What to do after a bereavement

You probably do not want to think about practical arrangements at this time of sorrow but some things have to be done. It is important that you contact a funeral director as soon as possible so that they can start to make arrangements on your behalf. You do not need to wait for the Medical Certificate Cause of Death (MCCD) to do this.

A member of our Bereavement Office will contact you by phone to introduce themselves and guide you through the next steps.

When we call, we will ask you for:

• your full contact details as next of kin
• whether there will be a cremation or burial
• the name of the funeral director you would like to use
• some personal history for the deceased that we may not be able to obtain from the hospital records
• whether you have any concerns about the circumstances of your loved one’s death or their recent care or treatment

Please do not come into hospital for paperwork, we will call you to arrange this.

If you think it would be too difficult to receive this call after the death of your loved one, it may be better for you to ask another person to speak to us. We will be flexible in who we give information to, to allow things to progress as quickly as possible without causing undue distress.

The Bereavement Office can be contacted on 01709 424 465. If we are unable to take your call, please leave a message and we will call you back as soon as possible. Alternatively, you can email us at rgh.tr.bereavementoffice@nhs.net 

We are open between 8am and 4pm Monday to Friday, excluding bank holidays.

The medical certificate of cause of death (MCCD) is a legal document that must be issued before you can register the death. It cannot be issued by any doctor – only a doctor who knows the cause of death and was involved in the care of the deceased.

Once the MCCD has been issued, a member of our Medical Examiner’s Office will contact you to go through the documentation.

Sometimes, the doctor may be required to get approval of a cause of death from the Coroner, which can sometimes cause a delay. In such event, until the cause of death is approved by the Coroner, we are unable to issue the MCCD.

We will try to complete the relevant documentation and issue the MCCD as quickly as possible. The Register Office guidelines suggest that a death should be registered within five days. However, this is not always the case and you should be aware that this is a complex legal process that can take longer if the Coroner is involved and there is an unavoidable wait for the MCCD.

Please bear this in mind when making funeral arrangements as your loved one cannot be released into the care of your appointed funeral director until this process has been completed.

The Medical Examiners are senior doctors who provide independent scrutiny of all deaths not referred for Coroner investigation. They carry out an independent review of the medical records and speak with Doctors completing the MCCD. They also speak with the next of kin, providing an opportunity to ask questions and raise any concerns before the MCCD is issued.

If the Medical Examiner detects any concerns or issues with the care your loved one has been given, they will pass these on for further investigation by the Trust. This helps us to identify learning and improvements to care for future patients.

A death sometimes has to be reported to the Coroner for legal reasons and the hospital staff will advise you if this has to happen. This is usually when a doctor is unable to issue a medical certificate of cause of death. The Coroner is appointed to investigate certain types of death.

A death will be referred to the Coroner:

• if the cause of death is uncertain
• if the death was sudden, violent or caused by an accident
• when death might be due to industrial injury or disease
• if the death occurred while the patient was undergoing an operation or was under the effect of an anaesthetic
• if a death occurred following an accident or fall, however it happened, or if an accident or negligence is alleged

There are other cases that must be referred to the Coroner, for example, death from industrial diseases, poisoning, suicide, murder etc. The Coroner’s Office will be able to help you and give you advice. If a post mortem is required, a delay may be experienced before the registration and funeral can take place.

You will have to wait to hear from the Coroner’s Officer before registering the death. If there is to be a post mortem, the Coroner’s Officer will explain the procedure to you and advise you when it is appropriate to register the death.

The Coroner may want to carry out a post mortem examination but if not they will issue a certificate for the register of deaths. This is issued direct to the Registrar.

Rotherham Hospital is covered by Doncaster Coroner’s Office
Telephone: 01302 737 136 and they are open 8am to 4pm, Monday to Thursday, and 8am to 3:30pm on Friday
Email: CER@doncaster.gov.uk 

A post mortem examination (also known as an autopsy) is the examination of a body after death. The aim of a post mortem is to determine the cause of death.

