examiner Officer has taken place, the Medical Examiner will liaise with the Doctor and the Care After Death Team to issue the Medical Cause of Death Certificate. The certificate will be checked and signed off by the Medical Examiner, and then sent to the Registrar and you will be able to Register the death of your relative/friend.

The Role of the Coroner The Coroner is an independent officer with the statutory responsibility for the legal investigation of some categories of deaths. The Coroner is usually a Lawyer by background, and is supported by a team of Coroner’s Officers, who investigate any deaths which are referred to the Coroner. The Coroner is usually involved with any deaths that are • Sudden or unexpected deaths, without regard to age; • Where death involved violence, trauma, physical injury or was caused by an accident; • Where the Cause of Death is unknown, and the Doctor is not able to issue a Medical Certificate of Cause of Death; • Where death has resulted from industrial injury or industrial disease; • Occurred as a result of a notifiable accident, poisoning or disease; • Occurred as a result of neglect or failure of care by another person; • Where death has occurred during or after surgery, treatment or medical procedure; • Where death has occurred as a result of poisoning, the use of a controlled drug, medicinal product, or toxic chemical; • Where death occurred in custody, or state detention This list is not exhaustive, and there are also many other reasons why a doctor may refer a death to the Coroner. If your relative/friend died in hospital, the Care After Death Team will be able to advise you if a referral has been made to the Coroner, and you may also speak to the Medical Examiner Officer too. Once the Coroner has received the referral, one of the Coroner’s Officers will contact you within a day or two to discuss the referral with you and listen to any views you may have. They will be able to answer any questions you have about the Coronial process, advise you on next steps and support you.

If the Coroner is satisfied that the death was due to natural causes, they will authorise the Doctor to proceed with writing the Medical Cause of Death Certificate. This means there will be no further investigation needed into your relative/friend’s death, and you can proceed with Registration once the certificate has been completed by the doctor and signed off by the Medical Examiner. There is more information about the Medical Examiner in this booklet, and the Care After Death Team can also help you to navigate this process. Sometimes, the Coroner may feel that further investigation is needed, and this investigation may include an Inquest. When this happens, the doctor will no longer need to issue the Medical Cause of Death Certificate and the Coroner’s Office will take over all aspects of paperwork relating to the death. An Inquest is a public court hearing held by the Coroner to decide who died, how, when and where the death happened. This can be with or without the need for a Post Mortem Examination of your relative/friend. The Coroner’s Officers will clearly explain to you what happens next and explain the procedure if this happens, as well as discuss with you the decision by the Coroner about whether a Post Mortem Examination is needed. You can find more detailed information about the role of the Coroner and what you can expect by following this link: A Guide to Coroner Services for Bereaved People (publishing.service.gov.uk) and the contact number for the Coroner’s Office is 01792 450650. Going through an Inquest can be upsetting and complicated at an already difficult time for you and your family. If you need any support during this process, our Care After Death Team are available to help you get the support you need, and you will find their contact details on the front page of this booklet.

Hospital Post Mortem A Hospital Post Mortem is not the same as a Coroner’s Post Mortem. A hospital consented Post Mortem is performed for research and educational purposes, which could help in the treatment of other patients or family members in the future, or give more detailed information about a Cause of Death. The doctor treating your relative/friend can request a Hospital Post Mortem, but you will have to give consent for this to take place. The doctor who has requested the Post Mortem will discuss with you the reasons for the request, and you will have the opportunity to ask any questions you may have. If you give your consent, they will advise you on the process and afterwards you will be able to discuss the results of the Post Mortem with them. Remember, this is your decision whether or not you give consent, and there is no right or wrong choice to make. The doctor, mortuary team and Care After Death Team will all be available to support while you decide and throughout the process.

Registering a Death Once the doctor has completed the Medical Certificate of Cause of Death, and the Medical Examiner has signed it off, you will then be able to Register the death of your relative/friend. The Medical Certificate of Cause of Death will be sent electronically to the Registrar for you by the Medical Examiner Service. If your relative/ friend has died in hospital, the Care After Death Service Team will advise you when this has been done. If your relative/friend has died in the community, the GP practice should be able to advise you when this has been done, or you can contact the Care After Death Team who can liaise with the GP on your behalf. The appointment at the Registrars will take place at the Register Office of Births, Deaths & Marriages, and it will be at the office in the jurisdiction where your relative/friend has died. If they died in Swansea, for example, you will need to register the death at Swansea Register Office. The Registrar will ask you for• the date and place of death • the full name and surname of the deceased person (and the maiden surname if the deceased was a married woman/civil partner) • the date and place of birth • the occupation of the deceased and, if the deceased person was married or in a civil partnership, the full name and occupation of their spouse or civil partner • their usual address • the date of birth of a surviving spouse or civil partner • details of any public sector pension e.g. civil service, teacher or armed forces. If you have them, it would be useful to take with you your relative/ friend’s Birth Certificate, Marriage or Civil Partnership Certificate and NHS Medical Card, or recent hospital letter with the NHS number. You may also need to take with you your own identification documents, such as• • 8

