Following a Bereavement
A practical guide for family and friends
Tunbridge Wells
Tunbridge Wells Hospital at Pembury
Introduction
If you have been given this booklet, you have experienced the death of someone close to you. We are very sorry for your loss and we know this can be a very difficult and distressing time. We hope this booklet will help you understand what you can expect from Maidstone & Tunbridge Wells NHS Trust.
When someone dies there are many decisions and arrangements that have to be made. Whilst it is impossible to cover every detail, we have tried to provide help and advice in this booklet on the main issues to be faced when arranging a funeral. There is also information about how to comment on the care your loved one received and what happens if a death will be looked into by the Coroner. It also provides details of the processes involved if you have any significant concerns about the care provided and gives practical advice, support and information. The GOV.UK website (www.gov.uk/ after-a-death) also provides practical information on what to do following a death.
This booklet has been prepared to help you in these first difficult days following your loss. It covers Maidstone Hospital and the Tunbridge Wells Hospital at Pembury. Arrangements may differ in each hospital, therefore please call the telephone number specific to each hospital.
Information contained in this booklet may need some explanation. There are members of staff who are available and are happy to help you. These include the Nurses, Doctors, Bereavement Officers and the Chaplaincy Teams.
If we can be of any further assistance, please do not hesitate to contact us. All numbers can be found in the following pages.
The Medical Examiner Service
The Medical Examiner Service is a national initiative to enable independent review of all deaths by a senior doctor or consultant in all hospital trusts. This review will take place before the Medical Certificate of Cause of Death (MCCD) is released to the family.
The Medical Examiner Service will:
• Make sure the bereaved receive a better service by giving them opportunity to raise any concerns about the care and/or death of their relative by an independent, impartial party not involved in the care of the deceased.
• Provide better safeguards, ensuring complete scrutiny of all non-coronial deaths and to improve the quality of death certification by making sure they are accurate and true to cause.
• Ensure deaths that should be referred to the Coroner are referred appropriately in the required timescale.
This service will also allow the family first access to the wording on the MCCD and to ask further questions to understand clearly what happened to their relative. Once this process is completed, all paperwork is passed to the Bereavement Team.
Medical Certificate, Release Form And Property
To obtain the Medical Certificate of Cause of Death (MCCD) and release form you will need to ring the numbers below to make contact with the Bereavement Officer who will explain the process of the paperwork through the Medical Examiner Service and will ask for admin details from you. At this point you can also make arrangements to collect any property held in safe keeping at the hospital. When all paperwork is completed the Bereavement Office will contact you.
The Medical Certificate is required to enable you to register the death; this is a legal document signed by the doctor, stating the cause of death. The Release Form will be part-completed with the name and Hospital Number of the deceased; you will need to complete and sign the form and hand to your chosen Funeral Director who will be unable to collect the deceased from the hospital without it.
The Bereavement Office can be contacted on the following number:
• Maidstone Hospital
Tel: 01622 224251
Ask to speak to the Bereavement Officer
Office times: Monday – Friday 10am – 4pm
• Tunbridge Wells Hospital at Pembury
Tel: 01892 632923
Ask to speak to the Bereavement Officer
Office times: Monday – Friday 10am – 4pm
If there is no answer leave your name, contact number and relationship to the deceased. When all the paperwork is completed, the Bereavement Officer will contact you.
Please contact the Bereavement Office during the office working hours as above, Monday to Friday. If necessary please leave a message and we will return your call as soon as possible after 10am.
Registering The Death
The death must be registered within five working days if it has not been referred to the Coroner; if it has been referred the five day ruling is waived. A death occurring in Maidstone Hospital or Tunbridge Wells Hospital can be registered any where in Kent apart from the Medway towns of Chatham, Gillingham, Rochester and Strood and the London boroughs of Bromley and Greenwich as these are not part of the Kent registration district.
Kent County Council provides this service through its Libraries and Gateways. Registration is by appointment only. To book an appointment please phone 03000 41 51 51 or use the online booking service on Kent County Council’s web pageswww.kent.gov.uk/births-ceremonies-and-deaths. You will be advised where to attend for your registration appointment.
The death cannot be registered until the doctor has completed a Medical Certificate of Cause of Death. As stated earlier this can be obtained from the Bereavement Officer.
