King George Hospital Bereavement Booklet

NHS Barking, Havering and Redbridge University Hospitals NHS Trust

Because we care...

King George Hospital Barley Lane, Goodmayes, Ilford, Essex, IG3 8YB Tel: 020 8970 8235

Queen’s Hospital Rom Valley Way, Romford, Essex, RM7 0AG Tel: 01708 435490 / 435455

Grieving for someone can be a lonely and frightening experience. This booklet is intended to offer reassurance and give suggestions about where to find help.

At this time many decisions and arrangements need to be made. This booklet contains information on some of the practical matters to be tackled, as well as advice on coping with your loss. It also gives details of support organisations.

Contents Barking, Havering & Redbridge University Hospitals Trust supports tissue donation - saving and improving lives 1 If you wish to see the person who has died

2

Medical Certificate of Cause of Death (is only available Monday to Friday)

4

Medical Examiner Office

5

Registering the death

6

Who can register the death

7

The registrar will require

7

The registrar will provide

8

Emergency registration (burials only)

9

Tell Us Once

10

The Coroner Office

11

What is a post-mortem examination or autopsy?

13

Why might there be an inquest?

14

Can I arrange a funeral before an inquest?

14

The inquest

15

May I take the body out of England?

15

Last will and testament

16

Arranging the funeral

17

Stopping Junk Mail to the recently deceased

18

Sources of practical advice

19

Financial help

20

Spiritual needs

20

Children and bereavement

21

Your bereavement is a Personal Journey

22

Notes

24

Barking, Havering & Redbridge University Hospitals Trust supports tissue donation - saving and improving lives Thanks to the generosity and understanding of our donors and their families, thousands of people every year receive life-transforming tissue transplants.

Tissue donated very shortly after death such as heart valves, bones, skin and eyes can save or dramatically improve the lives of people suffering from illness or injury. Early notice improves the success of tissue donation!

Barking, Havering & Redbridge University Hospitals Trust works in partnership with the NHS Blood and Transplant service (NHSBT) to facilitate and support the option of tissue donation. Everybody is referred directly by the hospital at the time of death.

A specialist nurse from NHSBT may call the primary next of kin, or with their permission, another family member to discuss the option of donation from your loved one. The nurse will provide enough information to enable them to make the decision that is right for your family.

If you do not wish the next of kin to be contacted or if you want to speak to a specialist nurse for tissue donation, please contact the National Referral Centre free on 0800 432 0559 or by email on www.nhsbt.nhs.uk/tissuedonation Throughout the donation, your loved one will be treated with respect and dignity. After donation, our specialist team will ensure that the donor maintains a natural appearance.

Tissue donation should not delay funeral arrangements.

1

If you wish to see the person who has died You may wish to see your loved one while they remain in our care. Some might prefer to wait until they have been transferred to the care of the funeral director, and others may not want to visit at all – it is a personal choice.

Facilities at both our hospitals include private, comfortable rooms.

If you would like to visit your loved one, please make an appointment with us.

To arrange a visit at King George Hospital please call 020 8970 8293 (Monday to Friday, excluding bank holidays) between 9am - 11am.

To arrange a visit at Queens Hospital please call 01708 435205 (Monday to Friday, excluding bank holidays) between 9am -12:30pm and 1:30pm – 3pm.

You will be asked for the name, date of birth, and home address of the deceased, as well as your name, your relationship to the deceased and your contact number.

2

To preserve the dignity of your loved one and to ensure the service is available for other bereaved families, we ask you to please understand the following.

•

visits are by appointment only

•

if the death has been referred to the coroner, we may need to gain additional permission from them which would mean, we will have to call you back

•

we cannot accommodate multiple appointments

•

appointment times are usually up to 30 minutes in duration

•

we cannot facilitate ritual washing or the burning of candles or incense.

•

if demand for visiting is high, an appointment may be offered for the following day

3

Medical Certificate of Cause of Death (available Monday to Friday) If the person has died please contact: King George’s Hospital, Bereavement Office on 020 8970 8235 between 9am - 3:30pm, Monday to Friday.

Queen’s Hospital, Bereavement Office on 01708 435490/ 01708 435455 between 8am - 4:30pm, Monday to Friday.

The bereavement officer will ask you for some details, including the next of kin’s information or that of the person dealing with the funeral. We will arrange for the Medical Certificate of Cause of Death (MCCD) to be completed by a doctor who cared for the deceased during their hospital admission. While waiting, you may also contact an undertaker/funeral director. Once the medical examiner (ME) has reviewed the medical notes, the medical examiner officer (MEO) will call you to discuss the cause of death and then refer you to the local register office.

