An information guide on what to do after someone has died in hospital

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The staff at North Bristol NHS Trust (NBT) offers their condolences to you at this time.

We understand that you may have important personal and cultural requests about the care of your loved one; please let a member of staff know and we will do our best to help in any way that we are able.

We know that giving all the information in this booklet can look daunting but please do not worry. Take time to share this information with a trusted family member or friend. This booklet will help you when you have the quiet time and space to read through it.

Contents

Overview of steps you will need to take

Next of kin or another person acting for the deceased

What you will need to do first

Medical Certificate of Cause of Death (MCCD)

Role of the Medical Examiner Office

The coroner

Property

How to arrange and view your loved one after death

Tissue donation

Who can register a death?

Registering a death

Documents you will receive

Organisations you need to contact

People you might need to inform

Arranging a funeral

Further information and bereavement support


Overview of steps you will need to take

  1. NBT (North Bristol NHS Trust) Patient Affairs officers will contact you via telephone the next working day following the death of your loved one.
  2. Contact funeral director and start to make funeral arrangements.
  3. Register the death.
  4. Finalise funeral arrangements with the funeral director.

Next of kin or another person acting for the deceased

The Patient Affairs team will correspond with the person recorded in the hospital records as next of kin concerning
the administration of your loved one’s death. This can be any person designated by the deceased prior to their death and may or may not be a relative of the deceased.

If there is no designated next of kin, then this will usually be the closest relative or other person who will take responsibility for registering the death.

It can be important at this sad and difficult time that the next of kin keeps family members, or those close to the deceased, informed of what is happening.

It is important to read ‘Who can register a death?’ below.

What you will need to do first

Following the death of your loved one, you should receive a telephone call from the patient affairs team between 9am and 4pm on the next working day.

The Patient Affairs team will take some details from you, tell you what to do next and answer any questions you may have.

You are advised not to make a Register Office appointment until you have spoken to the Patient Affairs team.

If you have a query, you can contact the Patient Affairs Office at Southmead Hospital on 0117 414 0184, Monday to Friday, 8am – 4pm.

Please note that the office is not open Saturdays, Sundays or on Bank Holidays.

The Patient Affairs Office is located in the Sanctuary, Level 1, Gate 30 of the Brunel Building, Southmead Hospital.

Medical Certificate of Cause of Death (MCCD)

The Medical Certificate of Cause of Death (MCCD) is an important legal document, showing the cause of death. This must be signed by a doctor who was responsible for the medical care of your loved one while they were in hospital.

Doctors are not always able to complete the paperwork immediately, so it may be several days before the certificate is ready. In some cases, they may need to contact the Coroner’s Office which will delay the paperwork further.

Role of the Medical Examiner Office

North Bristol Trust uses a medical examiner system. This is a role which has been implemented into all NHS hospitals within England. The role of medical examiners (MEs) is to provide support for bereaved families and to improve patient safety.

The Medical Examiner’s Office will be able to share any feedback to the clinical team or request they review the notes to reflect on the care provided and consider if there is any learning to improve the care of patients in the future.

There are two types of medical examiner:

Medical examiners (ME)

Medical Examiners are independent senior medical doctors who are appointed to review all deaths that occur in hospital. They are specially trained in the legal and clinical elements of death certification processes.

They are here to check the information written on the Medical Certificate of Cause of Death (MCCD) is correct, and that any referrals that need to go to the coroner are made in a timely fashion to avoid any delays.

They scrutinise clinical notes and meet with the treating doctor to discuss the deceased’s care and the cause of death.

Medical examiner officers (MEO)

Medical Examiner Officers are a mix of clinical and nonclinical staff who have received special training in the role.
They assist the ME.

You will receive a call from a Medical Examiner or Medical Examiner Officers in the coming days. They will help you understand the wording used on the MCCD. You will have a chance to ask any questions you may have regarding the care of the deceased or their last illness. The Medical Examiner Officers will advise you how you can obtain the Death Certificate and other forms from the Registry Office.