When you go to the registration appointment, you should take the following:
• Any War Pension order book of the deceased
• The deceased’s medical card, if possible
You will also need to provide the following information:
• The date and place of death and the deceased’s usual address
• The deceased’s full name and maiden name if appropriate
• The deceased’s date and place of birth
• The deceased’s occupation, and for women the name and occupation of the husband if applicable
• Whether the deceased was receiving a pension or allowance from public funds
• The deceased’s marital status and date of birth of the surviving spouse
The Death Certificate
This is a certified copy of the entry in the register of deaths. You may wish to discuss with the Registrar how many certificates you require as banks, building societies and most insurance companies require to see an original but do not need one to keep. They will photocopy an original and return it to you. A fee of £12.50 is charged for each certified copy.
If the death is referred to the Coroner, the Coroner’s Officer will contact the closest relative with details of when arrangements can proceed.
The Coroner’s Officers can be contacted on:
• Maidstone
Tel: 03000 410 502
• Tunbridge Wells
Tel: 03000 410 502
The Registrar will give you:
• A certificate, known as the Green Form - this form enables you to proceed and make the funeral arrangements with your chosen funeral director. They will not be able to help without the form.
• A White Form is also given to the next of kin as this acts as a Death Certificate for the Pensions and Benefits Agencies.
Tell Us Once
Tell Us Once reduces the amount of time you need to spend contacting government departments and organisations because you provide all the information to the Department for Work and Pensions (DWP) who then pass that information on to the people who need to know.
Now you have completed the death registration, the details of the death have been added to the Tell Us Once system. You now have 28 days to complete the Tell Us Once process. You can do this in the following ways:
• Online at www.gov.uk/tell-us-once
• By telephone: 0800 085 7308
• Alternatively, you can book a face to face Tell Us Once appointment at the Registry Office.
Tell Us Once can notify the following departments after you have registered a death:
• Adult Social Services
• Attendance Allowance
• Blue Badge parking permit
• Bus Passes
• Carer’s Allowance
• Child Benefit
• Child Tax Credit
• Children’s services
• Council housing
• Council Tax
• Council Tax Benefit
• Disability Living Allowance
• Driver and Vehicle
Licensing Agency
• Electoral services
• Employment Support Allowance
• Housing Benefit
• Incapacity Benefit
• Income Support
• Jobseeker’s Allowance
• Library services
• Owe payments to council
• Passport service
• State Pension
• Tax Help for Older People
• Working Tax Credit
• Personal Taxation
• War Pension Team
Where applicable, Tell Us Once will pass details to these departments on your behalf. The departments you choose to notify will contact you directly if they need any more information to process your change in circumstances.
Tell Us Once is a partnership between Kent County Council, the London Borough of Bexley, Kent’s District Councils and departments across Government.
Advice for Viewings
Relatives are recommended to arrange viewings of their loved ones at their chosen Funeral Director for more ambient surroundings, availability and ease.
The Mortuary in the hospital is a clinical area and not as comfortable as a funeral home for viewings, therefore only in exceptional circumstances would there be possible availability to accommodate a viewing in the Mortuary.
Please make contact on the Bereavement telephone numbers for advice.
Hospital Chaplaincy
Each hospital has a Chaplaincy Team. They have links with most faith groups and can usually contact an appropriate representative for you. The Chaplaincy Teams can offer support and advice at this time. You do not have to be a member of any particular faith group to ask for help from the Chaplaincy Team. If you are then one of the team can put you in touch with a local minister who will also be able to help.
During office hours there is usually a member of the Chaplaincy Team available in the hospital to help if needed. A 24-hour emergency service is available via the hospital switchboard.
The Chaplaincy Teams can be contacted on the following numbers:
• Maidstone Hospital Tel: 01622 224569
• Tunbridge Wells Hospital at Pembury Tel: 01892 635438
Organ Donation
You and your relative may have discussed organ donation or they may have carried a donor card. If you feel that you would like someone to discuss this with you please do not hesitate to ask a member of staff as soon as possible.
Some organs can be used up to 48 hours after death. People may also be able to donate corneas. Corneas are used to restore sight.
Heart valves may also be given up to 48 hours after death. Many people who are greatly incapacitated by defective valves are given new life, especially babies and children.
Post-Mortem Examinations
We understand this is a difficult time for you to consider such an issue as post-mortem examination. Post-mortems are only carried out to ascertain cause of death. (A post-mortem will not be carried out if the doctor gives a cause of death which is acceptable to the Coroner).
These examinations fall into two categories, a Coroner’s post mortem and a hospital post-mortem. Legally, your consent is not required by the Coroner to hold a post-mortem; however, you will be kept closely informed by the Coroner’s Office. Your consent is needed for the consultant to carry out a hospital post-mortem. You may also be asked for your permission with regard to procedures involving tissues and other samples taken during a post-mortem.
