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NHS

Sussex Community NHS Foundation Trust

Bereavement - a guide for relatives and friends Medical Examiner and Medical Practitioner

Overview Aim of this information pack On behalf of Sussex Community NHS Foundation Trust, we extend our sincere condolences to you. We appreciate that this is a difficult time to absorb all the information you will be offered. This booklet will help in this difficult time by giving you the practical information you will need in dealing with your loss. Although death and bereavement are an inevitable part of our lives, talking about it can be difficult and we may find ourselves unprepared to cope with bereavement when it happens. The aim of this booklet is to provide practical advice and information about where to start and what to get done first, how to register the death and how to arrange a funeral. It also covers who to tell about the death and advice about financial and emotional support that may be available in your area. Feedback We hope that this information is useful and provides you with helpful information and contacts. Any feedback received will be used to help improve and update the information to be given to carers in future. All comments will be treated with the strictest confidentiality. Thank you for taking the time to tell us your views.

Contents Medical Examiner and Medical Practitioner..................................1 What to do when a person dies.......................................................................2 Organ donation and medical research..................................................5 Caring for the body.............................................................................................................6 Registering the death......................................................................................................7 Funerals..............................................................................................................................................10 Help with funeral costs..................................................................................................13 Scattering or interring of ashes........................................................................14 Interment of ashes...............................................................................................................15 People you should tell....................................................................................................16 Repatriation of bodies to other countries...........................................18 Information and support..............................................................................................22

Medical Examiner and Medical Practitioner The medical examiner will be a point of contact for you should you have any questions or concerns regarding your relative or friend who has died. As part of the reforms that were introduced in September 2024, a medical practitioner will be eligible to be an attending practitioner and complete an MCCD (Death Certificate) if they have attended the deceased in their lifetime. The attending practitioner will propose a cause of death, if they can do so, to the best of their knowledge and belief. Once the relevant attending practitioner and the medical examiner have completed their declarations of certification and scrutiny, and the cause of death is confirmed, the MCCD (Death Certificate) will be sent to the registrar. You or the next of kin of your friend or relative will be notified at the same time that you can now contact the registrar to arrange the registration of the death and collection of the death certificate. Deaths will not be registered until the registrar receives a notification of the cause of death from the medical examiner or the coroner. This notification will start the 5 day statutory time frame which you have to register the death. You will have an opportunity to discuss and be aware of the cause of death before registration.

What to do when a person dies If the death occurs in one of our intermediate care units (hospitals) A nurse or doctor will verify the death and then a doctor will confirm the death, this may be the next working day if this occurs outside of normal hours. If the death was expected, they will contact the medical examiner who will review the medical notes. The medical examiner officer will speak to you or the named next of kin regarding the cause of death and ask if you have any questions of concerns. They will then send the death certificate (MCCD) to the registrar and inform the Intermediate care unit. You will be contacted to advise this has been done and this starts the 5 day period in which you must register the death. After you have left the hospital your relative or friend will be moved to a funeral home chapel of rest of your choice.

If the death occurs at home and the death was expected What to do first If someone dies at home and the death was expected for example they died from a terminal illness, the first thing to do is to contact the family GP. (If you are known to the community nursing services also call them as they will visit to verify the expected death). The nurse or doctor will contact the medical examiner who will review the medical notes. The medical examiner officer will speak to you or the named next of kin regarding the cause of death and ask if you have any questions or concerns. They will then send the death certificate (MCCD) to the registrar. You will be contacted to advise this has been done and this starts the 5 day period in which you must register the death. Your relative or friend will be moved to a funeral home chapel of rest of your choice. Things you need to return: Any unused medications or dressings should be returned to your local community pharmacy for disposal and destruction. The community nursing/health team will help in arranging collection of any equipment loaned to you and any paperwork. If the patient is known to community nursing/health team they will be in contact to arrange a bereavement visit/call.

