Torbay & District Community Hospitals by bereavementadvice

NHS

Torbay and South Devon

NHS Foundation Trust

Community Hospital

Help for you following 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)

Ref: Torbay & South Devon Community Hospitals Bereavement Book Review Date: November 2025 Publication Date: November 2023

Dear relative, carer or friend, the staff of Torbay and South Devon NHS Foundation Trust would like to express their sympathy to you and your family at this difficult time.

The first week of bereavement can be a time of grief and sorrow but it is also a period in which a number of matters must be dealt with.

We hope this booklet will provide you with some useful help during the early stages of your bereavement.

The following issues are covered in this booklet: What to do first Community Hospital Contact Numbers Patient Advice & Liaison Service (PALS) The Medical Certificate of Cause of Death Medical Examiner Cremation Forms Paying for the funeral Burial Cremation Hospital Post Mortem The Coroner Coroner’s Post Mortem People to inform Stopping Junk Mail Clothing and valuables The Registrar will then give you Arranging the Funeral The Hospital Chaplaincy and Pastoral Care Service Grief in Children and Adolescents After the funeral

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Remembering Suggested contact numbers for support and advice Disclaimer

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Bereavement Office, Level 4 Reception, Torbay Hospital Telephone: 01803 654818

What to do first It is important that you contact a funeral director as soon as possible so they can start planning arrangements on your behalf. You do not need to wait for the Medical Certificate with the Cause of Death (MCCD). The Medical Examiner’s office will be in touch with you to introduce themselves and guide you through the process. Medical Examiner’s office Telephone:  01803 654489 - 655085 in office hours to speak with us. When we call we will ask for: • Your full contact details. • Whether there will be a cremation or burial. • The name of the funeral director you will be appointing. • Some personal history regarding the deceased that we may not be able to obtain from the hospital notes. • Whether you have any concerns about the circumstances surrounding your loved one’s death, or any concerns regarding the treatment and care they received at the hospital. PLEASE DO NOT ATTEND THE HOSPITAL TO COLLECT THE PAPERWORK Do not make an appointment to register the death until you have been advised by the hospital that the MCCD has been completed.

Once the certificate has been completed, it will be sent directly to the registrars for the areas where your loved one died. Once this has taken place you will be able to call the registration service and make an appointment to register the death. Paignton Registrars Telephone:  – 01083 207130 Should your loved one have died in the Torbay locality, you can also book an appointment online through the following website – torbay.gov.uk > births, deaths & marriages > Book to register a death. Should your loved one have died in the wider Devon locality, Devon County Council Registration Service Telephone:  – 0345 155 1002 We will arrange to complete the paperwork as quickly as possible, but it is a complex legal process and, on some occasions, this can take several days. Please, bear this in mind when making funeral arrangements. Your loved one cannot be released into the care of the appointed funeral director until this process has been completed. Who can register the death If the person dies in a house or hospital, the death can be registered by: • A relative • Someone that was present at the death • The owner/manager/matron of the residential home or bereavement officer where the death occurred • The person responsible for arranging the funeral (but not the funeral director) Most deaths are registered by a relative. The registrar would normally only allow other people to register should there be no relatives available. 5

Information which will be required by the Register Office • The Medical Certificate for the Cause of Death from the hospital or certificate from the Coroner. • The date and place of death of the person who has died. • Their full name and surname (and maiden name if appropriate). • Their date & place of birth. • Their occupation (or former occupation if retired) • If the person was married/in a civil partnership, the name, occupation, and date and place of their husband/wife/civil partner. • Whether the person who has died was receiving a pension or allowance from public funds. • The information you will give 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. Patient Property Relatives shall be advised that valuables can only be returned to the executor of the Will or, if they are unable to attend, a person nominated in writing by the executor. Proof of identity (e.g. passport, driving license) is required together with either the original or certified copy of the Will before any items can be released. If no Will is held, then the closest Next of Kin may collect any property if the hospital is satisfied they are the correct recipient. An indemnity must be completed and signed.

Community Hospital Contact Numbers Brixham Hospital

01803 881399

Dawlish Hospital

01626 868500

Newton Abbot Hospital

01626 324500

Totnes Hospital

01803 862622

Patient Advice & Liaison Service (PALS), Torbay Hospital PALS is available for patients, their families or carers. If you have been unable to resolve a problem by speaking with the healthcare staff directly involved, we can help you with your questions or concerns. Should you wish to discuss any aspect of the care your loved one received please contact PALS Monday to Friday 9:00am to 4:00pm on: Telephone:  01803 655838 Email: tsdft.feedback@nhs.net Organ donation Many people will have made a decision, in life, about organ or tissue donation. Your loved one may have discussed their thoughts with you. It is very possible that they can help others through donating tissue (eyes for corneal transplants and/or heart for valve transplants) following their death. The donation will not delay funeral plans as the procedure must be carried out quickly, within 24 hours of death for eyes and heart valves. Eye donation does not alter the appearance of your loved one.