If a post-mortem is considered necessary by either the Coroner or the Hospital, you will be given further information and the details discussed with you.
Coroners’ Inquests
As already stated some deaths are referred to the Coroner, for example where the cause of death is unknown, or the death occurred in violent or unnatural circumstances. When a death is referred to the Coroner they may request a post mortem and/or inquest. The Coroner will decide whether an inquest is required. An inquest is a ‘fact finding’ exercise which normally aims to determine the circumstances of someone’s death.
We will inform you if we have referred the death to the Coroner. If we do not refer a death to the Coroner, but you have concerns about the treatment we provided, you can ask the Coroner to consider holding an inquest. It is a good idea to do this as soon as possible after your loved one has died, as delays in requesting an inquest may mean that opportunities for the Coroner to hold a post-mortem are lost.
The Coroner’s Office can be contacted by email on kentandmedwaycoroners@kent.gov.uk.
If you are seeking or involved in an inquest, you may wish to find further independent information, advice or support. There are details of organisations that can advise on the process, including how you can obtain legal representation, within this leaflet.
Care Of The Deceased
The respect and dignity of all individuals will be upheld at all times. All staff working in this area are trained to a high standard and will ensure the care, safety and dignity of the deceased is respected before they move into the care of a funeral director.
Funerals
What to do first
Contact a funeral director who can advise and discuss the funeral arrangements with you.
Funeral arrangements cannot be made until you have been informed that the death does not have to be reported to the Coroner. If the Coroner is involved this may affect the date when the funeral can be held.
A Will may have been made by the deceased, which may include requests about his or her funeral arrangements.
Funeral Directors
The hospital is not able to recommend a particular funeral director. There are no universal standards that apply to funeral directors, however some are members of professional organisations, which operate a code of conduct. The National Association of Funeral Directors (NAFD) and the Society of Allied and Independent Funeral Directors (SAIF) are examples of these.
• National Association of Funeral Directors (NAFD)
Tel: 0121 711 1343
www.nafd.org.uk
• National Society of Allied & Independent Funeral Directors
Tel: 0845 230 6777
www.saif.org.uk
A funeral director should be expected to give you a written quotation, which may not be exceeded without permission. This includes an estimate for a standard funeral, as well as any additional services.
The Trust operates a system for the safe release of your loved ones from our care. You will be given a white release form by the Bereavement Office for you to sign and pass on to your funeral director giving your permission for them to take the deceased into their care. Although funeral directors are used to organising the majority of funerals, some people prefer to organise them themselves.
You may also prefer to choose a Woodland Environmentally Friendly Burial. For further details please contact:
• The Natural Death Centre
Tel: 01962 712690
www.naturaldeath.org.uk
Help with funeral costs
Funerals can be expensive. If you are on Income Support, Family Credit or Housing Benefit, you may be able to get payment from the Social Fund, to help pay for the funeral. For advice please contact your local Job Centre Plus:
• Tel: 0800 169 0140 www.gov.uk/budgeting-help-benefits/how-to-apply
Under some circumstances Benevolent Funds are available for ex-service men and women and for other services such as the Police and Fire Brigade.
How Are You Feeling?
Bereavement is a very personal and, to some, a very painful life event to have to go through. It will be a time where you may be unprepared and overwhelmed by the strength of the thoughts, feelings and emotions experienced. There is no right or wrong way to grieve as it is unique to the individual and may be influenced by many things such as age, personality, family and culture.
It is not uncommon to initially feel shocked following bereavement, even if a death is expected it may still be a shock when it actually occurs. This may be followed by a sense of numbness and disbelief that the person who has died has really gone.
Symptoms and feelings you may experience:
Exhaustion
Grief can be very tiring as it is physically and emotionally demanding; many people find they have difficulty with sleeping and concentration. People can experience mood swings and not feel like eating. It is important to look after your own well-being and not to neglect your health. If you are worried about your health, you may wish to consult your GP.
Anger
Sometimes people feel angry. This may be directed at healthcare professionals, at friends or family, at a religious entity, or even the person who has died. Sometimes the anger may have no specific focus. In these circumstances, sharing thoughts and feelings with friends, family or a faith leader may be helpful.
Feelings of guilt and feelings of fear for the future
People may also experience feelings of guilt or regret, and may often reflect on things they wished they had said or done. It is often helpful to share these feelings with people that you feel comfortable with and can help you understand your emotions and feelings. Whilst for some people it may be tempting to make significant changes to your life in response to your grief it is important to recognise that now may not be the best time to do so. What seems right at the moment may change in the near future.
