Please call the Bereavement Office on 01925 662294 the following day after 11am (Monday – Friday) to give contact details
If a message is left the bereavement office will call back as soon as available
See page 3
One of the doctors who was looking after the deceased will refer the case to the Medical Examiner’s team for review
See page 3
Once a cause has been given the Medical Examiner’s Officer will give the named contacted next of kin a call to go through the cause to be documented on the Medical Certificate of Cause of Death
See page 3
Once the next of kin has been informed of the cause the Bereavement Officer will ask the doctor to complete a cause of death certificate
See page 4
Once completed the Medical Certificate of Cause of Death will be given to the Medical Examiner to be signed and then will be sent over to the Registrar Office in Warrington (Runcorn if Halton death)
See page 5
Once received by the registrars they will give the named next of kin a call to arrange date and time of registering the death
We are very sorry for your loss
We are here to help you at this very difficult time and hope this booklet will provide you with helpful information about what happens after a death. Please don’t hesitate to contact us if you are unsure what to do next.
Visiting the Bereavement Office
The Bereavement Office is located at the rear of Warrington Hospital site on the ground floor of Cheshire House. Cheshire House is near the Guardian Street entrance, adjacent to the railway line.
Access by car is from Lovely Lane and following the road around to the left and continuing on the road adjacent to the railway line. Cheshire House is clearly visible on the left-hand side. The Bereavement Office has disabled access via a ramp with handrail and dedicated parking is available outside the Office
The Bereavement Office Opening Hours
Monday-Friday 9.00 - 16 00
We politely request you telephone after 11.00am to allow the Bereavement Office time to liaise with Doctors and H.M. Coroner’s Office.
The Bereavement Team
Cheshire House
Warrington Hospital WA51QG
Phone: 01925 662294
Email: whh.bereavementteam@nhs. net
What to do first
Please telephone the Bereavement Centre after 11am the following working day after the loss of your loved one 01925 662294. We will take the name and contact details of the next of kin which will be given to the Medical Examiner’s office and Registrars.
Please do not attend the Bereavement Office without telephoning first, this is to save you an unnecessary journey as the Medical Certificate of Cause of Death will not be available for collection.
In most cases the doctor will complete a Medical Certificate (unless a death is legally reportable to the Coroner). After weekends or Bank Holidays this may take a little longer.
Once a Medical Certificate of Cause of Death has been issued by the doctor, the Medical Examiners Of fice will send to the registrars once issued and the registrar of fice will call you to give date and time for registering the death. The bereavement office will keep you updated if there is a delay for any reason, for example, the availability of a doctor legally eligible to issue the Medical Certificate or your relative’s death has been referred to the Coroner’s Office. (There is more information about this later in the booklet).
For deaths occuring at Halton Hospital
Should the death have occurred in Halton Hospital, please call the General Of fice after 11.00am the following working day on 01928 753125/ 753211.
All deaths at Halton Hospital must be registered at Halton Registry Of fice by appointment. Please call 0151 9078307.
Arranging the Funeral
Please contact a Funeral Director of your own choice or contact your personal faith/ spiritual leaders to arrange the funeral.
The Funeral Director/spiritual leader will guide and assist you with all the arrangements for the funeral and discuss the options of burial or cremation. It may be helpful to find out if there is a Will as it may contain the deceased person’s funeral requests.
Faith and Cultural Requests
We are committed to respecting and supporting our patient’s beliefs and will do everything we possibly can to accommodate all religious and cultural requests following the loss of your loved one.
We have support for all faiths if you have one and can connect you to local faith leaders if you require.
If you have any specific cultural or religious requirements, please advise the Bereavement Office when you contact us.
The Medical Examiner Service
The Medical Examiner System is a Government recommendation based on the findings of the Harold Shipman Inquiry. Since 2019 some senior NHS Doctors have chosen to train to act as Medical Examiners and thereby provide Independent scrutiny of all deaths not referred to H M Coroner.
Medical Examiners also look at the relevant medical records and discuss causes of death with the Doctor completing the Medical Certificate of Cause of Death. You can be confident Medical Examiners and their staff will provide an independent review as they will only review deaths of patients where they or their staff have not provided care for the patient.
A discussion with a Medical Examiner provides you with an opportunity to ask questions about the cause of death, have medical terminology explained, raise any concerns about your relative’s care or discuss anything else you are worried about.
