Torbay Hospital Bereavement Book by bereavementadvice

Torbay 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 Hospital Bereavement Book Review Date: September 2025 Publication Date: September 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 useful information during the early stages of your bereavement.

The following issues are covered in this booklet: What to do first

page 4

Medical Examiner

page 5

The Medical Certificate of Cause of Death

page 5

The Coroner

page 6

Patient Advice & Liaison Service (PALS)

page 9

Cremation Forms

page 11

Paying for the funeral

page 11

Hospital Post Mortem

page 12

Coroner’s Post Mortem

page 12

People to inform

page 13

Stopping Junk Mail

page 15

Arranging the Funeral

page 15

The Hospital Chaplaincy and Pastoral Care Service page 16 Grief in Children and Adolescents

page 17

After the funeral

page 18

Remembering

page 18

Disclaimer

page 19

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. There is no requirement for you to attend the hospital to collect the Medical Certificate with the Cause of Death (MCCD). You can make an appointment to register the death once you have been phoned.

Medical Examiner Medical Examiners are senior doctors who will not have been involved in the care of the person who died. Their role is to provide an independent review of the death. 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. 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 Patient. Our Medical Examiner’s team will arrange for this to be issued to you as quickly as possible. The Registry Office states that a death be registered within 5 days. On occasions this process may take longer, please do not worry, the Registrar maintains contact with the Medical Examiner’s office ensuring the process is moved as quickly as possible to avoid unnecessary delays.

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 or 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, should the death be of natural causes or the Coroner may open and adjourn an investigation/ inquest. 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. 6

Paignton Registrar Telephone:  – 01803 207130 You can also book an appointment online through the following website – torbay.gov.uk > births, deaths & marriages > Book to register a death. We will arrange to complete the paperwork as quickly as possible, this can take several days. 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. 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) 7

• 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. Bereavement Office Telephone:  01803 654818 in office hours to speak with us. Hospital Viewings Please contact the bereavement office to arrange if you wish to see the deceased whilst they are in the care of the mortuary at the hospital. Funeral Directors will also offer viewings in their own Chapel of Rest. 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 licence) 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 Bereavement Officer is satisfied they are the correct recipient. An indemnity must be completed and signed.

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. 9

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 for 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 groups. Donation will however always be discussed with family and next of kin.

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 Medical Examiner team. Paying for the funeral Funeral costs are normally recoverable from the deceased’s estate, but the person arranging 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. Where payment for the funeral is difficult, you may be entitled to help with the funeral costs through the Social Fund. 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 arranging 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.

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. 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.

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. • 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. After you have registered the death with the Registrar, they will give you a unique Tell Us Once reference number and you can access the service online. You can get more information and use the Tell Us Once online service. 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.

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. 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 arrange 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. 15

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 faith or denomination. They can be contacted on 01803 656406 or through the main hospital switchboard on 01803 614567. The Chapel at Torbay Hospital is situated near Sinclair Oncology Centre and is available to all patients, relatives, friends and staff for personal reflection and prayer. There is also a multi-faith prayer room nearby. Please ask at the Main Reception desk on Level 4 for directions to the Chapel.

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. 18

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.

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Directions to Registrar’s Office at Paignton Library, Great Western Road, TQ4 5AG Telephone 01803 207130

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.

�\\ bereavement

,�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.

TORQUAY

NEWTON ABBOT

EXETER

147 Babbacombe Road Torquay TQ1 3SU

King Street Newton Abbot TQ12 2LG

206 Topsham Road Exeter EX2 6AA

01803 32 94 94

01626 33 44 44

01392 43 33 33

A trading style of Turnside Marketing Ltd

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

01253 832400 enquiries@rns.co.uk

Do you need help with

Probate Matters? You may need help, support or advice on what to do when someone dies in relation to probate.

Freephone: 0808 168 5181 Mobiles: 0333 240 0360 We offer free guidance and advice on the legal and financial aspects of bereavement including your responsibilities and whether probate is required. Calls are free from most land lines, some calls may be monitored for training purposes and all calls are confidential. This service is provided by the Bereavement Support Network Ltd.