Anxiety, depression, helplessness
People can spend a significant amount of time and energy in trying to understand the events leading up to a death and may go over things repeatedly in their mind to try and make sense of their loss. This is part of the grieving process.
You may also feel: Sleeplessness and stress - Relief that pain and suffering has ended for your loved one - Aches and pains and other physical ailments.
You may become withdrawn from friends and family and find daily routines hard to cope with; be lethargic and have little interest in activities once enjoyed.
Grief for each person is very different and therefore you may experience any of the aforementioned symptoms which are all quite normal.
Self-help
Talking to family and friends may help. Allow them to give you support even if you feel like closing down and withdrawing from the world.
They may offer to:
• Help with funeral arrangements - emotional support or an extra pair of ears is very important at this time. Make the funeral arrangements when you feel ready – don’t be hurried into making any decisions. Funeral directors are very helpful. If you only have limited funds do not be embarrassed to tell them. They can help arrange a funeral within your finances.
• Help with financial arrangements – if you do not understand something ask a trusted relative or friend to assist you. Don’t make any big decisions in a hurry e.g. selling/buying a house. Give yourself time.
Contact your GP or local religious or faith community members - don’t feel you are being a nuisance; they are used to dealing with bereaved people and usually offer good support.
Children And Young People
Children and young people may respond differently to grief and have thoughts and feelings which they may want to express in different ways. Although it is not possible to protect children and young people from feeling sad, talking openly with them will help them. If you feel you would like further support and advice on how to talk to a child or young adult, please speak to a health professional who was involved in caring for your loved one. Alternatively, you may wish to refer to the websites listed in this leaflet.
The following “do’s and don’ts” may provide some useful guidance.
• Let your genuine care and concern show.
• Be available to listen when a child wants to talk.
• Say you are sorry about what has happened.
• Allow them to express as much unhappiness as they are feeling and are willing to share.
• Let them know it is not shameful to cry.
• Encourage them to be patient with themselves.
• Tell them it is okay to talk about the person who is dying or has died, and do so yourself.
• Encourage them to keep photos, paintings or letters they might have written to the person and talk about memories.
• Be honest and answer questions about death and burial.
• Offer practical help - this can be most important in the early stages.
• Be sensitive on special days, i.e. Birthdays etc.
• Remember for some children death is one of many losses they may have suffered and grieving may also be much more complicated if parents are divorced or separated. Give children permission to have fun and be happy.
• Let your own sense of helplessness keep you from reaching out.
• Avoid them because you feel uncomfortable.
• Say you know how they feel - you don’t.
• Say ‘you ought to be feeling better by now’.
• Tell them what they should feel or do.
• Change the subject when they mention the dead person or death in general.
• Avoid mentioning the bereavement out of fear.
• Point out that at least they have other siblings or parents.
• Suggest they should be grateful for what they have left.
• Make any comments which suggest the death was their fault.
• Say ‘you don’t mean that’ - try and find out what they do mean.
When to seek help
Bereavement can be a painful and overwhelming experience, but grieving for the loss of a loved one is a natural process. For many people the support of friends and family may be sufficient to adjust to circumstances and start to resume normal life.
Some people find it is easier to speak to a stranger rather than a loved one or close friend as they feel they may be burdening those close to them. If the person who has died was formerly under the care of a hospice, their bereavement service will be able to provide you with ongoing support. Your GP will also be able to assist you.
If you feel you need additional or longer term emotional support, we’ve listed below some organisations in England and Wales who are able to offer you quality time to help you cope with your grief.
• Compassionate Friends Nationwide
Self-help organization for bereaved parents.
Tel: 0345 123 2304
Web: www.tcf.org.uk
• Cruse Care for the bereaved.
Tel: 0808 808 1677 (Helpline)
For Maidstone area
Tel: 01622 671011
Web: www.cruse.org.uk
• Heart of Kent Hospice
Preston Hall, Aylesford ME20 7PU
Tel: 01622 792200
Web: www.hokh.org
• Holding On Letting Go
Charity for bereaved children – based in Medway
Tel: 03445 611 511
Web: www.holdingonlettinggo.org.uk
• Hospice in the Weald
Maidstone Road Tunbridge Wells Kent TN2 4TA
Tel: 01892 820500
Web: www.hospiceintheweald.org.uk
• Switchboard LGBT+ helpline
This group offers support and advice to lesbians and gay men who have been bereaved by the death of a partner.
Tel: 0300 330 0630
• The Lullaby Trust
Offers confidential support to anyone affected by the sudden and unexpected death of a baby or young toddler.