Please note that although we will make every effort to do this in a timely manner in all cases, we cannot promise an actual time or date for when you will receive their telephone call.

4

Medical Examiner Office Since September 2024 it is a requirement that all deaths, which are not investigated by the coroner, are reviewed by an independent senior doctor known as a Medical Examiner (ME). The role of the ME is to support clinicians and ensure accuracy and clarity when completing the MCCD. They provide advice and guidance where necessary, including decisions regarding referral to the coroner if needed.

Most importantly, they also give support, advice and any explanations needed to the bereaved family. The primary next of kin or someone chosen by them will receive a call from a medical examiner or officer to explain the medical terms surrounding the death and the proposed cause. They may ask some questions and address any concerns that you may have.

You can contact them directly on 01708 504343.

Their email is bhrut.medicalexamineroffice@nhs.net

5

Registering the death Once the Medical Examiner Office has informed you that the MCCD is ready to be emailed to the register office, you may telephone them or go online to make a face-to-face appointment. This should be within five days of the call by the Medical Examiners.

King George Hospital register office is: Redbridge Town Hall, 128 - 142 High Road, Ilford, Essex, IG1 1DD Telephone: 020 8708 7123 Online: www.redbridge.gov.uk Queen’s Hospital register office is: Langtons House, Billet Lane, Hornchurch, Essex, RM11 1XJ Havering Town Hall, Main Road, Romford, Essex, RM1 3BB Telephone: 01708 433481 Online: www.havering.gov.uk

6

Who can register a death?

The person registering the death should be a relative or partner of the person who has died. If there are no relatives, the death can be registered in hierarchical order by: • • • •

a person who was there at the time of death the person who is arranging the burial or cremation the personal representative of the deceased for example, a solicitor an official from the hospital, care home or building where the death took place

You can bring someone with you to the appointment.

The registrar will require About the person who has died • • • • • • •

date and place of death their full name and any other names they were known by their maiden name (if married or in a civil partnership) date and place of birth their occupation full name and occupation of their spouse or civil partner their home address

About you • • •

your relationship to the person who has died your full name your home address

You should bring proof of your identity and address.

7

Supporting documents It’s helpful to gather as much documentation as possible so that you can give us accurate information about the person who has died.

• • • • •

their birth certificate passport change of name documents bills or bank statements with their address on marriage or civil partnership certificates

It’s okay if you do not have everything on this list.

The registrar will provide A certificate for burial/cremation (green form) This will be issued if a post-mortem examination has not taken place. There is no charge for the above certificate. This will be emailed directly to the undertakers by the register office.

Death Certificate There is a charge for each death certificate. You may need to purchase more than one for dealing with insurance companies, pensions, banks and other organisations in matters relating to the deceased person’s estate. See the section called ‘Tell Us Once’ for more information.

8

Emergency registration (burials only) To arrange a same-day or next-day funeral, you will need to arrange for the release form (the green form) to be completed by the registrar as soon as possible and emailed to the undertakers.

If this is between Monday and Friday office hours you will need to follow the arrangements on the previous pages.

If this is out of hours or bank holidays or weekends, the ME will advise you when they have sent the MCCD to the registrars along with the next of kin details for them to contact you, and will give you the details for the relevant register office for you to make an appointment to register the death within five days of the medical examiner’s call (see page 6). The MEO will send the MCCD to the register office so that it is there when you call. You will not need to attend the hospital to collect it.

A registrar will need to check the certificate is correct and a green form can only be issued if everything is completed accordingly.

9

Tell Us Once ‘Tell Us Once’ is a free service provided by the register office that offers help with your recent bereavement administration. With your permission, relevant council services and central government departments will be informed of the death. Local services include council tax and council rentals etc. and national services include the Department for Work and Pensions (DWP), Passport Office (IPS,) Driving Licence (DVLA), Overseas Health and War Pensions department and others.

It will be necessary for the informant (person registering) to provide the deceased’s National Insurance number (if known) and relevant documents (i.e. passport, driving licence, library pass, blue badge or others) to apply for this service. If all the information is not available at the time of the death registration, the registrar will explain how to access the service from home using a reference number and free-phone telephone contact service with the DWP. This service is available up to 28 days following death registration and offers families assistance to inform local and central government departments at a particularly difficult time, saving them valuable time and money and lessening the distress of repeating information.