If the death was unexpected If your relative or friend dies unexpectedly you should call 999 immediately and explain what has happened, you may be totally unprepared. You may find it difficult to believe what has happened. If your relative or friend dies in an intermediate care unit the ward staff or GP will talk to you about what has happened and try to answer any questions you have. If the death was not expected it is possible that the death will be referred to the Coroner. The doctor will discuss this with the medical examiner and you will be contacted by them to inform you of the reason for the referral. A coroner is a doctor or lawyer responsible for investigating unexpected deaths. The coroner may call for a post-mortem or inquest to determine the cause of death. This may delay the funeral and you cannot register the death until the coroner gives you permission to do so. This is a standard procedure. Most deaths that are reported to the Coroner are natural. Find out more on the gov.uk website: www.gov.uk

Organ donation and medical research If the person who died carried a donor card, was listed on the NHS Organ Donor register or told you or someone else that they wanted their organs to be donated after their death, you should inform the clinical team, GP or Coroner’s office looking after the person. The sooner you tell them the more likely it is that their wishes will be carried out as organs need to be donated quickly. You can call the NHS Organ Donor Line to check if someone is on the register. NHS Donor Line - 0300 123 2323 Information: From Spring 2020 the law in England changed. All adults will be considered organ donors unless they opted out or in one of the excluded groups.

Caring for the body Our staff are not permitted to recommend a Funeral Director, so if you do not have one in mind, it is worth asking friends who live locally if they can recommend someone. Alternatively, you can find a Funeral Director through either www.nafd.org.uk or www.saif.org.uk Our intermediate care units can provide a list of local funeral directors for you but these are not recommendations only information of what is available in your area. The Funeral Director will arrange for your relative or friend’s body to be taken to the funeral home. Some people like to keep the person’s body at home before the funeral. The Funeral Director can give you information about how long the body can be at home and what you need to do. The Funeral Director will take care of your relative or friend’s body. They will carefully wash and dry them, and close their eyelids and mouth. They will tidy and sometimes wash their hair. If you would like to, you can help the Funeral Director wash and dress your relative or friend. They may also ask what you would like your relative or friend to be dressed in. This could be a specific outfit or jewellery that had special meaning to them, you should let the funeral director know as soon as possible if this is the case.

You should tell the Funeral Director if there are any cultural or religious practices you would like to be followed and they will do their best to accommodate these wishes. Some people want to be embalmed (sometimes referred to by Funeral Directors as ‘hygienic treatment’). This is when the body is disinfected and treated with chemicals to help preserve it and is usually carried out if the family wish to visit their loved one in the Chapel of Rest more than a day or two after the death. The Funeral Director can give you more information about this.

Registering the death You must register the death with the registrar of births, marriages and deaths. You need to do this within 5 days of the death, unless the death has been referred to the coroner. It is recommended that you go to the Registrar’s office in the area in which the person died, otherwise it may take longer to get the necessary documents and this could delay the funeral arrangements. Registering a death will take about half an hour and you will need to make an appointment beforehand. If the person died in a house or in a hospital the death can be registered by: • • • •

a relative someone who was present when the person died someone who lived in the house where the person died a person responsible from the hospital or home where the person died • the person making the funeral arrangements 7

You will need to know the following information about the person who has passed away: • the medical certificate showing the cause of death, signed by a doctor (you can collect this from the registrar when you visit to register the death) • the date and place of death • the deceased’s last (usual) address • the deceased’s full name (and maiden name if appropriate) • the deceased’s date and place of birth/birth certificate if you have one • the deceased’s occupation and the name and occupation of their spouse • whether the deceased was receiving a pension or allowance from public funds • if the deceased was married the date of birth of the surviving widow/widower The registrar will give you: • a certificate for burial or cremation - this is known as the green form and gives permission for burial or for an application for cremation to be made • a certificate of registration of death - Form BD8 in England and Wales. If the person who dies was receiving any benefits or state pension, you can use this form to ensure that those payments are adjusted. This won’t be necessary if you use the governments Tell us Once service • leaflets about bereavement benefits for widows, widowers and surviving civil partners, if appropriate

• a death certificate - for which there will be a charge. This is a certified copy of what is written in the death register and is needed for the will and any claims to pensions or savings. It may be a good idea to pay for several certified copies at this time as additional copies at a later date will cost more. Photocopies are not accepted by some organisations, such as banks or life insurance companies Information: Remember - it’s a good idea to pay for a few extra copies of the death certificate as it will be needed when sorting out the estates of the person who has died.