Bereavement Support line
Tel: 0808 802 6868
Web: www.lullabytrust.org.uk
• Macmillan Nurses
Macmillan nurses work with cancer patients and others with serious illness and their families. They provide support throughout the illness and during bereavement. For Maidstone area
Tel: 0808 808 00 00
Web: www.macmillan.org.uk
• The Miscarriage Association
A group that provides support and information for all who have suffered a pregnancy loss.
Tel: 01924 200799 (Monday - Friday 9am - 4pm)
Web: www.miscarriageassociation.org.uk
• Road Peace
An organisation to help people who have experienced bereavement or injury through a road accident.
Tel: 0800 160 1069 (Monday - Saturday 9am - 5pm)
Web: www.roadpeace.org
• Samaritans
A 24 hour helpline.
Tel: 116 123
Web: www.samaritans.org
• SANDS
The Stillbirth and Neonatal Death Society which offers support and advice to the parents and families of babies who have died at or around the time of birth.
Tel: 0808 164 3332 (Monday - Friday 9.30am - 5.30pm)
Web: www.sands.org.uk
• Slideaway
Charity for children based in Maidstone
Tel: 07970 597715
Web: www.slideaway.org
• SUDDEN
A charitable initiative to support people bereaved by sudden death.
Web: www.suddendeath.org
• Terrence Higgins Trust
A support group for those who are HIV positive and/or have AIDS and their friends and families.
Tel: 0808 802 1221 (Monday - Friday 10am - 10pm)
(Saturday / Sunday 12pm - 6pm)
Web: www.tht.org.uk
The following organisations are also available for advice:
• Age UK
For Maidstone area
Tel: 01622 753618
For Tunbridge Wells area
Tel: 01892 522591
Web: www.ageuk.org.uk
• Citizens Advice
For Maidstone area
Tel: 08082 505704
www.maidstonecab.org.uk
For Tunbridge Wells area
Tel: 0808 278 7992
Web: www.citizensadvicenwk.org.uk
• Relate
Confidential counselling on all aspects of relationships including bereavement.
For Maidstone area
Tel: 0300 100 1234
For Tunbridge Wells area
Tel: 0300 100 1234
www.relate.org.uk
• Victim Support
A voluntary group offering help and support for those who are victims of crime.
Tel: 08 08 16 89 111
Web: www.victimsupport.org.uk
• WAY Widowed and Young
Web: www.widowedandyoung.org.uk
• Winston’s Wish
Charity for bereaved children
Tel: 08088 020 021
Web: www.winstonswish.org
Understanding What Happened
(The following information has been prepared with the support of families, trusts and other stakeholders)
As a family member, partner, friend or carer of someone who has died whilst in the care of Maidstone and Tunbridge Wells NHS Trust, you may have comments, questions or concerns about the care and treatment they received. You may also want to understand more about the reasons for their death. The staff who were involved in treating your loved one should be able to answer your initial questions. However, please do not worry if you are not ready to ask these questions straight away, or if you think of questions lateryou will still have the opportunity to raise these with us (the trust) when you are ready through your named contact at the trust.
It is also important for us to know if you don’t understand any of the information we provide. Please tell us if we need to explain things more fully.
If you have had cause to contact the Trust regarding the above, you should also have received a letter from us, either in advance, or accompanying this information. The letter should have included the details of someone in the trust who you can contact for support and if you have any questions. Please do get in touch with them if you want to provide comments; ask questions; or raise any concerns. If you need to speak to someone immediately and have not yet received a letter from us, please contact the Bereavement Office on 01622 224251(Maidstone) or 01892 632923.
Reviews Of Deaths In Our Care
Case note reviews (or case record reviews) are carried out in different circumstances. Firstly, case note reviews are routinely carried out by NHS trusts on a proportion of all their deaths to learn, develop and improve healthcare, as well as when a problem in care may be suspected.
A clinician (usually a doctor), who was not directly involved in the care your loved one received, will look carefully at their case notes. They will look at each aspect of their care and how well it was provided. When a routine review finds any issues with a patient’s care, we contact their family to discuss this further.
Secondly, we also carry out case note reviews when a significant concern is raised with us about the care we provided to a patient. We consider a ‘significant concern’ to mean:
• any concerns raised by the family that cannot be answered at the time; or
• anything that is not answered to the family’s satisfaction or which does not reassure them.
This may happen when a death is sudden, unexpected, untoward or accidental. When a significant concern has been raised, we will undertake a case note review for your loved one and share our findings with you.