We understand this is a difficult time for people. You can nominate another member of the family or a friend to speak to the Medical Examiner or their staff in your place or decline a discussion at all. It is totally your choice and is not compulsory. As well as answering any questions you may have this service helps the NHS provide better care for other patients in the future.
If any concerns are raised, the Medical Examiners will pass them onto someone else to investigate. Medical Examiners will not investigate further themselves, as they must complete their work within set time limits for the death certification process.
Medical Examiners will make every effort to avoid any delays and work with families so they should be able to meet legal requirements for registering deaths.
The Medical Examiner’s Office is based in Cheshire House, Warrington Hospital. Telephone 01925 665087
If you are not satisfied with the Medical Examiner’s advice, we suggest you discuss with them first, and if necessary, you can also contact the Patient Advice and Liaison Service (PALS) on telephone 01925 662 281.
Registering the Death
The Register Office, Council Offices One Time Square, Warrington, WA1 2NT. Tel: 01925 442194
This office is open 09:00 to 4:30 Monday- Friday.
The register office will call the next of kin documented to arrange a date and time for registering the death. This will need to be done before 5 days of the registrars receiving the Medical Certificate for Cause of Death
The Registrar will issue:
•A Green Form – This is free and will be required by the funeral director for cremation or burial (unless the coroner is involved and will either be given to the next of kin or sent electronically to the appointed funeral director)
•A Certificate of Registration BD8 (for social security purposes). This is different from the Death Certificate. This is free and you should send it to the Department for Work and Pensions.
•A Death Certificate – a fee will be charged for death certificates, currently £12.50 each (but can change. The registrars will advise the cost at the time of calling).
The Registrar will need the informant or the next of kin to provide the following information:
•The Medical Certificate of Cause of Death
•The deceased National Health Card (if available)
•The deceased birth certificate
•The deceased marriage certificate (if applicable)
•Date and place of birth
•Occupation and occupation of spouse (if applicable)
•Date of birth of any surviving spouse
•Name and address of person registering the death
•The date and place of death
Please note, if any of these documents aren’t available, the Registrar will accept your word as true and correct.
Who can register a death?
It is the responsibility of the next of kin, or person arranging the funeral, to register the death within five working days. This does not apply if the coroner is involved. The death can be registered by:
•The next of kin or family member (with permission from the next of kin)
•A person present at the death
•The deceased’s lawyer or executor of the estate
•The occupier/owner of the premises where the death took place
•Any person making the funeral arrangements
The registrar will issue a Death Certificate. It will be useful to request more than one copy and a charge of £12.50 (subject to change) will be made for each certificate.
The ‘Tell Us Once’ service is offered by most Local Authorities on behalf of the Department for Work and Pensions (DWP). The service allows the bereaved person to inform central and local government services of the death at one time rather than having to write, telephone or even attend each service individually.
The Tell Us Once service can save you a great deal of time and effort. Further information is available from the Registrar when you register the death.
The Coroner
There are some occasions when a death must be reported to His Majesty’s Coroner by law. Examples of when a death requires reporting to the Coroner are:
•The cause of death is unknown
•The deceased was not seen by a doctor in the previous 14 days (currently extended to 28 days).
•The death was unnatural
•The death was as a result of trauma
•The death was violent or suspicious
•The death may be due to an accident, (even when the accident was some time ago)
•The death was due to self–neglect or neglect by others
•The death occurred during an operation, or before recovery from anaesthetic
•The death may be suicide
•The death occurred whilst in detention, in police or prison custody
• The deceased was subject to detention under the Mental Health Act
If the doctor reports the death, one of the Coroner’s officers will usually want to speak to the next of kin or family representative. If the Coroner agrees that the doctor may issue a medical certificate of death, the Coroner will confirm this with the Registry Officer. They will send a supporting document, known as a Part 100A to the Registrar to enable the registration of the death.
If the Coroner does not give permission for the attending doctor to issue a medical cause of death certificate, then the Coroner’s office will inform you of the next steps. This may involve a post-mortem examination having to take place. The Coroner does not need the permission of the family for the examination to go ahead, the Coroner may also wish to hold an investigation into the circumstances leading up to the death. This is called an Inquest.
If an inquest is to be held a death certificate may not be available for some time, however the Coroner can issue an interim certificate for administration purposes.