If you know their wishes about organ donation or would like to find out more, please contact Tissues National Referral 0800 4320559 or for information regarding tissue donation please visit www.nhsbt.nhs.uk Eyes: Eyes can help restore sight to people with cornea problems (the clear part of the eye). This may be a result of damage caused by eye disease or injury, or defects from birth, and the white part of the eye (the sclera) can be used in operations to rebuild the eye. Heart Valves: Heart valves can be transplanted to save the lives of children born with heart defects, and adults with damaged heart valves. Donated tissue, such as skin, bones and eyes, can save or dramatically improve the lives of many people suffering from illness or injury. Thanks to the generosity of our donors and their families, tissue from thousands of deceased donors are collected across the UK every year. Annually, this provides support around 8,500 life-changing implants for over 2,600 patients. As of April 2020, the law around organ donation in England changed. All adults are now considered to be donors when they die, unless they have opted out, or are in one of the excluded group. Donation will however always be discussed with family and next of kin.

The Medical Certificate of Cause of Death The Medical Cause of Death Certificate (MCCD) is a legal document and can only be issued by a Doctor who knows the cause of death and was involved in the care of the deceased. Our Medical Examiner team will arrange for this to be issued to you as quickly as possible, but it is a complex legal process. The Registry Office guidelines suggest that a death be registered within 5 days, but sometimes the process may take longer and mean there is an unavoidable delay in producing the certificate, please do not worry. Our Medical Examiner team will endeavour to finalise the paperwork for you at the earliest opportunity. Please bear this in mind when making funeral arrangements as the deceased cannot be released into the care of your appointed funeral director until this process has been completed. If the Doctor is required to get approval of a cause of death from the Coroner, this may also cause a delay and in this scenario until the cause of death is approved by the Coroner, our Medical Examiner team will not have permission to issue the medical certificate.

Medical Examiner Medical Examiners are senior medical Doctors who are contracted for a number of sessions a week to undertake medical examiner duties, outside of their usual clinical duties. They are trained in the legal and clinical elements of the death certification process. The purpose of the medical examiner system is to: • Provide greater safeguards for the public by ensuring proper scrutiny of all non-coronial deaths. • Ensure the appropriate referral of deaths to the coroner. • Provide a better service for the bereaved and an opportunity for them to raise any concerns to a Doctor not involved in the care of the deceased. • Improve the quality of death certification. • Improve the quality of mortality data. Cremation Forms In the case where a person is to be cremated, a cremation form will be required. This form will be sent to your funeral director by the Hospital. 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 any arrangements. Many people now purchase their funeral in advance through a prepurchased funeral plan. You may need to check if this has been arranged. 10

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 is likely to be a delay with the paperwork. 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. Hospital post mortem The Doctor issuing the Medical Certificate for the 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.

The Coroner The Coroner is a Lawyer or Doctor 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: • All deaths where there has been any invasive surgical procedure during the latest admission which has contributed to death. • The death may be due to trauma e.g. a fall with fractured neck of femur or a head injury. • Cause of death is unknown. • The death may be due to self-neglect or neglect by others. • The death may be due to an industrial disease (e.g. Mesothelioma) or related to the deceased’s employment. • For any other concerning features. If the Coroner does not wish to carry out a post mortem they will issue a certificate (Form A) for the registrar of deaths. You will be advised if your loved one will come under the care of the Coroner and a Coroners Officer will guide and update you through the process until such time your loved one comes back under the care of the Hospital. The Coroner’s Office can be contacted on:  01752 487402 The Coroner’s Office normal working hours are Monday to Fridays 7.30am to 3.00pm. 13

Coroner’s post mortem Occasionally, deaths have to be reported to the Coroner who decides if there should be a post mortem. If this is the case, there may be a delay before you can proceed, but the Coroner’s Officers will advise you when you can register the death with the Registrar in Paignton. The Coroner’s Office telephone number is: 01752 487402. 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 offer a “Tell Us Once” service and they 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. • Local Authority Services, such as; Council Tax, Housing Benefit, Electoral Services, Library Services, Blue Badge Department, Adult Social Services, Bus Passes. To book an appointment, please contact your local register office and ask for a Tell Us Once appointment. You will need to bring the National Insurance number of the person you are notifying us about, and if applicable, their passport, driving licence, blue badge, bus pass, and library card.

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 • 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.