Aside from case note reviews, there are specific processes and procedures that trusts need to follow if your loved one had a learning disability; is a child; died in a maternity setting; or as a result of a mental health related homicide. If this is the case, we will provide you with the relevant details on these processes.
Investigations
In a small percentage of cases, there may be concerns that the death could be or is related to a patient safety incident. A patient safety incident is any unintended or unexpected incident, which could have, or did, lead to harm for one or more patients receiving healthcare. Where there is a concern that a patient safety incident may have contributed to a patient’s death, a safety investigation should be undertaken. The purpose of a safety investigation is to find out what happened and why. This is to identify any potential learning and to reduce the risk of something similar happening to any other patients in the future.
If an investigation is to be held, we will inform you and explain the process to you. We will also ask you about how, and when, you would like to be involved. We will explain how we will include you in setting the terms of reference (the topics that will be looked at) for the investigation. Investigations may be carried out internally or by external investigators, depending on the circumstances.
In some cases, an investigation may involve more care providers than just Maidstone and Tunbridge Wells NHS Trust. For example, your loved one may have received care from several organisations (that have raised potential concern). In these circumstances, this will be explained to you, and you will be told which organisation is acting as the lead investigator.
You will be kept up to date on the progress of the investigation and be invited to contribute. This includes commenting on the drafts of investigation reports before they are signed off. Your comments should be incorporated in the reports. After the final report has been signed off, the trust will make arrangements to meet with you to further discuss the findings of the investigation.
You may find it helpful to get independent advice about taking part in investigations and other options open to you. Some people will also benefit from having an independent advocate to accompany them to meetings etc. Please see details of independent organisations that may be able to help, later in this leaflet. You are welcome to bring a friend, relative or advocate with you to any meetings.
Where the death of a patient is associated with an unexpected or unintended incident during a patient’s care, staff must follow the Duty of Candour Regulation/ Policy (www.cqc.org.uk/guidance-providers/regulationsenforcement/regulation-20-duty-candour). AvMA (Action Against Medical Accidents (www.avma.org.uk) has produced information for families on Duty of Candour which is endorsed by the Care Quality Commission.
Providing Feedback, Raising Concerns And/ Or Making A Complaint
Providing feedback
We want to hear your thoughts about your loved one’s care. Receiving feedback from families helps us to understand (i) the things we are doing right and need to continue; and (ii) the things we need to improve upon.
Raising concerns
It is also very important to us that you feel able to ask any questions or raise any concerns regarding the care your loved one received. In the first instance, the team that cared for your loved one should be able to respond to these. After this, your named contact at the Maidstone and Tunbridge Wells NHS Trust is the best person to answer your questions and concerns. However, if you would prefer to speak to someone who was not directly involved in your loved one’s care, our Patient Advice Liaison Service (PALS) team will be able to help.
PALS Office opening times are Monday to Friday 10.00am to 4.00pm. Both offices offer a 24 hour answering machine. Messages will be responded to within one working day, so please do leave a contact number.
PALS Maidstone Hospital 01622 224960
PALS Tunbridge Wells Hospital 01892 632953
PALS Email mtwpals@nhs.net
PALS SMS 07747 782317
Making a complaint
We hope that we will be able to respond to any questions or concerns that you have. Additionally you can raise concerns as a complaint, at any point. If you do this we will ensure that we respond, in an accessible format (followed by a response in writing where appropriate to your needs), to the issues you have raised.
The NHS Complaints Regulations (www.legislation.gov.uk/ uksi/2009/309/pdfs/uksi_20090309_en.pdf) state a complaint must be made within 12 months of the incident happening or within 12 months of you realising you have something to complain about.
However, if you have a reason for not complaining to us sooner we will review your complaint and decide whether it would still be possible to fairly and reasonably investigate. If we decide not to investigate in these circumstances you can contact the Parliamentary and Health Service Ombudsman (PHSO www.ombudsman.org.uk).
Please note you do not have to wait until an investigation is complete before you complain - both processes can be carried out at the same time. For example, a complaint can trigger an investigation, if it brings to light problems in the care that were not previously known about. However, if both the complaint and investigation are looking at similar issues, a complaint could be paused until the associated investigation is complete.
If you are not happy with the response to a complaint, you have the right to refer the case to the Parliamentary and Health Service Ombudsman. PHSO has produced ‘My expectations for raising concerns and complaints’ for users of health services, which sets out what you should expect from the complaints process (www.ombudsman. org.uk/publications/my-expectations-raising-concerns-andcomplaints).
Please see the frequently asked questions section on page 37 of this booklet for more information on what to do if you are not happy with the responses you receive from us.