Passport/Driving Licence/Birth Certificate Proof of Address (like a utility bill or bank statement)

The Registrars will take you step by step through the process of Registration, and at the end of your appointment you will be given certified copies of the Certificate of Cause of Death, sometimes referred to as a ‘death certificate’. The Certificate of Cause of Death is often required for bank accounts, insurance purposes, or any other financial or legal purpose, so it is often worth purchasing some copies if needed - most places won’t accept a photocopy, only an original copy. You can purchase official copies at the time of your appointment with the Registrar. The registrar will also issue a ‘Green Form’. The official name of this form is the Certificate of Burial or Cremation. The Registrar will send this form electronically to your Funeral Director. There are two Register Offices in the Swansea Bay University Health Board area• Swansea Registrars, Register Office, Civic Centre, Oystermouth Road, Swansea SA1 3SN. Please be aware that your contact details will have been provided to Swansea Registrar, and they will contact you in the first instance to arrange an appointment. Should you need to contact them, their number is 01792 636188. Further information about Death Registration at Swansea can be found by following this link: www.swansea.gov.uk/registeringadeath • Neath Port Talbot Registrars, Register Office, Forster Road, Neath SA11 3BN Please be aware you will need to contact Neath Registrar to make an appointment once the doctor has completed the Medical Cause of Death Certificate. Their contact number is 01639 760021. Further information about Death Registration at Neath Port Talbot can be found by following this link: www.npt.gov.uk/1321

Tell Us Once Service Tell Us Once is a service run by the Department for Work and Pensions (DWP) and is a service that lets you report a death to most government organisations in one go. This includes the DVLA, Passport Office, all Local Authority services, all DWP services, such as State Pensions or Income Support, and any HMRC (His Majesty’s Revenue & Customs) services. At the time of the registration, the registrar can provide you with a unique reference number which will be used to notify various government and local authority departments of the death. More information will be given to you by the registrar at your appointment. You can either phone the Tell Us Once service or complete a form online, but this must be done within 28 days of getting your unique reference number from the Registrar. To use this service, you will need on hand • the deceased’s National Insurance Number • details of any benefits or services they may have been receiving • their driving licence • their passport

Visiting your relative/ friend at the Mortuary The Mortuary Services Team consists of a small group of staff who have chosen to dedicate their careers to the provision of high quality care for the deceased and the bereaved. They are here to help you in whatever way they can as they care for your relative/friend. If you wish to visit your relative/friend, please contact the Mortuary Service Team, who will be able to have a chat with you and book your appointment. They will ensure you have space, time and support during your visit, and will also discuss with you any options you may have for memory-making. They may also contact the Care After Death Team to support you, if you feel you need it when you visit. We request that family members or friends wishing to visit the mortuary attend together and arrive at the arranged time. You must be the next of kin, or have permission from the next of kin, to view the deceased. To make an appointment to visit, please contact Morriston Mortuary 01792 703250 Opening hours: 9.00am - 3.00pm Monday - Friday Singleton Mortuary 01792 285377 Opening hours: 1.30pm - 3.00pm Monday to Friday Currently, there is no facility for visiting at the Mortuary in Neath Port Talbot Hospital. You may also contact the Care After Death Team and they can help you to arrange an appointment. If you do not wish to visit your relative/friend at the mortuary, or you are not able to for any reason, you may be able to visit them when they are in the care of your chosen Funeral Director. Please discuss this option with your Funeral Director, and they will be happy to support you. Please remember, there is no right or wrong when it comes to visiting your relative/friend after they have died. It is a personal choice whether or not you chose to do so - the Mortuary and Care After Death Teams, along with your Funeral Director, will be able to advise you and support you - whichever decision you make. 11

‘Grief is not a disorder, a disease or sign of weakness.

It is an emotional, physical and spiritual necessity, the price you pay for love.

The only cure for grief is to grieve’

Earl Grollman.