Most post mortems are carried out digitally, a digital post mortem is a non-invasive post mortem in which digital imaging technology, such as with computerised tomography (CT) or magnetic resonance imaging (MRI) scans, is used to develop three-dimensional images for a virtual exploration of a human body.

Post mortems are carried out by pathologists (doctors who specialise in understanding the nature and causes of disease). They provide information about how, when and why someone died. They also enable pathologists to obtain a better understanding of how diseases spread, supporting the development of more effective treatments in future.

If your child, partner or relative has died and a post mortem is to be carried out, our Bereavement Office can sign post you to support services.

In the case where a person is to be cremated, this information should be given to the Bereavement Office so the correct process is completed.

If your loved one’s death occurred in UECC or on the way to the hospital, a doctor may not be able to issue a MCCD and a referral to the Coroner may therefore be required.

The doctor will advise if they are able to issue a cause of death, the Coroner’s Officer will advise the treating doctor if the cause of death is acceptable, or whether a post mortem will need to be carried out.

If you are present at the time of your loved one’s death, please try to take clothing and valuables with you before you leave.

If you would prefer to collect property from the Bereavement Office, please let us know and we will call the ward and ask for them to bring the property to the Oldfield Centre, take it from the ward and arrange a convenient time for you to collect from us. Any property not collected within one month, will be disposed of.

If you need to visit the Bereavement Office, we can provide you free parking within our office hours.

Probate is the word normally used to describe the legal and financial processes involved in dealing with the property, money and possessions (called the assets) of a person who has died. It is the process of proving that a will is valid (if there is one) and confirming who has authority to administer the estate of the person who has died.

Before the next of kin or executor of the will can claim, transfer, sell or distribute any of the deceased’s assets they may have to apply for a grant of probate from the Probate Registry.

If the person died without leaving a will (known as dying intestate) the probate process is called applying for a grant of letter of administration. In this situation, it is the law that determines who inherits what and who can administer the estate. It can be complicated to deal with probate when there is no will and there can be a greater risk of mistakes being made in the identification of the estate administrators and beneficiaries. You should therefore consider obtaining legal advice if the deceased has left no will.

Probate may not be necessary if the estate is small. It also may not be necessary if the assets are held jointly, such as a joint bank account or a property held as joint tenants, and these will pass to the surviving co-owner under the right of survivorship. The co-owner will need to produce the death certificate to formally transfer the asset into their sole name, but usually won’t need probate to do this.

For applications and enquiries relating to probate you should call the HMRC information line on 0300 1231 072.

If you have difficulty in dealing with the deceased’s property, possessions or guardianship of their children, you should consider obtaining advice from a solicitor or the Citizens Advice. Speaking with a solicitor may be helpful and many solicitors are prepared to offer up to half an hour of free legal advice.

Most funeral directors can be contacted 7 days a week and, if you wish, they will visit your home to advise you on the necessary arrangements.

When you register the death, the registrar will ask you which funeral director you will be using. They will send the funeral director the certificate for burial or cremation – more commonly known as the ‘green form’. This gives the funeral director permission to come to the hospital, take your relative or friend into their care and proceed with the funeral arrangements.

Funeral costs are normally recoverable from the deceased’s estate. However, the person organising the funeral will normally be responsible for initially paying the bill.

It is advisable to check where the money will come from to pay for the funeral before you make arrangements. Some people now purchase their funeral in advance through a pre-purchased funeral plan and so you should first check if such a plan is in place.

Many funeral directors require payment before probate is granted, so please ensure you discuss payment at an early stage. Where probate or letters of administration are required, many (but not all) banks and building societies may release money to pay for the funeral before probate is granted.

Where payment for the funeral is difficult, you may be entitled to help with the funeral costs through the Social Fund. There is now a one-stop contact number at the Department for Work and Pensions (DWP) on 0800 731 0469. This will cancel all DWP benefits, as well as establish if you are eligible for help towards costs (a funeral grant) and advise you on eligibility for other benefits.

There is a time limit for claiming bereavement benefits and a funeral expense payment so it is important to contact them as soon as possible. Funeral expense payments can help pay for some of the costs. How much will depend on your circumstances and will not usually cover the costs of the funeral.