Independent Information, Advice And Advocacy
If you raise any concerns regarding the treatment we gave your loved one, we will provide you with information and support; and do our best to answer the questions you have. However, we understand that it can be very helpful for you to have independent advice. We have included details on the next page of where you can find independent specialist advice to support an investigation into your concerns. These organisations can also help ensure that medical or legal terms are explained to you.
Some of the independent organisations may be able to find you an ‘advocate’ if you need support when attending meetings. They may also direct you to other advocacy organisations that have more experience of working with certain groups of people, such as people with learning disabilities, mental health issues, or other specialist needs.
The list on the following pages does not include every organisation but the ones listed should either be able to help you themselves, or refer you to other specialist organisations best suited to addressing your needs.
In addition all local authorities (councils) should provide an independent health complaints advocacy service, which is independent of the trust, that people can access free of charge. If you would like to use this service, please contact them on The Advocacy People, www.theadvocacypeople.org.uk.
We may also be able to provide you with details of other organisations and services that provide local support, and if relevant, we would be happy to talk these through with you.
Local/Regional Organisations
• The Advocacy People
Provides a range of general advocacy services across the south of England.
Web: www.theadvocacypeople.org.uk
• POhWER
Offers general advocacy services in the south and midlands and independent health complaints advocacy to support people to complain about NHS services in many London boroughs.
Web: www.pohwer.net
National Organisations
• Action against Medical Accidents (‘AvMA’)
An independent national charity that specialises in advising people who have been affected by lapses in patient safety (‘medical accidents’). It offers free advice on NHS investigations; complaints; inquests; health professional regulation and legal action regarding clinical negligence. Most advice is provided via its helpline or in writing but individual ‘advocacy’ may also be arranged. It can also refer to other specialist sources of advice, support and advocacy or specialist solicitors where appropriate.
Web: www.avma.org.uk
Tel: 0845 123 2352
• Advocacy after Fatal Domestic Abuse
Specialises in guiding families through inquiries including domestic homicide reviews and mental health reviews, and assists with and represent on inquests, Independent Office for Police Conduct (IPOC) inquiries and other reviews. www.aafda.org.uk
Tel: 07887 488 464
• Child Death Helpline
Provides a freephone helpline for anyone affected by a child’s death, from pre-birth to the death of an adult child, however recently or long ago and whatever the circumstances of the death and uses a translation service to support those for whom English is not a first language. Volunteers who staff the helpline are all bereaved parents, although supported and trained by professionals. www.childdeathhelpline.org.uk
Tel: 0800 282 986
• Hundred Families
Offers support, information and practical advice for families bereaved by people with mental health problems, including information on health service investigations. Web: www.hundredfamilies.org
• Inquest
Provides free and independent advice to bereaved families on investigations, inquests and other legal processes following a death in custody and detention. This includes mental health settings. Further information is available on its website including a link to ‘The INQUEST Handbook: A Guide for Bereaved Families, Friends and Advisors’.
www.inquest.org.uk
Tel: 020 726 31111
• National Survivor User Network
Is developing a network of mental health service users and survivors to strengthen user voice and campaign for improvements. It also has a useful page of links to user groups and organisations that offer counselling and support.
Web: www.nsun.org.uk
• Patients Association
Provides advice, support and guidance to family members with a national helpline providing specialist information, advice and signposting. This does not include medical or legal advice. It can also help you make a complaint to the CQC.
Web: www.patients-association.org.uk
Tel: 0800 345 7115
• Respond
Supports people with learning disabilities and their families and supporters to lessen the effect of trauma and abuse, through psychotherapy, advocacy and campaigning.
Web: www.respond.org.uk
• Support after Suicide Partnership
Provides helpful resources for those bereaved by suicide and signposting to local support groups and organisations.
Web: www.supportaftersuicide.org.uk
Future updates to this information
Please note that this information will be updated in the future as a result of expected new guidance and processes. These include:
• The outcome of the consultation on the Serious Incident Framework.
• The implementation of the role of the Medical Examiner.
• Guidance on Child Death Reviews.
• The ambition in the original CQC report ‘Learning from Deaths’ to include all providers of NHS commissioned care, including primary care.
Further policy developments that may be of relevance.
Frequently Asked Questions (FAQ)
What should I do if I have concerns about my relative/friend’s treatment contributing to their death?
Please speak to your named contact at the trust; the staff involved in the treatment of your loved one; or the Patient Advice and Liaison Service (PALS). If necessary, you can ask for an investigation. You can also make a formal complaint, either to the trust directly or to the relevant clinical commissioning group (CCG) – please see below for more information.
