Warwick Hospital

Warwick CV34 5BW

Telephone 01926 495321 extension 8131

Introduction

We understand that the loss of a relative or friend is an extremely difficult time. We would like to offer our condolences to you and to reassure you that there is help available, should you require it.

Our aim is to provide you with support and assistance to help you through the procedures following a death. This booklet is provided as practical guidance for the first steps you need to take following the death of your relative or friend.

Bereavement Officers

The Bereavement Officer will provide advice and information about what happens next and the formal procedures following a death. If you have a question please do not hesitate to contact the Bereavement Office on 01926 495321, extension 8131. The Office is open between the hours of 09:00 and 16:30 hours, Monday to Friday (excluding Bank Holidays) and is located at Warwick Hospital.

The Bereavement Officer is also the primary contact for relatives and friends of patients who died at Warwick Hospital. They will contact the next of kin or nominated representative the next working day usually in the morning.

What happens next

If your relative or friend died at Warwick Hospital the Bereavement Officer will contact the next of kin or nominated representative the following day, or on Monday if the death was at the weekend.

The doctor will establish the cause of death and complete the Medical Certificate of Cause of Death and where required the Cremation Certificate. This will be done in a timely manner, however these are important documents and they need to be completed by a doctor who directly cared for your relative or friend in the last 28 days.

The certificate and relevant medical records will then be passed to the Medical Examiner for an independent review. Once the cause of death is approved the Medical Certificate of Cause of Death will be sent to the Registrar of Births and Deaths.

In some circumstances the death will need to be referred to the Coroner for further investigation. If this is necessary the doctor will complete an electronic referral to the Coroner and a Coroner Officer will contact the next of kin or designated representative.

You will be able to register the death when the certificate has been released. The Medical Examiner Officer will contact you to confirm this has been completed.

Medical Certificate of Cause of Death

When someone dies, the doctor or sometimes the Coroner has to issue a medical certificate giving the cause of death. This is called the Medical Certificate of Cause of Death (MCCD) and is a legal document which must be completed in accordance with regulations by a doctor who has seen the patient in the last 28 days, or has seen the patient after death and treated them during their last illness.

Our aim is for the doctor to complete the certificate the next working day, although sometimes there are unavoidable delays in the issuing of the certificate. This is often due to legal considerations surrounding who is eligible to complete the death certificate, and the need to seek approval from the Coroner.

After the certificate has been completed it is reviewed by an independent Medical Examiner who will approve the cause of death given. A Medical Examiner Officer will contact the next of kin or nominated representative to advise when it has been approved and the cause of death given.

The Medical Certificate of Cause of Death is required before the death can be registered with the Registrar of Births and Deaths. We advise you not to make an appointment with the Registration Office until you have been notified the cause of death has been approved. You will not need to collect the certificate as it will be sent directly to the Registration Office.

Medical Examiner

The Medical Examiner is a senior doctor who conducts an independent review of all adult inpatient deaths. They also review a number of cases where the death occurred in a community hospital, hospice or at home. The Medical Examiner will review the deceased’s medical records and the proposed cause of death to ensure the information contained is correct. They will confirm no further investigation is necessary and the Medical Certificate of Cause of Death can be issued.

This review will be completed in a timely manner to avoid unnecessary delays.

Once approval has been given the Medical Examiner Officer will contact the next of kin or nominated representative to confirm the cause of death and answer any questions they may have. The certificate will be sent electronically to the Warwickshire Registration Service.

When the Coroner has to be involved

In certain situations the hospital cannot issue the Medical Certificate of Cause of Death and will need to report the death to the Coroner’s Office. The Coroner is an independent judicial officer with statutory responsibility for the legal investigation of the cause of death in some circumstances. These include:

• Where the cause of death is unexpected or unknown

• Where the patient had a fall or a fracture that needs to be included on the medical certificate

• If the death is due to an industrial disease

• Where the cause of death is deemed as being unnatural

• Where the death occurs during, or shortly after surgery

Once the referral has been reviewed, the Coroner’s Office may decide that the hospital doctor can issue the Medical Certificate of Cause of Death. The Coroner’s Officer will advise you of this decision.

The Coroner may order a post mortem examination to determine the precise cause of death. This is a legal decision and does not require the consent of the next of kin. Following a post mortem the Coroner’s Office will issue the appropriate paperwork allowing the death to be registered.

In some circumstances the Coroner may request an inquest into the death; this is common when a fall or a fracture is included within the Medical Certificate.

Hospital Post Mortem

Occasionally a doctor or relative may ask for a post mortem examination to be carried out in order to understand more clearly what happened or to obtain more information about the disease.

As these types of post mortems are not considered necessary to establish the cause of death they are organised by the hospital. Unlike a Coroner’s Post Mortem, a Hospital post mortem can only be carried out with the agreement, and signed consent, of the patients legal next of kin or nominated representative.