It is essential to consider this when organising a funeral to prevent running up large costs if you cannot afford them.

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’s Office whether there may be a delay with the paperwork, which may happen if there needs to be a post mortem or an inquest.

Once you have registered the death, you can confirm a date for the funeral.

Most churches have set fees for burials of which your funeral director can advise you. The costs may be higher for the burial of someone who lived outside the parish. Most non-denominational cemeteries are owned by either local authorities or private companies, so fees may vary.

No one can be cremated until the cause of death is definitely known. The funeral directors will advise you of the process.

Ashes can be scattered in a garden of remembrance or in a favourite spot, where permission is granted. Ashes can also be buried in a church yard or cemetery.

If your religion requires that a burial takes place within a certain timeframe, please inform the ward manager and Bereavement Office as soon as possible. We will do everything we can to facilitate this and we can guide you through the expedited process. Your funeral director can also help with this.

The main Register Office is located at Riverside House, Main Street, Rotherham, S60 1AE. Telephone: 01709 823542.

Once the Medical Certificate of Cause of Death has been completed the Bereavement Officer will send the MCCD electronically to the Registrar. All deaths must be registered with the Registrar of Births, Deaths and Marriages within five working days. The Registrar will contact you by telephone to make an appointment to register the death. A copy of the death certificate can be purchased. You may need several copies.

The registrar of births and deaths will have given you a notification of death certificate (white certificate).

Deaths must be registered without unreasonable delay in the area where the person died. All deaths at Rotherham Hospital must therefore be registered at Rotherham Register Office at a face to face appointment.

We recognise that this may be difficult if you do not live locally. If this is the case, please call the Register Office, who will be able to advise on what options are available.

There is specific information you will need in order to register the death. It is advisable to prepare this information in advance of your appointment as once information has been recorded in the register, it cannot be easily corrected.

Rotherham Register Office can be contacted on 01709 823 542 (available 9am to 5pm, Monday to Friday).

When you register the death, you will need:

• Medical Certificate of Cause of Death (MCCD)
• Medical card or NHS number of the deceased
• National Insurance number
• Date and place of death
• Full name and surname
• Previous names (if applicable)
• Date of birth
• Town and country of birth
• Last full time occupation
• Name and occupation of their husband, wife or civil partner (if they were married or in a civil partnership)
• Address, including postcode
• If the deceased was married, the date of birth of the surviving spouse
• Reference number of any pension paid out of public funds, apart from state retirement pension

The information you give to the registrar will form the entry on the register of deaths. You can buy certified copies of the entry at the time of registration.

Most organisations will not act on information about a death until the death has been registered.

At the Register Office, the Registrar will discuss the Tell Us Once service with you. Tell Us Once is a free service that allows you to inform government and council departments through one online form.

When you register a death the Registrar will:

• generate a unique reference number for you to use on the ‘Tell Us Once’ online page or by telephone
• give you instructions on how to use the service

The service enables you to notify:

• The Department for Work and Pensions (DWP) to cancel state pensions, pension credit, benefits
• HM Revenue and Customs (HMRC) to deal with personal tax
• Driver and Vehicle Licensing Agency (DVLA)
• Passport Office
• Local council
• Veterans UK
• Social Security Scotland
• Most public sector pension schemes

The Register Office will give you more information about the Tell Us Once service at your appointment to register the death and further information is available on the gov.uk website.

Private organisations, such as banks and insurance companies, are not covered by the Tell Us Once service and you will need to inform each individually. Some, but not all, will require a copy of the death certificate. It is worth checking requirements for each organisation as you will be charged for each additional copy of the death certificate that you request. Additional copies of the death certificates can be purchased at any time after registration.

People you may need to notify

When notifying a building society or insurance company, you will need to include a copy of the death certificate. Photocopies are not accepted for insurance or legal reasons. You may also need to include the relevant account and policy numbers, if available.

