Swindon & District Community Nursing Bereavement Booklet
Introduction
When someone dies there are many decisions and arrangements that need to be made. This booklet has been prepared to give you help and guidance about what to do and to help you in your bereavement, especially in the difficult days immediately afterwards.
The arrangements that need to be made can be bewildering, so please do not be afraid to ask if there is anything that you are unsure of, we will be pleased to help you in any way we can.
Following a death there are certain formalities to be dealt with, such as registering the death and arranging the funeral. We hope this booklet will help you with some of these.
This information booklet is available in other languages and formats. If you would like a copy, please inform the bereavement services and they will arrange for the different languages.
What to do when someone dies
If someone dies in hospital, please call the Bereavement Service on 01793 604392/604393. Please note office hours for telephone contact are Monday – Friday (excluding bank holidays) 10.00am – 4.00pm.
Sometimes you might get through to an answerphone, please leave your contact details and a member of the Bereavement Services will return your call as soon as possible. If someone dies in the community, the process is slightly different. At the time of death, please call the Community Nursing Service on 01793 646436. An appropriately trained healthcare professional will visit the deceased to verify the death.
Faith Requirements
The Trust will endeavour to facilitate the release of the deceased patient in line with any faith requirements where this is possible and within legal bounds. Please inform the clinical team as soon as you can should your loved one have a specific faith consideration we need to be aware of.
The role of the Medical Examiner
The Medical Examiner is an independent senior doctor whose role it is to ensure the information entered on the Medical Certificate of Cause of Death (MCCD) is correct and that referral to the Coroners are appropriate and completed in a timely manner. The Medical Examiner will review the relevant Medical Records and discuss the cause of death with the clinical team. You can be confident Medical Examiners and Medical Examiner Officers will provide an independent view, they will never look into the causes of death of a person they cared for.
The Medical Examiner will ascertain whether anything could have been done more effectively. If this is the case, we will refer for further internal investigation.
The Medical Examiner will contact a designated family member to help you understand the cause of death. You will have an opportunity to ask further questions if you wish to do so. You will also be asked if you have any feedback regarding your loved one’s care during their final illness. Although he or she may not be able to answer your questions immediately, the Medical Examiners will advise you regarding sources of additional support of information.
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 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 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 and will refer these on to the appropriate team for further investigation.
As well as answering your questions, talking to a Medical Examiner helps the NHS provide better care for other patients and carers in the future; for example, by identifying ways in which patient and family care could be improved.
What can I do if I have questions or concerns about the Medical Examiner process?
If you are not satisfied with the Medical Examiner’s advice, please first discuss this with the staff in the Medical Examiner’s office or email the team on:
Email: gwh.mefeedback@nhs.net
Or you can scan the QR Code.
If you are still not satisfied, you can also contact the Patient Advice and Liaison Service (PALS) on 01793 604031 or gwh.pals@nhs.net
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 Cause of Death is completed - but we can arrange another way of contacting you if you let us know what you prefer.
How can I contact the Medical Examiner office?
Address: Medical Examiner Office, Bereavement Services, Great Western Hospital, Marlborough Road, Swindon, SN3 6BB.
Email: gwh.medicalexaminer.services@nhs.net
Opening Hours: Monday - Friday 8am to 4pm.
Obtaining a Medical Certificate of Cause of Death (MCCD)
The MCCD is the certificate you will need to enable you to register the death. An MCCD can only be issued by a doctor after the death has been reviewed by a Medical Examiner.
If the death occurred in the hospital the doctor looking after your relative/friend will complete the MCCD. If the death occurred in the community, and the cause of death is known, the MCCD will be completed by the GP. The MCCD will be sent electronically to the Register Office.
The MCCD is not always available on the same day and can take up to three working days for completion. The Bereavement Service or the relevant GP surgery will contact you when the MCCD has been sent to the Register Office.
Should the Coroner be informed and a Coroner’s Post Mortem be required, the Coroner’s Officer will contact you directly to inform you of this decision. If the Coroner decides that no further investigation is necessary, they will issue a Form 100a that will be sent direct to the Registrar and will complement the doctor’s MCCD. Bereavement Services will also be informed that the cause of death has been agreed. The hospital Doctor or GP will complete the MCCD and the Bereavement Office or GP surgery will inform you once completed.
Collecting property
Any property and/or valuables that have not been collected from the ward will be returned to you. The Bereavement Service will inform you if they have any property for you to collect. Property remaining at the Hospital and not within the Bereavement Service the team will redirect you to the ward.