Funerals The funeral service is your opportunity to say ‘goodbye’ in a way that you feel is right and that the deceased person would have wanted. Most funerals do not have to be carried out within a certain time frame, the exception being for specific religious beliefs and customs. Before you start to plan the funeral, check whether the Will of the person who has died includes their wishes or instructions for the service. They may have made specific requests or instructions for what they want so make sure you check first. In most cases the Funeral Director will guide you through the funeral arrangements. Most funerals are arranged by a Funeral Director but you don’t have to use a funeral director when someone dies. You can arrange a do-it-yourself funeral, but this would involve more for you to organise, it can cost less and be more environmentally friendly as well as more intimate and personal. This type of funeral is often arranged before death by the person themselves as involves advanced planning. If you require more information regarding this option please see below, Natural Death Centre. Natural Death Centre The go-to place if a family wants to organise the service without a funeral director, or as a useful source of advice to be consulted alongside advice from the family’s chosen funeral director. 01962 712 690 www.naturaldeath.org.uk 10

If the person who has died has not left any clear wishes for funeral arrangements the executor of the Will or nearest relative usually decides on funeral arrangements and if the body will be cremated or buried. You can make decisions about how the funeral is organised and what it involves. Favourite pieces of music, hymns, poems and reading can all be included. Stop and think about the type of service you would like and discuss this with other family members. Do not be rushed into making decisions. Funerals do not have to be carried out within any certain length of time and can wait until you have had time to decide or if family have to travel to attend. The person taking the service (a Celebrant or Minister, depending on your wishes) and Funeral Directors are happy to support you in all these matters and whatever small detail that may be important to you can be discussed. Taking into consideration the person’s last wishes you will need to decide: • • • • •

which Funeral Director to use whether the deceased is to be buried or cremated which cemetery or crematorium to choose where the body will rest until the day of the funeral whether there will be a funeral service. There is no legal requirement to have a funeral service • if there is a service you can choose both the person to conduct the service and the venue in which the service will take place • whether you want flowers for the funeral, donations to a named charity, or both • whether you want a notice placed in a newspaper 11

All of these arrangements can be made by your chosen Funeral Director. This can often make things easier for you so that you are not having to make lots of separate arrangements yourself, and also so that you only have one invoice to pay afterwards. The Funeral Director will give you all the advice, guidance and support you need and will give you the costs of the funeral in writing. If the person who died doesn’t have the money in their estate (this is their property, money and possessions) to cover the cost of the funeral, the person who organises it will have to pay. If you need advice regarding funeral costs, the Registrar will be able to give you details of a council department who may be able to assist. Do not confirm the funeral arrangements until you are sure the death does not have to be reported to the Coroner, since this may affect the date when the funeral can be held. Useful information Remember to check if the person who has died had a life insurance policy or pension scheme which provides a lump sum towards funeral costs or into a pre-paid funeral plan.

Help with funeral costs If you’re responsible for arranging the funeral and you’re on a low income you may be eligible for a funeral expenses payment to cover various costs. These payments are made through the Social Fund - a government fund to help people with one-off payments and emergency expenses. If you receive money from the person’s estates, you’ll usually have to repay the funeral expenses payment from this. A house or personal items left to a surviving spouse or civil partner are not counted as part of the estate. To be able to claim the payment you must be the partner of the person who has died or a close relative or friend, and you or your partner must receive certain means tested benefits, such as pension credit. The department for works and pensions (DWP) can refuse an application from a close relative or friend if it considers that another close relative could arrange and pay for the funeral. You must claim within six months of the funeral, and the amount you receive may be reduced if the person who has died had a pre-paid funeral plan or life insurance policy. If there’s no money for a funeral or if no one is willing to pay for or arrange a funeral, the council will arrange a public health funeral, although they may seek the costs back from the estate. Contact your local council for more information. DWP Bereavement Service DWP Bereavement Service carries out eligibility checks on surviving relatives to see what benefits they can claim. Takes claims for bereavement support payments and funeral expenses payments. 0800 151 2012 13

Scattering or interring of ashes Following cremation, the family may wish to scatter the ashes of the deceased. The deceased may have documented preferred wishes for what to do in this instance, but if not the guide below will assist you. The ashes are usually given to the Funeral Director but the next of kin may arrange to collect them. You may need proof of identity to do this. The crematorium will provide a certificate of cremation with the ashes. This is a legal document showing the name of the deceased and date, time and location of the cremation. The ashes may then be scattered or interred, depending on the deceased’s wishes. If the deceased has not expressed any preference, the relatives are free to make their own decision. Most crematoriums will have a garden of remembrance where you can plant a tree, shrub or place a memorial plaque. There is usually a charge for this service. The family/next of kin may decide to scatter the ashes in a place which had personal or significant meaning to the deceased. There are no laws preventing scattering of ashes in rivers, lakes or on land, but consideration should be taken around environmentally sensitive areas. You should always seek permission from the landowner.