• Bank or building society
• Credit companies
• Energy companies
• Water company
• Window cleaner
• Deliveries
• Rental companies
• Insurance companies
• Solicitor
• Employer
• Trade union
• Newspaper subscription
• NHS equipment loan
• Cancel any planned appointments

Sample letter

Here is an example of some wording you may wish to use when informing people about the death.

Dear Sir/Madam

I wish to inform you of the death of [name of deceased and date of birth].

Please find enclosed with this letter the documentation/papers which need to be returned to you.

[Name of deceased] died at [hospital name or home address] on [date].

If you require any further information, please contact me at the above address.

Yours faithfully
[Your name]

The death of someone close to you can be a painful experience and often creates intense emotions that are not easy to cope with.

The grieving process is often described in terms of different stages. You may experience all or some of these stages and they may happen on several occasions. The time it takes to go through this process can vary considerably and is often longer than most people imagine. We are all different and grief in one person will not necessarily follow the same pattern as in another. The following emotions are some of the stages of grief you may experience.

Shock and disbelief

When a death happens, even if expected, it can be a shock. You may find it difficult to accept and not believe this has happened to you.

People sometimes describe feeling numb, as if the events are not real and do not affect them. This is a normal reaction and allows you to cope with the situation over a period of time.

Sadness and depression

As the numbness wears off, there are often periods of intense sadness and crying, leading to exhaustion. You may feel that you are not in control and have days when you feel depressed. This experience will usually alternate with times of being focused, organised and able to cope.

These changes in mood can go on for several months, although the intensity should diminish over time. Being able to express your emotions and share your feelings with someone you trust can be a great help.

Anger and guilt

Anger and guilt can also be expressions of grief and responses to the loss of somebody close. Anger can also be directed at what has happened or the apparent injustice that death brings.

People often become angry when hurt and want to blame someone, even if that person is not at fault.

You can sometimes feel guilty and direct the anger at yourself, blaming yourself for what you think or feel you could have done differently. This is all part of the wish for things to be different and to seek an explanation for what has happened.

It really does help to talk to somebody about how you are feeling as this often puts matters into perspective.

Acceptance

There will be a time when your inner resources are replenished and feelings of strength and purpose return.

Life will be different but you will be able to talk about the deceased person by name, recall happy memories, laugh over various things that have happened and all without feeling you are going to cry or feel hopeless again. All of this may seem far away at the moment but that day will come.

Remember

Grief is a very individual process. Each of us reacts differently so please don’t worry if your grief does not follow a general pattern. It is a time consuming, exhausting and isolating experience. But it can help to remember that millions of people have survived grief and, in time, you will too.

Talking to children about death

As adults we feel the need to protect our children from things that we might find difficult. It is easy to assume that children will not understand death and bereavement, or that it will be too upsetting for them.

We can often under estimate a child’s ability to cope. Like adults, children find it harder to cope if they are not told what is happening and can be more frightened by their own imagination.

Children should be told honest facts in a simple manner, using appropriate words, for example dead, rather than lost or asleep.

Give them plenty of time to ask questions, and offer plenty of love and reassurance. It is helpful for adults to share feelings with children, such as feelings of sadness. By doing so, they learn that it is natural to feel sad when someone dies. Children often like to draw pictures or write stories as part of their way of saying goodbye.

The Bereavement Office will be able to signpost you to various support agencies if you feel your child may need some extra help dealing with their grief.

Support from your GP

Bereavement can turn our world upside down and is one of the most painful experiences we have to endure. Bereavement is something that we all go through, most of the time without the need for medical attention. However, on occasion, you and your family may need medical support. Your GP will be experienced in knowing what support to offer.

Even if we do not need medical support, many of us may need additional help to deal with grief or feel the need for extra support. Help is available and may people gain comfort from accessing it.

Age UK Rotherham

Telephone: 01709 835 214
Unit 4, Galax Building, Fitzwilliam Road, Eastwood Trading Estate, Rotherham, S65 1SL
Supports anyone over 50.

British Association of Counselling and Psychotherapy

Telephone: 0145 588 3300
Help and advice finding an accredited counsellor in your area.