Please be aware that Bereavement Services, PALS, GP surgeries and the Coroner’s Office are closed at weekends and public holidays.
Arranging the funeral
It is important to contact the funeral director of your choice as soon as possible so they can start making provisional arrangements on your behalf.
If the patient died in the community, the death needs to be verified by an appropriately trained healthcare professional first. They will visit the deceased to verify the death, once this has been completed, the funeral director can be contacted.
You do not have to wait until the MCCD has been issued, however do not arrange a date for the funeral before receiving the MCCD in case there are unavoidable delays in completing the paperwork.
Most funeral directors are available 7 days a week and are usually happy to visit you at home to help and advise you. Prices for funerals may vary and you may wish to contact several Funeral Directors to compare prices before making a decision.
Last Respects
If the death occurs in hospital, you may be able to pay your last respects to the deceased. This can be arranged in the hospital by the Bereavement Services during the hours of 9am - 3pm, Monday to Friday. This is an appointment system only. Please note there is no Chapel of Rest in the hospital. If a Chapel is required, we recommend that you contact your Funeral Director, who will be pleased to make an appointment for you. If the death occurs in the community, contact your Funeral Director who will make the arrangements for you.
The Coroner
In some circumstances, by law (Notification of Deaths Regulations 2019), it is necessary to report a death to the Coroner. The primary role of the Coroner is to find out the cause of the person’s death. Your relative’s care will be referred to the Coroner if for example (not a complete list):
• It is difficult for doctors to establish the cause of death
• The death was sudden or unexplained
• If the death may have resulted from an accident or act of self-harm
• They died during or following surgery
• The death was unnatural
• The death may have involved an industrial disease such as mesothelioma.
If you believe that the patient who died falls into any of the categories above, please seek advice from the Bereavement Services in the hospital or your Community Nursing Service in the community, as the procedure is different.
After reviewing the individual’s care the Coroner will either:
• Authorise the patient’s doctor to issue the MCCD and complete and send a Form 100a OR
• Authorise a Post Mortem to take place. This will be completed at the Hospital and all contact will be handled by the Coroner’s Office. The purpose will be to try and establish a cause of death and to ascertain whether the Coroner needs to investigate the death any further. PLEASE NOTE – You should not make any funeral arrangements if a Post Mortem is undertaken until you are told to do so by the Coroner’s Office
The doctor who certified the death may ask permission from the next of kin to carry out a post mortem examination. A Post Mortem is an important examination that aims to discover more about a person’s illness. It may also inform individuals about possible acquired or genetic diseases that may need treatment and care. More generally, a Post Mortem examination is important in improving clinical care, maintaining clinical standards, increasing understanding of disease, identifying the spread of infectious diseases and supporting research and training.
The examination, including removal, storage and use of organs and tissue and the various purposes for which tissue might be kept, may involve tissue or whole organs to be taken. If this is requested it must be in accordance with the provisions of the Human Tissue Act.
The process of gaining consent is detailed and involves asking a number of questions to ensure the deceased person’s wishes, and those of the next-of-kin are ascertained and respected.
The Post Mortem examination is carried out in hospital, sympathetically, and by consenting to this examination you are still able to register the death and make funeral arrangements. The result of the examination may be obtained from the deceased person’s consultant or GP.
The clinicians will be able to support you in making the decision that is right for you.
Registering a Death
The death needs to be formally registered with the Register for Births, Deaths and Marriages. Registration is normally the responsibility of a relative, if this is not possible check with the Register Office if you are qualified to act as an informant. It is a statutory requirement to register a death within 5 days (unless the death is reported to a Coroner).
Where you must register the death
The death must be registered in the district where it occurred. The Register Office for Swindon Registration District is located at:
Swindon Register Office
Civic Offices
Euclid Street
Swindon
SN1 2JH
01793 522738
Opening hours are Monday to Friday 9.00am to 4.00pm. The Register Office operates an appointment system. Once you have received confirmation from the Bereavement Office or GP’s Surgery that the MCCD has been completed and sent to the Register Office, you can book an appointment online, via www.swindon.gov.uk. If you do not have access to the internet then please call 01793 522738.
Once your appointment is confirmed, the email confirmation will provide you with the information that you need to have to hand for the appointment. This appointment will last between 30-40 minutes.
It is possible for a death to be registered by declaration at another Register Office if you do not live in the Swindon area. The details are sent through to the Registrar of the district where the death occurred and all necessary documentation has to be issued by them. There are obvious delays in this procedure. Please consult with your local Register Office for further information.