Environment Agency advice is that ashes should not be spread: • within 1km of any drinking water supply • where the water is used for commercial, agricultural or recreational purposes, e.g. marina close to anglers • no non-biodegradable bags, wreaths or objects should be put into the water There are also specific companies that may be able to turn ashes into jewellery, art or glass, etc.

Interment of ashes Most churches and crematoriums have a garden of remembrance for the interment of ashes. To use these you must get permission from the church or crematorium authorities. In addition, there are now designated woodland and green burial sites which offer the opportunity to inter ashes.

People you should tell When someone dies, there are a lot of official agencies and organisations that need to be told. These include: • any NHS department from where the deceased person was obtaining services • their GP (if different from certifying doctor) • their dentist • HM Revenue and Customs • Department for Work and Pensions • their employer (if they were working) • their car insurance company (if you were insured to drive under the person’s policy, you may not be legally insured to drive it after their death) • gas, water, electricity, telephone and other service suppliers if the bill was in their name (they usually want to see an original copy of the Death Certificate) • the local council, i.e. housing, social services and Council Tax • the person’s bank and building societies • the person’s insurance company • the Post Office, i.e. redirecting any post. They can also give you a form to fill in to stop unwanted junk mail being sent to the deceased The Tell Us Once service can be used to report a death to most Government departments in one go, rather than having to make lots of different calls.

Some people find it helpful to write down a list of all the organisations they need to contact and gradually work through it over a few weeks. Others prefer to contact them all at once. It is important to tell insurance companies straight away, as insurance policies become invalid as soon as someone dies and this could mean that the home or car is then uninsured. You can also register the name of the deceased person with the bereavement register which removes their details from mailing lists and stops most advertising mail. Information: The Stopmail service: register the name of the deceased person to stop unsolicited mail. 0333 006 8114 www.stopmail.co.uk

Repatriation of bodies to other countries Repatriation of deceased from the UK This guide explains how to repatriate a body abroad if the person died in the UK but you would like to bury or cremate them overseas. A funeral abroad might be something your loved one requested as part of their final wishes.

How to repatriate a body abroad When repatriating a body out of the UK, it’s important to check the specific requirements of the country concerned, as some of the steps below can vary by location. 1. Notify the relevant authorities about the death You will need to contact the UK authorities and the relevant embassy to tell them that the person has died. As part of this process, you should also notify the consulate of the country where your loved one is being repatriated to. They will be able to confirm what documents will be needed in order for body’s repatriation to take place. This step is important, as the documents needed can vary by country. 2. Inform the Coroner that you’d like to repatriate the body overseas This is done via a ‘Form of notice to a Coroner of intention to remove a body out of England or Wales’. The prescribed period which must elapse after the receipt of the notice by the Coroner is four clear days.

If the Coroner states that they are satisfied and there is no requirement to make further enquiries concerning the death, the body may be removed at any time after the acknowledgement has been received by the person to whom it is addressed. In the case of urgency, where the family would prefer not to wait the full period of four clear days, they may be able to proceed earlier if the Coroner agrees. The Form of notice to a Coroner must be accompanied by a copy of the Registrar’s Certified Copy of an Entry of Death. The Coroner acknowledges receipt of their formal notice by issuing Form 103 ‘Form of acknowledgement by the Coroner’. 3. The Coroner will issue an ‘Out of England’ certificate Once the decision is made to repatriate the body out of England and Wales, the local Coroner should be approached for an ‘Out of England’ certificate. Every country has different regulations, so it will depend on where you would like to bury the deceased. 4. Determine whether a post-mortem is needed For transportation to some countries, this is an essential requirement. Depending on the results of the postmortem, the Coroner may decide to order an inquest to determine how the person died. To make sure you have everything you need, you should contact the consulate of the country where the deceased will be repatriated to. 19

5. Arrange the relevant documents The documents you may need include: • acknowledgement from the Coroner - Form 103, a ‘Certified Copy of an Entry’ from the Registrar • ‘Freedom from Infection Certificate’ showing cause of death, and a declaration from the doctor stating that as far as the sanitary regulations are concerned, there is nothing to prevent the body from being exported • certificate of embalming (although this isn’t always required, most countries will require this as standard procedure) • the deceased’s passport Further support can be provided by your Funeral Director if needed. 6. Prepare the body for repatriation Before repatriation can take place, the body will need to be prepared for transporting. This will include: • embalming of the body - will delay changes to the deceased’s body and gives them a more restful appearance • provision of a zinc-lined coffin - this is often required for transporting a body overseas • correct size of coffin - the coffin or casket size must be checked to make sure that it is acceptable, particularly if there is to be onward transmission by a smaller aircraft later in the journey