Where a hospital post mortem is requested the doctor must discuss with the Pathologist and the next of kin or nominated representative. You will be invited to attend the hospital and meet with the Doctor and a Bereavement Officer trained in seeking consent. At the meeting the request for post mortem will be explained and your questions will be answered before you are asked to sign a consent form.

We do not carry out post mortems on our hospital sites and patients will be transferred to University Hospital Coventry and Warwickshire for the post mortem examination.

Cardiac Pacemakers and other Devices

There are many different types of medical devices in us, many of these can cause significant damage to the cremator if not removed or deactivated. It is very important that you inform the Bereavement Officer or Medical Examiner Officer and your chosen Funeral Director if you are aware your relative or friend had a medical device in place.

Collecting property and valuables

Any property or valuables left at the hospital will be kept safely. Items classed as non-valuable will be taken to the Bereavement Office. Valuable items will be put into a secure storage bag and handed to the Security Office and put in the hospital safe. Please be aware that it requires two authorised key holders to open the safe.

You may arrange a time to collect the property from the Bereavement Office but if you are unable to get to the hospital we can arrange for items to be delivered to your home. Unfortunately it is not possible to store property after 30 days and arrangements should be made for collection prior to this time.

Spending time with your relative

Saying goodbye to the one you love is important. It can be distressing, but it often helps to see the person who has died. Visiting your relative on the ward just after death will be possible for a limited time.

After this time families usually visit their relative at the funeral directors. If however, you wish to see your relative at Warwick Hospital please notify the Bereavement Co-ordinator who will arrange an appointment for you. Please be aware that we are only able to offer viewings on weekdays during office hours.

Registering the Death

Once you have the medical certificate you will need to take it to the Registrar of Births and Deaths Office, usually within five days of the death. All Registration Offices operate an appointment system, please telephone to make an appointment before attending to prevent unnecessary waiting. Please note you may not register the death unless the Medical Certificate of Cause of Death has been issued. The registration should take approximately 40 minutes. However, in some circumstances the Registrar may have to refer to the Coroner which may result in further time being necessary.

It is preferable that persons registering a death do so in the registration district in which the death occurred to avoid delay and enable certificates to be obtained at time of registration.

Warwickshire Registration Offices are located at:

• Warwick

• Stratford upon Avon

• Rugby

• Nuneaton

If it is not convenient for you to visit the Registration Office for the district where the death took place, you can go to any other Registration Office in England and Wales to make a declaration of the death. Please contact your nearest office for further information.

The Registrar will ask you the following details relating to the deceased:

• Full name

• Any surname previously used, including maiden name

• Date and place of birth

• Occupation

• Usual address

• The full name, date of birth and occupation of his/her spouse or civil partner

The following documents are helpful to take when registering the death, but please do not worry if you cannot find them:

• Medical card

• Birth certificate

• Marriage certificate

The Registrar will issue you with a Green Form (the Certificate for Burial or Cremation) this form will be sent to your chosen Funeral Director.

The Registration Service provide a ‘Tell us Once’ Service and can inform government organisations about the death on your behalf. In order to take up the Tell Us Once service on the day you register the death, you will need to take some additional information with you about the person who has died:

• National Insurance Number

• Details of any benefits or services they were receiving

• Driving licence

• Passport or passport number

• Blue disabled parking badge

• National Insurance Number of his/her spouse or civil partner

Death Certificates

The Registrar can also provide you with a death certificate, there is a fee to be paid to the Registration Service for any death certificate issued.

The death certificate will be required by banks, building societies, solicitors or for private pension and insurance claims. You may therefore need to purchase more than one copy.

Arranging the Funeral

You do not have to wait until the death has been registered before making arrangements for the funeral, but you may not feel ready to do this immediately.

Please do not book a funeral too soon if you have been advised a referral to the Coroner or a post mortem is required. Most people appoint a Funeral Director to make arrangements on their behalf and they will meet with you to discuss what you would like. Most Funeral Directors belong to one or more of the recognised associations listed which have a code of practice which they must adhere to:

• National Association of Funeral Directors (NAFD)

• The Society of Allied and Independent Funeral Directors (SAIF)

It is not essential to employ a funeral director and some families will choose to arrange the funeral themselves. However, please be aware that there are strict guidelines which must be followed.

Funerals can be expensive and although basic costs tend to be similar the final cost can vary considerably. You may wish to contact several funeral directors in order to compare prices and the level of service before you make a decision. It is useful to check your relative or friend had contributed to a scheme, or if there are any insurance policies in place which pay for the funeral.

If you have any worries at all about the cost of the funeral, please ask for advice before making arrangements from the Funeral Director or the Bereavement Officer at the Hospital. A funeral payment may be available from the Department of Work and Pension Social Fund. To qualify for this you must be in receipt of an eligible benefit.

Wills and Estates

When a person dies somebody has to deal with their estate (money, property and possessions left) by collecting in all the money, paying any debts and distributing what is left to those people entitled to it.