The Medical Examiners Office will make reasonable attempts to contact the deceased’s Next of Kin. If you have any questions and have not been able to speak with the medical examiner, please contact the Patient Affairs team.

Once completed the death certificate will be delivered to the Bristol Registrars from the hospital by email (you do not need to collect the death certificate).

You will need to make a telephone appointment to register the death with the Bristol Registrars (telephone number 0117 922 2800) or complete an online form through the Bristol City Council Website: www.bristol.gov.uk/residents/births-deathsmarriages/deaths/register-a-death

The Medical Certificate of cause of Death will not be issued until the cause of death has been reviewed by the Medical Examiners Office or the Coroner’s Office.

The coroner

In some instances, the hospital doctor is legally required to discuss the death with the coroner. The coroner is
an independent judicial officer and are responsible for investigating deaths in circumstances such as:

  • all sudden and unexpected deaths
  • deaths where the cause is unknown
  • unnatural deaths for example accident or suicide
  • deaths that occur during or shortly after an operation
  • deaths caused by industrial diseases
  • deaths involving a bone fracture
  • deaths from acute alcohol poisoning or drug related illnesses

Once information is obtained by the Coroner’s Office from the medical staff, a decision will be made as to whether or not a post mortem is necessary.

In many cases, permission will be given to issue a Medical Certificate of Cause of Death.

However, you should note that the post mortem procedure with the Coroner takes at least 3 working days to complete before the certification can be released and in these circumstances an appointment with the Register Office cannot be made until all documentation has been completed and issued.

The post mortem examination will usually take place within a week of the death at the Coroner’s Mortuary in Flax Bourton.

The Coroner’s Office will take over responsibility from the Patient Affairs Office and will be responsible for keeping you informed of what is happening and guiding you in the next steps that you should take.

The coroner does not require the consent of any other person for this to take place. Funeral directors should be advised about the post mortem and are usually happy to proceed with funeral arrangements.

You will be informed by the Coroner’s Office when they have sent paperwork to the Register Office so that you can make an appointment to register the death.

The Coroner’s Office can be contacted on 01275 461 920. Opening hours: 7.30am - 3.30pm, Monday to Friday.

Coroner’s inquest

In some circumstances the coroner will proceed to open an inquest.

The purpose of an inquest is to find out four facts.

  • Who the deceased was?
  • When, where, and how they died?

They will also record the medical cause of death.

You may be contacted by one of the coroner’s officers if an inquest has been opened. You may be asked to provide a statement about your loved one. The Trust will also provide the coroner with statements from those who cared for the deceased.

Once the coroner has considered this evidence, there may be a hearing. This is a fact-finding hearing, not to apportion blame, but to answer the above four questions. You will have the opportunity to ask questions.

The coroner will then record a conclusion, such as natural causes or suicide.

Whilst the aim is for this process to conclude within 6 months of the death, it can sometimes take longer. You will be kept up to date by the coroner’s office.

Property

If the deceased has property or clothing in the care of the Patient Affairs team which is not taken by relatives at the time of death, the Patient Affairs team will contact you to discuss arrangements for returning the property to you or the disposal of any unwanted property.

Jewellery (for example wedding rings, earrings) is usually left on the deceased unless family request otherwise and will go to the funeral director where it is removed if requested.

It is important that you agree the arrangements for the return or disposal of property with the Patient Affairs Office.

Any property not collected after 3 months will be disposed of without recourse to the Trust.

How to arrange to view your loved one after death

You may wish to come to the hospital’s viewing room to see your loved one. The viewing room is a separate room within the hospital Mortuary.

If this is something you wish to do, you can make an appointment with the Mortuary Team by telephoning 0117 414 0184 between 8am - 4pm, Monday to Friday, to arrange this. We do not currently offer viewings on evenings or weekends.

Alternatively, you may prefer to wait until the deceased is transferred to the care of the chosen funeral director.

On the rare occasions when the cause of death may be a criminal matter there will be restricted viewing. In these
circumstances, the police will advise.