Who orders a post-mortem or inquest?
In some cases we refer deaths to the Coroner and in some cases the Coroner may then order a post-mortem to find out how the person died. Legally, a post-mortem must be carried out if the cause of death is potentially unnatural or unknown. The Coroner knows this can be a very difficult situation for families and will only carry out a post-mortem after careful consideration. A family can appeal this in writing to the Coroner, giving their reasons, and should let the Coroner know they intend to do this as soon as possible. However, a Coroner makes the final decision, and if necessary, can order a post-mortem even when a family does not agree. Please note that the body of your loved one will not be released for burial until it is completed, although a Coroner will do their best to minimise any delay to funeral arrangements. You speak directly to the local Coroner’s Office about having a post-mortem and/or inquest.
What should I do if I think the treatment was negligent and deserving of compensation?
Neither patient safety investigations nor complaints will establish liability or deal with compensation, but they can help you decide what to do next. You may wish to seek independent advice from Action against Medical Accidents (see the section on ‘Independent information, advice and advocacy’). They can put you in touch with a specialist lawyer if appropriate. Please note: there is a three-year limitation period for taking legal action.
What should I do if I think individual health professionals’ poor practice contributed to the death and remains a risk to other patients?
Lapses in patient safety are almost always due to system failures rather than individuals. However, you may be concerned that individual health professionals contributed to the death of your loved one and remain a risk. If this is the case, you can raise your concerns with us or go directly to one of the independent health professional regulators listed on page 39.
Where can I get independent advice and support about raising concerns?
Please see the section on independent information, advice and advocacy which details a range of organisations. Other local organisations may also be able to help.
Other Organisations That May Be Able To Help
• Integrated Care Board (ICB)
Integrated Care Boards pay for and monitor services provided by NHS Trusts. Complaints can be made to the relevant ICB instead of the trust, if you prefer. Please ask us for contact details of the relevant ICB(s).
Web: www.nhs.uk/nhs-services/find-your-local-integratedcare-board/
• Parliamentary and Health Service Ombudsman (PHSO)
The PHSO make final decisions on complaints that have not been resolved by the NHS in England and UK government departments. They share findings from their casework to help parliament scrutinise public service providers. They also share their findings more widely to help drive improvements in public services and complaint handling. If you are not satisfied with the response to a complaint, you can ask the PHSO to investigate.
www.ombudsman.org.uk
Tel: 0345 015 4033
• Care Quality Commission (CQC)
The CQC is the regulator for health and social care in England. The CQC is interested in hearing about concerns as general intelligence on the quality of services, but please note that they do not investigate individual complaints.
Web: www.cqc.org.uk
• National Reporting and Learning System (NRLS)
Members of the public can report patient safety incidents to the NRLS. This is a database of incidents administered by NHS Improvement, which is used to identify patient safety issues that need to be addressed. Please note though that reports are not investigated or responded to.
Web: www.england.nhs.uk
• NHS England- Specialised Services
Specialised services to support people with a range of rare and complex conditions. They often involve treatments provided to patients with rare cancers, genetic disorders or complex medical or surgical conditions. Unlike most healthcare, which is planned and arranged locally, specialised services are planned nationally and regionally by NHS England. If you wish to raise a concern regarding any specialised services commissioned in your area, please contact NHS England’s contact centre in the first instance.
Email: england.contactus@nhs.net or Tel: 0300 311 22 33
• Nursing and Midwifery Council (NMC)
The NMC is the nursing and midwifery regulator for England, Wales, Scotland and Northern Ireland. It has a Public Support Service that puts patients, families and the public at the centre of their work. More information can be found within the ‘Concerns about nurses or midwives’ section on their website: www.nmc.org.uk
• General Medical Council (GMC)
The GMC maintains the official register of medical practitioners within the United Kingdom. Its statutory purpose is to protect, promote and maintain the health and safety of the public. It controls entry to the register, and suspends or removes members when necessary. Its website includes ‘Guides for patients and the public’, which will help you decide which organisation is best placed to help you. More information can be found within the ‘Concerns’ section.
Web: www.gmc-uk.org
• Healthcare Safety Investigations Branch (HSIB)
HSIB’s purpose is to improve safety through effective and independent investigations that don’t apportion blame or liability. HSIB’s investigations are for patient safety learning purposes. Anyone can share cases with HSIB for potential investigation (but an investigation is not guaranteed).
Web: www.hsib.org.uk
Tunbridge Wells Hospital Bereavement Booklet
Issue date: August 2024
Review date: August 2026
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.
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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.