At the Registrar’s Office
The MCCD will be sent electronically to the Register Office by the Medical Examiner or the GP. If possible you should also take supporting documents such as the person’s birth and marriage or civil partnership certificates, proof of address, NHS medical card and any War Pension information.
The registrar will ask you the following questions (use the space provided to write down the information at home before you go to the Registrar Office):
• The date and place of birth
• The full name and surname/family name
• Maiden surname/family name (if applicable)
• The date of birth of the person who has died
• The town and country of birth
• Address (including postcode) of the person who has died
• Pensions or allowances from public funds
• The last full time occupation of the person who has died
• If applicable, the name and occupation of the deceased’s spouse or civil partner
• If the person who has died was married or in a civil partnership, the date of birth of the surviving spouse or civil partner
Documents provided by the Registrar
The registrar will provide you with the following documents:
• White form (BD8) which you may need to claim or stop any benefit payment
• Green form (9) which is the undertaker’s authority to proceed with the funeral arrangements
• Death Certificate (or if the case is referred to the coronerInterim death certificate). It is recommended that sufficient copies are obtained for Probate, insurance policies, savings accounts and investments. Each certificate is £11 and those ordered on the day can be collected the same day.
Who to inform about the death
There are various people who need to be informed of the death and it may be useful to use these checklists to guide you:
People to inform Contacted Completed
DWP - benefits or pension stopped
0800 169 0310
Employer
Inland Revenue (HMRC)
Banks / Building Societies
/ Credit Card Companies
Local Tax Scheme
Insurance companies:
Life insurance
Car insurance
Property insurance
Mortgage company / Land Registry
Housing Association / Landlord
Social Services - If involved
Family Doctor
Relevant Hospital Doctors
Utility providers - Gas, Water etc
School / College - If applicable
National Savings and Investments
Store cards
Telephone company inc. Mobile
Community nursing service 01793 646436 (if known to the service)
DVLA
People to inform Contacted Completed
Union / Professional organisations
Stopping junk mail
www.stopmail.co.uk
Things to cancel Cancelled
Care / household service:
Home help / Meals on wheels / Cleaner etc
Appointments:
Hospital / Dentist / Optician etc
Newspapers
Redirect mail if required
Milk if required
Magazine subscriptions
Items to return Returned
Medicines back to Pharmacy (tablets & injectable medications
Driving licence returned to DVLA
Library books
Any equipment borrowed from Hospital or Social
Services - Commode, walking sticks, hospital bed contact stores on 01793 464777
Passport returned to passport agency
Community nursing notes, call 01793 646436
Season tickets / concessionary travel documents
- Bus pass to relevant company
Organ/Tissue donation
Organ/Tissue donation is the gift of an organ or tissue to help someone who needs a transplant. A transplant can save and dramatically improve someone’s life, but they depend entirely on the generosity of donors and their families.
As of the 20th May 2020 organ donation law in England has changed. We have moved to an opt out system meaning that all adults in England will be considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate or are in one of the excluded groups.
More detailed information for NHS Organ Donation is available on www.organdonation.nhs.uk or telephone National Tissue Donation Service, 0800 432 0559. This is a pager service and if your name and contact number are left then a Tissue Donation Specialist Nurse will ring you back.
Body Donation
Some people very generously choose to donate their body to medical science. In most cases bodies donated are used for teaching anatomy to medical students or for trainee surgeons to refine their skills. Each medical school has responsibility for a certain area of the country, and you can find the list of postcodes and contact details for the medical schools at www.hta.gov.uk. This activity is regulated in law by the Human Tissue Authority.
Funeral Arrangements
Arranging a funeral and choosing a Funeral Director
This section includes information about:
• Your rights and options
• The Funeral Director’s role
• Funeral costs and sources of help
• How to complain if you are not satisfied with the services provided.
Rights and Options
In England and Wales all deaths are certified by a doctor or Coroner, are registered at Registrar of Births, Marriages and Deaths, and the body either buried or cremated.
• You do not have to have a funeral ceremony
• You do not have to use a religious minister
• You do not have to use a Funeral Director
• A ceremony does not have to take place in a crematorium or place of worship.
There are more options concerning the content of a funeral ceremony and its duration than many people realise. Woodland burial and other green options are increasingly available. The majority of people may choose to make their arrangements through a Funeral Director, but you could also get information from the Natural Death Centre.
Choosing a Funeral Director
Funeral Directors will manage the funeral arrangements and give advice and support.
Check if the Funeral Director you choose belongs to a trade association. This requires them to provide full information about their services and prices. The following may influence your choice:
• Location of the firm’s premises. Range of services provided
• Cost
• Recommendation of those who have used the service
• Ownership (small family business or large firm).