Grieving and Support Death can be very distressing and grieving is a normal human response to loss or death. Grief can affect people in many different ways, and people feel many different things - it is a unique and personal experience, and there is no right or wrong way to feel when you are grieving. The practical elements and tasks to do following a death can often take over and take up much of your time in the first few weeks. This can often seem overwhelming at times while you are grieving, or at its opposite you may find that your grief may not fully ‘hit’ you until after all the practicalities are done. Whether you need support early on in your bereavement or later down the line, the Care After Death Team can help to support you. The team are not counsellors, but are trained in Bereavement Support and work with a wide range of people and parties to help you get the support that you need. Some of the people the team work with are listed in the ‘Further Support’ section of this booklet, and the contact numbers for the Care After Death Team are on the opening page. Please be aware that the Care After Death Team are not able to provide ‘crisis’ support and do not provide a 24-hour helpline, but if you feel you need to speak with someone urgently, you can call either of the support options below NHS Wales 111 Option 2 The Samaritans 116 123 You may also choose to see your GP or attend the hospital if you feel you are at risk and need urgent support.

Further Support

• Cruse Offers bereavement counselling, advice and information. UK National Helpline: 0808 808 1677 Email: helpline@cruse.org.uk Swansea branch Tel: 01792 462845 142 Walter Rd, Swansea SA1 5RW • Marie Curie Bereavement Support Offers emotional help as well as handle the practical side of losing someone close to you. Tel: 0800 090 2309 • Samaritans Samaritans can be contacted at any time, day or night, and someone will be available to listen and provide confidential and non-judgmental emotional support. Telephone: 116 123 (English) or 0808 164 0123 (Welsh) Text: 07725 909090 • 2wish Supporting sudden deaths in children and young adults. Tel: 01443 853125 Email: info@2wish.org.uk • DPJ Foundation Providing bereavement support in agriculture, including support for those bereaved suddenly and by suicide. Tel: 0800 587 4262 or text 07860 048799 • SANDS SANDS provides support for bereaved parents and their families when their baby dies at or soon after birth. Tel: 0808 164 3332 • Sandy Bear Sandy Bear is a registered charity providing a service to all children and young people up to 18 years who have suffered a bereavement. Tel: 01437 700272 Email: admin@sandybear.co.uk

• Child bereavement UK Information and support line. Tel: 0800 028 8840 • Brake Offer support to people bereaved and seriously injured by road traffic accidents. Victim helpline: 0808 800 0401 • Hope Again (Cruse) Supporting young people who have recently lost someone. Tel: 0808 808 1677 Email: hopeagain@cruse.org.uk • Compassionate Cymru Helping people access and offer information, care and support in a compassionate way within their communities. Email: contact@compassionate.cymru • Mind Cymru Provide advice and support to empower anyone experiencing a mental health problem. Tel: 0300 123 3393 Email: info@mind.org.uk • Bereavement Support Network Tel: 0808 168 9607 • SOBS If you have been bereaved or affected by suicide and you would like to talk with one of our volunteers about your experience, you can get in touch. Email: email.support@uksobs.org • Welsh Widows A group of people who have lost their loved ones through a variety of different circumstances offering a listening ear via website or in person, in a safe environment. Tel: 07749542858 Email: friends@welshwidows.co.uk • Jac Lewis Foundation The Jac Lewis Foundation is a charity to provide support for mental health and wellbeing in the community. Email: admin@jaclewisfoundation.co.uk Tel: 03301 336510 15

Reviewed: August 2022 Next Review Date: August 2024 Author: Care after death service Published: June 2024

Bereavement Services Feedback At Swansea Bay University Health Board, we fully understand what a difficult time this can be for you and your family, but as an organisation we really value your feedback, good or bad. This will help us to ensure we are providing the right support to you during your bereavement and provide the best service we can. You can return this form to: Kimberley Hampton-Evans, Care After Death Service Manager, Care After Death Service, Morriston Hospital, Heol Maes Y Eglwys, Swansea SA6 6NL or alternatively complete this feedback form online, via this link: forms.office.com/r/tAFXnd0m9Y 1. Please could you tell us where and what date your relative/friend died ......................................................................................................................................................................................................

2. From our Care After Death Service, was there anything you found particularly helpful during this difficult time? ......................................................................................................................................................................................................

3. From our Care After Death Service, was there anything that you found unhelpful during this difficult time? ......................................................................................................................................................................................................

4. If you have any suggestions on how we can improve our service to bereaved relatives/friends, please comment below ...................................................................................................................................................................................................... ......................................................................................................................................................................................................

Thank you for taking the time to provide us with your feedback, we really appreciate it. 17

The Hospital would like to thank RNS Publications for publishing this information and the following pages contain some features from services offering their help at this time. Whilst the Hospital is grateful of their support it does not endorse or recommend any of the services that they provide.

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.

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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. RNS Publications, Trium House, Unit 15, Broughton Way, Whitehills, Blackpool FY4 5QN

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