Tissue donation

After someone has died it may be possible for their tissues to be donated to help others. Your loved one may have carried a donor card, be on the Organ Donor Register or may have discussed donation with you during their lifetime. Even if they did not, you may want to consider tissue donation at this time.

To ensure tissue transplants are as successful as possible, tissues can only be donated in certain circumstances.

  • Eyes for Corneal Transplantation can be donated up to 24 hours after death.
  • Heart valves can be donated up to 24 hours after death.

If you choose this for your loved one, they will be cared for with dignity and respect and their appearance will be restored. Tissue donation will not delay funeral plans.

You may be contacted by a specialist tissue donation nurse after someone dies to offer information about tissue donation. The nurse will explain the options available for tissue donation and answer any questions.

Please remember, tissue donation is entirely voluntary. If you would like further information, please contact NHS Blood and Transplant National Referral Centre on 0800 432 0559. Please leave your name and contact number and a tissue donation nurse will call you back promptly.

Alternatively, you may ask a doctor, or nurse involved in the care of your loved one to contact the appropriate person on your behalf.

Who can register a death?

You can register the death if you are:

  • A relative
  • Someone present at the death
  • An administrator from the hospital
  • The person making arrangements with the funeral directors

Registering a death

Once the Medical Certificate of death has been issued by the doctor and emailed to the registrar, you will need an
appointment to register the death with the Bristol City Council Registrars.

The whole process will be completed in person at the Registrar’s office at Southmead Hospital or at a local Registrar’s office close to you.

You will need to tell the registrar:

  • The person’s full name at the time of death
  • Any names previously used e.g., maiden name
  • The person’s date and place of birth
  • Their last address
  • Their occupation
  • The full name, date of birth and occupation of a surviving or late spouse or civil partner
  • Whether they were receiving a state pension or any other benefits

Documents you will receive

When you register the death, you will receive the following:

  • A Certificate for Burial or cremation (the ‘green form’), this gives permission for burial or an application for cremation.
  • A Certificate for the Department of Work and Pensions Benefit (form BD8) – you may need to fill this out and return it if the person was receiving a state pension of benefits.
  • There is an opportunity to purchase death certificates – these will be needed for sorting out the person’s affairs with the bank, insurance companies, private pensions etc.

Once you have registered the death you can inform your chosen funeral director that the death is registered so that arrangements can now proceed.

If the death has been referred to the coroner, you will not be able to register the death until the registrar has received a notification from the coroner’s office.

Organisations you need to contact

Tell Us Once

You will need to report the death to various organisations and government departments. Bristol City Council runs a service called Tell Us Once, which will help you to contact these. In doing so you will not have to pay for extra death certificates for each organisation they contact. There is a cost in providing the certificate to organisations who are not contacted by the council.

If you wish to use this service, inform the registrar when you attend the Register Office, and the options will be explained to you. The registrar will show you what to do and this is a service many people find invaluable. You will be able to access this service by telephone or online once you have registered the death.

If you choose not to use the Tell Us Once service, you will need to report the death to various organisations and
government departments.

The following are organisations which may be appropriate to notify.

Local councils

  • Housing Benefit Office
  • Council Tax
  • Collection of payment for council services
  • Libraries
  • Electoral Services
  • Blue Badges
  • Adult Services
  • Children’s Services
  • Council Housing

Department for Work and Pensions (DWP)

  • Pension, Disability and Carers’ Service
  • Jobcentre Plus
  • Overseas Health Team

Revenue and Customs

  • Child Benefit
  • Child Tax Credit and Working Tax Credit
  • Personal Taxation

Identity and Passport Service

  • Driver and Vehicle Licensing Agency
  • Ministry of Defence
  • Service Personnel and Veterans Agency
  • War Pensions Scheme

People you might need to inform

Please ask a member of staff for a printed copy of this patient leaflet if you would like a checklist to complete.