Funeral Costs
Costs for the same services may vary considerably from one Funeral Director to another. You may wish to get more than one quote to compare costs.
‘Disbursements’ are fees paid to others, eg for crematorium, minister, doctors’ certificates, newspaper announcements, flowers etc.
Ask the Funeral Director for a written quotation detailing all these fees.
• Funeral payments are normally recoverable from the deceased’s estate
• Remember the cheapest service is not necessarily the best value.
Financial Help
If you arrange a funeral you are 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 a Social Fund Funeral Payment providing you or your partner receive one of the following:
• Income support
• Income-based Jobseeker’s Allowance
• Pension Credit
• Working Tax Credit where a disabled worker is included in the assessment
• Child Tax Credit at a rate higher than the family element
• Housing benefit
• Council tax benefit.
Bereavement Benefit forms are available through the Job Centre either in person or forms can be downloaded from the internet at www.gov.uk. Search for “deaths and benefits” or you can call the Bereavement Services helpline on 0800 731 0469.
Complaints
Most funerals are conducted well. But if you have a justified complaint, you should contact your Funeral Director.
If you are not satisfied with the response, you can complain to whichever of the two trade associations listed below your Funeral Director belongs to:
• The National Association of Funeral Directors (NAFD)
• The National Society of Allied and Independent Funeral Directors (SAIF).
You may be able to get advice from your local trading standards department.
Further information is also available from:
National Association of Funeral Directors
618 Warwick Road Solihull
West Midlands B91 1AA
Tel 0121 7111343
www.nafd.org.uk
The National Society of Allied and Independent Funeral Directors 3 Bullfields
Sawbridgeworth
Hertfordshire CM21 9DB
Tel 0345 230 6777
www.saif.org.uk
The Natural Death Centre In The Hill House, Watley Lane, Twyford, Winchester, SO21 1QX
Tel 01962 712 690 www.naturaldeath.org.uk
Funeral Directors - Swindon Area
The Trust does not recommend, or endorse, any of the following Funeral Directors. This list is simply an extract from Yellow Pages, where a full list can be found.
AJB Funerals
57A Pickwick Road, Corsham 01249 713134
26A Church Street, Melksham 01225 708736
3B New Road, Chippenham 01249 660554
Blackwells Funeral Service
Thames House, Thames Lane, Cricklade 01793 750225
38 Cheney Manor Road, Swindon 01793 611060
Brooks Independent Funeral Directors
21 High Street, Malmesbury 01666 822200
Camp Hopson
90 West Street, Newbury 01635 522210
Charles S. Winchcombe & Son Ltd
37 New Park Street, Devizes 01380 722500
Claridge Funeral Service 01672 511836
Parade Mews, The Parade, Marlborough 01672 563440 / 512110
Cowley & Son
Triangle House, 62 Victoria Road, Cirencester 01285 653298
Wootton Bassett Funeral Care 118a High Street, Royal Wootton Bassett 01793 848700
E Wootten & Son
1 North Street, Calne 01249 812258
Grief - Some thoughts
Bereavement is something most of us experience at some time in our lives. We can all react to it in different ways. Grief is as individual as we are. Bereavement can invoke powerful feelings, which are a natural part of us and our reaction to loss. Sometimes there can be feelings of total numbness. It can be very difficult to take in the fact that someone has died, even when it is known and accepted that they were seriously ill. There may be feelings of unreality as the funeral is prepared. The death of a person can seem incredible and with so much to think about, there may be feelings of anxiety, panic and inadequacy. The Undertaker chosen will sensitively take care of the funeral arrangements.
After the funeral, you may feel several different emotions; powerful feelings of isolation, loneliness, despair and desolation which can occur at any time. Physically, people can feel run down or might find it difficult to eat and sleep. Grief is a time consuming and exhausting experience. Other feelings that can be experienced are guilt, panic, emptiness, self-pity and anger. Feelings need not be hidden, they can be shared if you want, with a sympathetic listener. This may be a friend, minister, nurse, doctor, Hospital Chaplain, counsellor or Spiritual Carer. Sometimes people feel that family and friends are avoiding them. Reasons for this might be that they feel embarrassed or don’t know what to say. By taking the first step in talking, it gives permission to others to talk openly. This can signal that help is needed and that you are ready to talk about the person who has died.
Understandably you may want to avoid painful memories, things and people. You might need plenty of time to work things through before making big decisions, or having a feeling of confidence to start looking to the future without a feeling of panic. It is important simply to allow yourself to grieve in your own time.