At the conclusion of the inquest the Coroner registers the death with the Registrar
A copy of the Death Certificate can then be obtained from the Registrar a few days after the inquest.
It is advisable to speak to the Coroner’s office to check if the death has been registered – telephone 01606 363 892
Paying your Respects
Sometimes we receive requests from families who wish to see a loved one after death. Once a patient has left the ward and been transferred to the care of the Mortuary, it is possible to visit your loved one within the Mortuary Chapel of Rest by arranging an appointment – telephone 01925 662107 (there will be an answerphone service before 13:00) Appointments to pay your respects are during the afternoon only (13:00 - 15:00) Each visit to the Mortuary Chapel of Rest is limited to 30 minutes.
Your Relative’s Belongings and Valuables
If your relative has belongings that you were unable to collect at the time of their death, the ward staff will take them to the bereavement Office where the property can be collected Monday (ex. Bank Holiday) to Friday. You are advised to bring personal identification with you.
Tissue Donation
When a relative/friend dies at home or in hospital it may be possible for them to donate tissues for transplant or research. Donated tissues can dramatically improve people’s lives and cornea donation can restore sight.
If your relative/friend had expressed a wish to donate or you would like to discuss this further, please speak to the nursing staff, bereavement office team or call NHS Blood and Transplant Tissue Donation on 0800 432 0559 to speak to a specialist nurse. Donation can take place up to 24 hours after someone dies (occasionally 48 hours afterwards). A specialist nurse will explain the process and discuss consent with you before any donation takes place.
Only those tissues you have given consent for will be donated.
Dealing with the emotional aspects of grief
The death of a loved one is an experience that we all face at some time in our lives. Grieving takes place after any sort of loss, but most powerfully after the death of someone we love. To mourn deeply for someone we have loved is entirely normal.
Bereavement is a very distressing experience and an individual journey. You may experience very different emotions and feelings at different times. There is no right or wrong way and there are no set timescales to the process of grieving.
People often experience feelings of numbness, disbelief, denial, shock, anger, agitation, bargaining, yearning, depression, guilt and eventually acceptance. Most people will usually reach this point in one or two years.
Even when death comes after a long illness and was expected, you are still likely to be left in a state of shock. You may even find it hard to cry. It’s important to express and acknowledge your feelings, and this is all part of a natural and healing process.
It’s important during the first few days, in addition to having to do official things related to the death, that you remember to rest, look after yourself and most of all be kind to yourself.
You may also find that feelings about previous losses come to the surface. It’s important to remember these feelings and reactions may come and go during a bereavement.
Your feelings may change from hour to hour and from day to day. One day you may feel you are coping, the next day you may be over-whelmed by feelings of sadness and loneliness. It’s quite normal to have ups and downs like this.
Dealing with the physical aspects of grief
Many bereaved people feel strained and physically rundown. Grief is time consuming and exhausting. Many bereaved people experienced some or all the following symptoms:
• Breathlessness
• Palpitations, tightness in the chest and throat
• Exhaustion
• Loss of appetite or over-eating
• Sleep problems
• Symptoms similar to those experience by the person who has died
It is always important to share with your doctor any anxieties about such symptoms in order to gain reassurance.
Chaplaincy and Spiritual Care
We have a spiritual care centre at both Warrington and Halton Hospitals (at Warrington the centre is located in Burtonwood Wing and at Halton the centre is located at the Nightingale Building).
Anyone – all faiths or none – is welcome to sit and reflect and enjoy the tranquillity of the centre.
We have a number of spiritual leaders who will gladly offer their support to those in need, they provide a listening ear and can be a source of comfort to you in your grief. You do not have to have a faith to access their support and they are also able to connect you to your own faith leaders should you wish.
They can be contacted on 01925662146 or through the switchboard on 01925635911.
Useful Support Organisations
• Hospital Spiritual Care Service - 01925662146
• Hospital Bereavement Of fice - 01925662294
• National Referral Centre for Tissue Donation- 08004320559 (free phone)
• Age UK (Age Concern and Help the Aged) - www.ageuk.org.uk
• Cruse Bereavement Care 0808 808 1677- www.cruse.org.uk
• Amparo Support following Suicide - www.amparo.org.uk
• The Lullaby Trust (baby sudden death) - www.lullabytrust.org.uk
• The Miscarriage Association - www.miscarriageassociation.org.uk
• The Samaritans - www.samaritans.org
• Support After Murder and Manslaughter (SAMM) - www.samm.org.uk
• The Terrence Higgins Trust (AIDS or HIV) - www.tht.org.uk
• Survivors of Bereavement by Suicide - www.uksobs.org
• Child Bereavement UK - www.childbereavementuk.org
• The Compassionate Friends (support for bereaved parents of a child of any age) - www.tcf.org.uk
Your own GP should also be able to support you further at this dif ficult time.