You should check if your relative or friend had prepared a Will as soon as possible as this may include special requests about funeral arrangements.

If there is a Will, it should confirm who has been appointed to administer the estate, they will be the executor. Where the person did not leave a Will, or left a Will which did not name an administrator the estate is usually dealt with by the next of kin.

The person administering the estate may need to apply to the Court for Probate. This can be completed online or by post if preferred, www.gov.uk/applying-for-probate/applyforprobate. The Probate Service will issue either:

• Grant of Representation or

• Letter of Administration

These give the applicant the Court’s authority to administer the deceased person’s estate.

You will not need Probate if the estate either:

• Passes to the surviving spouse/civil partner because it was held in joint names

• The value of the estate is below a certain amount.

It should be noted that the first item to be paid out of a person’s estate is the cost of the funeral and this has priority over all other payments. If you have difficulty in dealing with the deceased person’s estate you should seek advice from a solicitor or the Citizens Advice Bureau.

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 only take a few minutes to complete. This free of charge service provided by the Bereavement Support Network will actively reduce the unwanted marketing mail but can also help reduce the likelihood of identity theft following the death of someone close.

Additionally to Stop Mail a comparable service can also be accessed from the Bereavement Register or Deceased Preference Service if you would prefer to use them.

Many people have social media accounts and you may wish to deactivate them, turn them to a ‘memorialised account’ or leave them as a ‘live’ account. To close an account you will need to access the Help Centre and search ‘deceased family member’. You have the option to memorialise or remove the account. You will need to upload a copy of the death certificate.

www.facebook.com/help help.twitter.com help.instagram.com

Learning from Deaths

It is a national requirement that the Trust looks at all hospital deaths to ensure that the best possible care is given and that lessons are learnt. The Medical Examiner Service will identify any cases that they consider the Trust should carry out a mortality review. Findings are reported and monitored through the Trust’s mortality review group.

In addition to this it is very important that we investigate any concerns you may have about your relative or friends care. If there is anything that you are worried about that you did not manage to raise previously please do let the Bereavement Officer or Medical Examiner Officer know. It may be helpful for you to have a meeting with the treating team to discuss your concerns and the officers will be able to arrange this.

Further Advice and Support

At each point over the next few days there will be people who are able to provide support and advice including the funeral director, the person conducting the funeral service, your own family doctor as well as hospital staff and bereavement care agencies. Below is a list of services and their contact details:

Bereavement Officer

Warwick Hospital 01926 495321 extn 8131

www.swft.nhs.uk

Medical Examiner Office

Warwick Hospital 01926 495321 extn 8141

Warwickshire Registration Service

0300 555 0255 www.warwickshire.gov.uk/ registrations

The Pension Service 0800 731 7898

www.gov.uk/contact-pension -service

Warwick District Council

01926 450000

Citizens Advice Bureau

Leamington Spa

0300 330 1183 www.casouthwarwickshire.org.uk

Cruse Bereavement Care

0808 808 1677 www.cruse.org.uk

Coroner’s Office

Leamington Spa

01926 738409, 738410, 738411, 738412 and 738413

Email: coroner@warwickshire.gov. uk

The Benefits Agency

Helpline

0800 882200 www.direct.gov.uk

Your comments

Probate and Inheritance Tax Helpline

0300 123 1072

www.gov.uk/applying-for-probate www.gov.uk/inheritance-tax

Stratford on Avon District Council

01789 267575 www.stratford.gov.uk

Age UK

Leamington Spa

01926 458100 www.ageuk.org.uk/coventryand warwickshire

The Child Bereavement Charity

0800 02 888 40 www.childbereavementuk.org

Our aim is to support bereaved families and friends as much as we can. If you have any comments or suggestions about the Bereavement or Medical Examiner Service we would like to hear from you.

Please send your feedback to the Patient Experience Manager, at Warwick Hospital, Lakin Road, Warwick, CV34 5BW.

Email: PatientExperience@swft.nhs.uk.

At South Warwickshire NHS Foundation Trust we are fully committed to equality and diversity, both as an Employer and as a Service Provider. We have a policy statement in our Equality Strategy that clearly outlines our commitment to equality for service users, patients and staff:

• You and your family have a right to be treated fairly and be routinely involved in decisions about your treatment and care with dignity and respect. You will not be discriminated against on any grounds including age, disability, gender reassignment, marriage and civil partnership, pregnancy or maternity, race, religion or belief, sex or sexual orientation.

• You have a responsibility to treat other service users, patients and our staff with dignity and respect.

Our information for patients can also be made available in other languages, Braille, audio disc or in large print.

We offer a Patient Advice and Liaison Service (PALS). This is a confidential service for families to help with questions or concerns about local health services.

You can contact the service by the direct telephone line 01926 600054 or by calling in at the office located at Warwick Hospital.

Published September 2023

Review date September 2025

Catalogue Number SWH - 00024

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.

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