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 Registrar or Deceased Preference Service if you would prefer to use them. Clothing and valuables Any property and valuables should have been collected from the ward. To collect any valuables from the cashiers you may be required to provide specific paperwork. Please contact the relevant Community Hospitals switchboard who will transfer you to the correct team.

The Registrar will then give you: A Certificate for Burial or Cremation (also known as the Green Form) unless the Coroner has given you an Order for Burial or Certificate for Cremation to give to the Funeral Director. The Registrar will also discuss with you the process for informing the Department of Work and Pensions (DWP). The ‘Tell Us Once’ service will be offered to you at the time of booking your registration appointment. You can also purchase certified copies of the Death Certificate for financial and other matters. We recommend that you obtain at least one copy and the Registrar will explain the cost of this to you. Arranging the Funeral Following a death it is important that you contact a Funeral Director as soon as you are able so they can start making preliminary arrangements for you. You can do this even before the MCCD has been issued. Funeral Directors are a valuable source of information for you and most Funeral Directors are available seven days a week. They can advise you on registering the death and other issues. Costs of funerals do vary and you may wish to ask for a brochure and price list or compare the costs before making a decision. A funeral can take place in the Funeral Director’s own Chapel. If you wish, the Funeral Director can organise the cremation without your attendance and this can reduce costs considerably. You may wish to organise things by yourself but please consider asking for help from relatives or a close and trusted friend. They will want to help and support you in any way they can. 17

If you receive State Benefits you can apply for help in paying for funeral costs. You can obtain form SF200 (Funeral Payment from the Social Fund) from your local Department of Work and Pensions Office or Job Centre Plus. Please check what costs the Social Fund will cover. The Hospital Chaplaincy and Pastoral Care Service During this time you may feel that you need the support of others. It may help to speak to someone about your feelings. This is often a difficult time for family and friends too and they may be afraid to speak about your loved one for fear of upsetting you. You may need to take the first step and let them know you would like their support. The Hospital Chaplaincy and Pastoral Care Service are here to support you and, if you wish, they can put you in touch with a minister of your own denomination. They can be contacted on 01803 656406 or through the main hospital switchboard on 01803 614567.

Grief in Children and Adolescents Generally children do not understand the meaning of death until they are three or four years old. However, they feel the sense of loss of a close relative or friend in much the same way as adults. Even in infancy, it is clear that children grieve and feel great distress. Children experience the passage of time differently to adults and can appear to overcome grief more quickly. However, children in their early school years may need reassuring that they are not responsible for the death of a close relative as they often blame themselves for one reason or another. It is important that the grief of a young person is not overlooked as they will often not want to burden parents by talking about their feelings. It can be helpful to include them in the arrangements.

After the funeral Although settling the estate of the one who has died can be confusing and distressing, obtaining probate for the estate through the Probate Registry can be quite simple, though a little time consuming. This can reduce costs considerably for the Executor. (Probate is the court’s authority to administer a deceased person’s estate). If you are the Executor, 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 assets. If it seems likely to be complex it may be worth using solicitors and accountants to sort it all out. Fees will be charged for those services and they will come out of the estate. You will need to make it clear precisely what work they need to do for you. Whilst this is going on, access to monies in the estate can be difficult but banks and building societies may write a cheque out of the estate to cover funeral expenses even before probate is granted. For those who have been close relatives or friends the process of adjustment to their loss may take a while. Try to avoid making hasty decisions during this time, especially if you are living alone. Remembering Everyone will have their own way to remember the person who has died. Talk about them and mention their name often and put the emphasis on the good things that happened when they were alive. Members of the family or close friends may appreciate a photograph or small object as a reminder. Most important of all will be your own memories. 20

Suggested contact numbers for support and advice Benefit Enquiry Line

0800 151 2012

Bereavement Advice Centre Tax, Benefits and Probate

0800 634 9494

Carers UK Advice and support for carers

0808 808 7777

Veterans UK

0800 169 3458

Probate Registry - Cardiff

0300 3030 648

Pension Help Line

0800 731 0469

Torbay Hospital Chaplaincy

01803 656 406

Patient Advice Liaison and Support (PALS)

0800 028 2037

Cruse Bereavement Care (for adults and children) www.cruse.org.uk

0300 330 5466 0808 808 1677

Age UK

01803 555 181

Samaritans

116 123

Samaritans Torquay

0330 094 5717

Disclaimer The costs of producing this leaflet are met by the advertisers. Whilst we gratefully acknowledge this welcome support it does not imply that we recommend the services or products advertised. All rights reserved.

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.

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,�port network stopping mail

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.

Torbay & District Community Hospitals

Articles inside

Registering the death

After the funeral

Grief in Children and Adolescents

When someone dies

Arranging the Funeral