The Remembrance Garden
We are pleased to provide a private, calm and peaceful space for you to visit and reflect at any time.
You do not need to ‘check in’ anywhere and you do not need to come into the Bereavement Office or the hospital.
Away from the main hospital areas with subtle, scented plants as well as pergolas, trellis and trees for privacy, our remembrance garden is a place for family and friends to remember loved ones.
Designed with seating areas, including covered ones for wet weather, and paths suitable for wheelchair users our garden has been designed to provide colour and interest all year round.
The garden was provided by our Hospitals’ Charity (WHH Charity) to provide some additional comfort for bereaved families, friends and staff.
If you would like to find out more about how our hospitals’ charity supports patients and families visit www.whhcharity.org.uk
Stopping junk mail to the deceased
If someone you know has died, the amount of unwanted marketing post being sent to them can be greatly reduced which helps stop painful daily reminders.
By registering with the free service www.stopmail.co.uk the names and addresses of the deceased are removed from all mailing lists, stopping most advertising mail within as little as six weeks.
If you cannot access the internet you can call 08081689607, where you will be asked for very simple information that will take a few minutes to complete.
This free of charge service provided by the Bereavement Support Network will actively reduce the unwanted marketing mail and 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. A comparable service can also be accessed from the Bereavement Register or Deceased Preference Service if you would prefer to use them.
Care Review
As part of national requirements the Trust reviews several deaths every year to ensure that the care provided has been of the highest quality possible and that improvements are made where needed. These reviews are undertaken by doctors and other staff not directly involved in the care of the patient. Reviews are automatically undertaken on certain groups of patients:
•Patients under the age of 18
•Maternal deaths
•Neonatal deaths
•Patients whose death is sudden, unexpected, untoward or accidental.
The Trust also undertakes reviews when a significant concern is raised about the care provided to a patient. A ‘significant concern’ is considered to mean:
•Any concerns raised by the family that cannot be answered at the time
•Anything that is not answered to the family’s satisfaction or that does not reassure them.
In most cases the reviews find that care is very good and no concerns are raised. However, in a small number of cases the review may identify something that requires further investigation. If this is the case, the hospital will get in touch with you to give you the name and telephone number of a contact in order for you to be involved in any discussions.
We appreciate that this may cause distress to relatives and sincerely apologise if this is the case. We want to assure you that you are under no obligation to participate in the review, however please do understand that this is a national, mandated process which is intended to ensure that the hospital learn from any incidents or lapses in care so that they are not repeated.
At Warrington and Halton hospitals, we have a strategy to continually sustain and improve the care and support for patients who are dying, and for the people close to them. A vital and highly valued aspect of this work is your feedback.
A few months after the death of your loved one you are likely to receive a questionnaire through the post which is anonymous and can be completed via a secure online link, or returned on paper via a franked addressed envelope. If you are able to, we would appreciate hearing your thoughts about the care received during the last days of their life and your experience at that time. Your help would be greatly appreciated, but there is no obligation.
Please note, the questionnaire is separate from the hospital complaints process.
Remembering a loved-one
Giving a gift in memory of a loved one is an extremely valuable way to celebrate their life. By donating to WHH Charity you can play a vital role in helping provide the additional comforts, care and experience for the direct benefit of our hospitals’ patients and their families beyond that of which the NHS provides.
A simple way for everyone to pay their respects is an online tribute where a personal and permanent memory is created of a loved one. It is simple way to share messages and memories with family and friends, and to collect donations for the hospitals’ charity in their memory. Create your personalised tribute page www.whhcharity.org.uk/inmemory or call us on 01925 662666.
We are also grateful for donations instead of flowers that many families elect to choose. Donations can also be made via www.whhcharity.org.uk or by sending a cheque made payable to Warrington and Halton Hospitals Charity, Warrington Hospital, Lovely Lane, Warrington WA5 1QG.
Please include your contact details so we may thank you for your kind support and you can share this with your kind supporters.
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.