• suitable packing for coffin - this varies depending on the country to which the body is being transported, but can include requirements such as wrapping the coffin in hessian or bubblewrapping How much does it cost to repatriate a body abroad? The cost of repatriation depends on several factors. These include where the deceased is going, which coffin the family choose and whether the coffin must be hermetically sealed (airtight). It is difficult to advise on costs, however, these could range from £2,000 to £4,000. How long does it take to repatriate a deceased person abroad? The timescales for this are difficult to predict. Although circumstances can differ, on average it takes approximately two weeks to organise for a body to be repatriated abroad.

Information and support If you want to talk to someone or share feelings but don’t know who to turn to, or just need additional information and support following the death, below is a list of organisations who can help: Age UK www.ageuk.org.uk 0800 678 1602 Alzheimer’s Society www.alzheimers.org.uk/about-us/contact-uk 0333 150 3456 Dementia Support Line Bereavement Support Network Providing guidance on practical matters such as probate. www.bereavementsupport.co.uk Free helpline 0333 240 0360 Child Bereavement UK www.childbereavementuk.org Helpline: 0800 028 8840 CRUSE Bereavement Support Counselling and advice service for bereaved people that offers information and practical support. www.cruse.org.uk 0808 808 1677 DWP Department for Work and Pensions - Bereavement Service Carries out eligibility checks on surviving relatives to see what benefits they can claim, and takes claims for bereavement support payments and funeral expenses payments. 0800 151 2012 22

Dying matters www.dyingmatters.org Good Grief Trust www.thegoodgrieftrust.org GOV.UK Government website which provides information about bereavement benefits and the tell-us-once service. www.gov.uk www.gov.uk/tell-us-once Human Tissue Authority www.hta.gov.uk 02072 691 900 Marie Curie - Bereavement support www.mariecurie.org.uk/help/support/bereavement Marie Curie - Guidance on different faith customs around death and dying. www.mariecurie.org.uk/talkabout/articles/death-customsofdifferent-faiths/260276 MIND - Loosing someone to suicide www.mind.org.uk/information-support/guides-tosupportandservices/ bereavement/bereavement-by-suicide/ Samaritans Confidential, non-judgemental support for people in distress, 24 hours a day. www.samaritans.org 020 8394 8300 or free helpline 116 123

Stopmail Register the name and address of a deceased person to help stop unsolicited mail. www.stopmail.co.uk 0333 006 8114 Sue Ryder Online bereavement support including advice and counselling services. www.sueryder.org The Compassionate Friends Supporting bereaved parents and their families. www.tcf.org.uk 0345 123 2304 The Natural Death Centre Provides information on all types of funeral choices, but especially family organised, environmentally friendly funerals and natural burial grounds. www.naturaldeath.org.uk 01962 712 690 Veterans UK Administers the pension and welfare schemes and provides support services to members of the Armed Forces and veterans. www.gov.uk/government/organisations/veterans-uk 0808 191 4218 Terence Higgins Trust helpline www.tht.org.uk 0808 802 1221

Child Death Helpline www.childdeathhelpline.org.uk 0800 282 986 The Stillbirth and Neonatal Death Society (SANDS) www.sands.org.uk 0808 164 3332 Lullaby Trust The Lullaby Trust raises awareness of sudden infant death syndrome (SIDS), provides expert advice on safer sleep for babies and offers emotional support for bereaved families. www.lullabytrust.org.uk Bereavement Advice - 0808 802 6868 Information and Support - 0808 802 6869

Reference: Crawley Hospital Bereavement Book Review Date: July 2028 Publication Date: July 2026

The Hospital would like to thank RNS Publications for publishing this information and the following pages contain some features from services offering 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. Please note, whilst information is correct at the time of publication, this may be subject to future change.

STOPPING JUNK MAIL If someone you know has died, we can reduce the amount of unwanted marketing post being sent to them, stopping painful daily reminders. By registering with our free service, the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks.

Call: 0333 006 8114 OR

Visit our website: www.stopmail.co.uk bereavement support network stop mail

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