After a period of several months these feelings may have subsided and you may feel more able to move forward. If you or someone you know feels unable to move on, or feels stuck in grief, then more help may be needed. You may wish to discuss this with your GP, or you can contact one of the bereavement support organisations, for advice and support.
How children react
It may be tempting to exclude children from conversations about the person who has died, and the funeral arrangements. But children are no different to adults when it comes to bereavement. There is no right way to react and every child will respond differently. Grieving children need honest and appropriate explanations, in languages they understand, which acknowledges their loss. It is important to remember that children may not have the words to express their feelings and may show how they feel through behaviour. Do contact their school/nursery so that the child can be supported there too.
CRUSE Bereavement Support
Provides face to face, telephone, email and website support.
Tel: 0808 808 1677
Hope Again
Tel: 0808 808 1677
Website www.hopeagain.org.uk
The Good Grief Trust
Provides information on bereavement support and bereavement services across the country
Website: www.the goodgrieftrust.org
Feedback Request
At the Great Western Hospital Trust we welcome comments and recognise the importance of monitoring the quality of the care given to dying patients and those important to them in the community and in the hospital.
Please complete the Care of the Dying Evaluation:
If your relative/friend died in the Great Western Hospital
• Via the internet
Type the following into your browser: https://forms.office.com/r/cfASgSz72Z.
• Via a mobile device click on the QR code:
• To answer the questions over the phone
Please phone the Pastoral Care Office on 01793 604289 and leave a message to let them know when it’s best to call you back.
If your relative/friend died in the Community
• Via the internet
Type the following into your browser: https://forms.office.com/e/d5rpcPeM5s
• Via a mobile device click on the QR code:
• To answer the questions over the phone
Please phone the Pastoral Care Office on 01793 604289 and leave a message to let them know when it’s best to call you back.
Thank you for your time and help Front Cover Design - Samantha Singfield
Organisations that may be able to help you and give you support
Winston’s Wish: (Bereavement support for children)
National Helpline - 08088 020 021
www.winstonswish.org
Stopping Junk Mail to the recently deceased
If someone you know has died, the amount of unwanted marketing post being sent to them can be greatly reduced which helps to stop painful daily reminders. By registering with the free service www.stopmail.co.uk the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks. If you cannot access the internet you can call 0808 168 9607, where you will be asked for very simple information that will take only a few minutes to complete. Alternatively, ask the bereavement team or your GP Surgery for a leaflet that can be returned in the post.
This free of charge service provided 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. In addition to Stop Mail, a comparable service can also be accessed from:
• The Bereavement Register (www.thebereavementregister.org.uk)
• The Deceased Preference Service (www.deceasedpreferenceservice.co.uk)
• GOV.UK (www.gov.uk)
Ref: Community Nursing Bereavement Book Review Date: May 2026
Publication Date: May 2024
Please carefully cut out this form
A Book of Remembrance
Has been placed in the Chapel at the Great Western Hospital
If you would like the name of your loved one to be entered into the book, please complete and return this form to the Chaplain’s Office, The Great Western Hospital, Marlborough Road. Swindon SN3 6BB. No charge is made for this, however you may wish to make a donation. Please make any cheque payable to Great Western Hospitals NHS Foundation Trust.
Your Name and Address .......................................................................
Name of the person to be entered in the Book of Remembrance:
Date of Death...................................which is annually remembered. Would you like to add a short inscription? (Inscription can be up to a maximum of 44 characters including spaces).
Donations in lieu of flowers at the funeral
You may wish for donations to be made to a charity in lieu of flowers at the funeral. Remembering a loved one through in memory donations to Brighter Futures (registered Charity of the Great Western Hospital) is a wonderful lasting and meaningful way to pay tribute to that special person.
Please specify if you would like the gift to benefit a particular ward/department, or the Pink Butterfly Fund which supports palliative and end of life care in the hospital and community. Donations may also be made to projects and appeals including cancer care and dementia. Whatever you choose you can be sure that your donation will help the cause closest to you and your family’s heart.
Your support allows us to improve the hospital environment, fund ground breaking research, support the development and training of hospital staff and provide state-of-the-art equipment.
Please remember to let us know the name of the person you are giving in memory of, and your own name and contact details so we can write to thank you for your donation.
To discuss making donations in memory please get in touch with Brighter Futures on 01793 605631.
Alternatively you can email gwh.fundraising@nhs.net or visit www.brighterfuturesgwh.nhs.uk.
Registered Charity 1050892
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.
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.
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.