Macmillan Cancer Support

Telephone: 0808 808 0000
A telephone information and advice service offering support for people with cancer, their relatives and friends.

Marie Curie: Bereavement support

Telephone: 0800 090 2309
Marie Curie volunteers offer you a safe, confidential space to discuss your feelings and emotions around bereavement. The service may not be suitable for people who require a greater level of support, such as counselling or psychotherapy.

Child Death Helpline

Telephone: 0800 282 986 or 0808 800 6019
Website: www.childdeathhelpline.org.uk 
Free helpline for anyone affected by a child’s death.
Translation service available to support those for whom English is not a first language. Volunteers who staff the helpline are all bereaved parents, supported and trained by professionals.

Citizens Advice Bureau Rotherham

Telephone: 0808 278 7911
Website: www.citizensadvice.org.uk 
2 Upper Millgate, Rotherham, S60 1PF
Advice given on legal and practical matters following a death.

CRUSE Helpline

Telephone: 0808 808 1677
Email: helpline@cruse.org.uk 
The free national helpline is staffed by trained bereavement volunteers, who offer emotional support to anyone affected by bereavement. A range of free confidential support for adults and children.

The Samaritans

Telephone: 116 123
Offers confidential telephone support for all in despair.

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 in as little as six weeks.

If you cannot access the internet, you can call 0800 168 9607 where you will be asked for very simple information that will take only a few minutes to complete.

This free of charge service provided by the Bereavement Support Network will actively reduce the unwarranted marketing mail but also can help reduce the likelihood of identity theft following the death of someone close. The information is not used for any other purpose and you only have to complete this once.

The majority of those who join the NHS Organ Donor Register choose to donate all their organs. Although the law around organ donation has changed to an opt out system in many parts of the UK, you will have been consulted if organ donation was a possibility.

It is possible to use tissue from a donor with their family’s consent after they die. Donating tissue can dramatically improve the quality of life for others. As many as 50 people can be helped by the donation from one person.

Many kinds of tissue can be donated after death including skin, tendons, bone, heart valves and eyes to help repair or rebuild the lives of thousands of severely injured people. It is also possible to donate bone or amniotic membrane (part of the placenta in certain hospitals while you are alive, during hip surgery or an elective caesarean.

Unlike organ donation, you don’t need to die in a hospital intensive care unit or emergency department to donate tissue after death. Almost anyone can be considered for tissue donation, and donation needs to take place within 24 to 48 hours of death. To ensure that all donated tissues are safe, the donor’s medical and lifestyle history is assessed at the time of donation.

Settling the deceased person’s estate can be difficult, time consuming and distressing. If you have been named as executor in the will, 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 other assets.

If it all seems too complicated, it may be worth using a solicitor and or an accountant to help you. Fees will be charged for these services, usually by the hour, and the money will normally come out of the estate. It is therefore important that you understand and make it clear what work you want your solicitor or accountant to do and get an estimate of the cost.

While the estate is being sorted out, immediate access to funds can sometimes be difficult. A solicitor may be able to arrange alternative financial support or alternatively you can contact the Citizens Advice for free advice.

Life may start to return to normal for some people, except close relatives and friends who could find the process of adjustment to their loss more difficult. Try to avoid making hasty decisions, especial if you now find yourself living alone.

Everyone will have their own ways to remember the person who has died. Try to talk about them or mention their name as often as you can and put the emphasis on the good things that happened when they were alive.

Members of the family or close friends might appreciate a photograph or small keepsake as a reminder. We offer memory boxes, please speak to one of the team if this is something you are interested in hearing more about.

Most important of all will be your own memories.

As a learning organisation, we want to make sure you have had the opportunity to share any comments you may have about the care your loved one has received in our hospital. This enables us to understand how to improve for the benefit of other patients and their families. We can also pass on your thanks to the relevant clinical teams.

If you wish to provide feedback as a compliment, concern or formal complaint, you can contact us by:
Email: your.experience@nhs.net 
Telephone: 01709 424 461

The team are available Monday to Friday, 9am to 5pm.