  • Family
  • Friends
  • Healthcare providers, i.e. optician, dentist, GP
  • Bank or building society, credit card providers
  • Premium bonds, long term savings companies (ISAs)
  • Anyone holding money for the deceased
  • Social Services such as home help or care
  • Previous/current place of work (occupational pension), trade unions
  • Executor of the estate (Will)
  • Insurance Companies (car, home, life insurance)
  • Residential or nursing home
  • Landlord or housing agency
  • Mortgage company
  • Utility companies (water, electric, gas, phone, internet, TV licence, Internet)
  • Hire purchase companies
  • Post Office (to redirect mail)
  • Cancel any upcoming payments
  • Transport (to day centres or clubs)
  • Deliveries (milk, food boxes, newspapers)
  • Return of any borrowed equipment (medical or social)
  • Religious organisations (faith leaders)
  • Stop any junk mail

Arranging a funeral

Before going ahead with any arrangements, it is advisable to check whether the deceased person left a Will and any instructions for the funeral.

If you are not the next of kin (nearest relative) or executor, you should check with the next of kin or executor that you have the authority to proceed.

Most funeral directors are members of one of 2 trade associations:

  • National Association of Funeral Directors (NAFD)
  • Society of Allied and Independent Funeral Directors (SAIF)

Member firms must provide you with a price list on request and cannot exceed any written estimate they give you without your permission.

Most people would probably require the funeral director to provide the following services as a minimum:

  • Make all necessary arrangements
  • Provide appropriate staff
  • Provide a suitable coffin
  • Transfer the deceased from the place of death to the funeral director
  • Care for the deceased prior to the funeral
  • Provide a hearse to the nearest cemetery or crematorium
  • Arrange for burial or cremation as appropriate

Embalming, viewing of the deceased, or providing a limousine for mourners are optional extras. Discuss these fully with your funeral director and make sure you receive an itemised written quotation.

Funeral costs for the same services may vary considerably from one funeral director to another.

It is advisable to get more than one quote to compare costs and services. Funeral directors should provide detailed price lists for you to take away. Disbursements are fees paid to others, for example doctors (for cremation forms), a minister, newspaper announcements, flowers, and crematorium. Ask the funeral director for a written quotation detailing all these fees.

In addition, it should be remembered:

  • When you arrange a funeral, you are responsible for paying the bill.
  • Funeral payments are recoverable from the deceased person’s estate and banks are obliged to release money to pay for funeral costs when requested.
  • It is recommended that the funeral is held within 3 weeks of death to prevent deterioration of your loved one.

If you receive certain benefits from the Department of Work and Pensions you may be entitled to some assistance towards the funeral expenses of your relative. For further information please contact the nearest Jobcentre Plus Centre.

A bereavement payment or bereavement allowance may be made in certain circumstances if you are the partner or spouse of someone who died whilst employed. These are dependent upon National Insurance contributions and other conditions. Please contact Jobcentre Plus to find out more.

Further information and bereavement support

The time ahead may be a very difficult one for you. If you have any further questions, a member of the chaplaincy team (0117 414 3700) or your GP would be happy to help.

If you would like to discuss any aspect of your loved one’s care, please contact the ward to arrange an appointment with a member of the medical/nursing team.

Useful websites

GOV.UK - What to do when someone dies

www.gov.uk/after-a-death/overview

Age UK - What to do when someone dies

www.ageuk.org.uk/money-matters/legal-issues/what-to-do-when-someone-dies/what-to-do-firstwhen-someone-dies/

Bristol City Council Bereavement Support

www.bristol.gov.uk/births-deaths-marriages/bereavement-support

GOV.UK - Get help with funeral costs

www.gov.uk/funeral-payments

How to contact us

Patient Affairs Office

0117 414 0184

If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.

If you’re an overseas visitor, you may need to pay for your treatment or you could face fraud or bribery
charges, so please contact the overseas office: Tel: 0117 414 3764 Email: overseas.patients@nbt.nhs.uk

© North Bristol NHS Trust. This edition published April 2023. Review due April 2026. NBT002506