10

The Coroner’s Office The coroner is a lawyer or sometimes a doctor, who is responsible for investigating deaths in the jurisdiction where the person dies, and where: •

• • • •

the patient was not seen by a doctor or no doctor who treated them during their life can reasonably give a natural cause of death based on his or her knowledge of the deceased. the death was due to an accident, violence or other unnatural or suspicious circumstances the cause of death was not known, or was uncertain the death occurred while the patient was undergoing an operation or was under the effect of anaesthetic the death was caused by an industrial disease

The coroner will speak to the doctor who cared for the deceased or the medical examiner. If, after discussion, the death is found to be due to natural causes, the doctor or medical examiner can be asked to complete the MCCD if appropriate. A coroner’s officer may speak to the primary next of kin.

11

The coroner’s contact details for this area are: The Coroner’s Office Queen’s Road, Walthamstow, E17 8PQ Tel: 020 8496 5000 Where a natural cause of death cannot be agreed, the coroner will take authority for the next stages of investigation and will liaise with the appropriate next of kin. It will be for the coroner’s officer to explain the options open to the coroner, but these may include a post-mortem examination, an inquest or a coroner’s investigation and appropriate certificates will be issued by them to allow prompt, respectful release of the deceased.

Not all referrals to the coroner require a post-mortem or cause undue delay to the release.

12

What is a post-mortem examination or autopsy?

This is an independent surgical examination of the body to find a more accurate cause of death. The coroner is legally empowered to request a post-mortem examination if he or she judges that it is necessary, so that a death certificate can be issued and the funeral allowed to take place, irrespective of the family’s social or religious beliefs. You may, of course, discuss with the coroner any concerns that you may have. In some cases, a post-mortem may be done with new scanning technology where appropriate. However, if this is not successful in finding a cause, the coroner may direct a postmortem anyway.

Every effort is made to release the deceased in a timely manner.

If the post-mortem examination shows that the death was due to natural causes, the coroner will inform the next of kin of the cause of death and send this directly to the registrar. When the coroner’s office informs you that this has happened, they will guide you so that you can register the death. If a natural cause is not found, then the coroner may proceed to an inquest.

13

Why might there be an inquest?

The coroner can require an inquest with or without a postmortem examination. In most cases, it does not mean that there is anything suspicious or untoward about the death. An inquest is an inquiry into the medical cause and circumstances of a death. It is held in public, sometimes with a jury. The coroner will organise the inquiry to serve the interests of the deceased person’s relatives and the public. Relatives may attend the inquest and ask questions of witnesses about the medical cause and circumstances of the death.

Can I arrange a funeral before an inquest?

The coroner will open the inquest and generally adjourn it for further investigation and reports. He or she will issue an ‘order for burial form’ or ‘certificate of cremation’ so that the funeral can take place.

The coroner will send the next of kin interim certificates when the inquest is opened to allow some administration to take place.

14

The Inquest The coroner’s officer will inform you further about the inquest process and specific requirements. They may issue summonses to witnesses or simply read statements out in court (documentary hearing).

On completion of the inquest the coroner will inform the register office of the cause of death and they will register the death. Full certificates will then be available from the register office, and so you will not need to register the death again.

May I take the body out of England?

(Repatriation)

Whether or not the coroner needs to investigate the death, in all circumstances, only a coroner can give permission for the body to be taken out of England (which includes to Scotland) and extra paperwork may need to be issued to facilitate this.

This does not include the repatriation of ashes which do not need the coroner’s permission.

15

Last will and testament If the deceased person has made a will, this may be in the house, with the solicitor who drew it up, or at the bank.

The will may contain the deceased’s wishes as to funeral arrangements. If you need to contact the probate registry, the register office will give you a booklet (PA2) containing the nearest office then you register the death. In order to settle the estate according to the terms of the will, the executor will need to contact the probate registry.

If there is no will, the next of kin will need to contact the probate registry. Further advice or information can be obtained from your local Citizens Advice Bureau or a solicitor.

16

Arranging the funeral You will need to contact a funeral director as soon as possible. Prices for funerals vary and it is advisable to obtain estimates from two or three directors before making a choice.

Many funeral directors can provide leaflets giving costs of a basic cremation or burial, and giving details of additional services and options available.

The funeral director will ask whether a burial or cremation is required. If the deceased had expressed any wishes in their will regarding the funeral, the executor will need to inform them of this. Once you have chosen a funeral director, he or she will contact your priest, minister or representative of your faith to arrange the service. You may also wish to contact them directly. Your loved one may be buried in a churchyard, or a local authority or private cemetery. Cremated remains may also be buried in a churchyard or cemetery, or be made available to the family to make whatever arrangements they wish.

Details of local funeral directors can be found online, and all are independent of the trust. We cannot recommend a funeral director.

If you choose a member of the National Association of Funeral Directors (NAFD), they must comply with a code of practice. All members must supply a written estimate prior to the funeral. You can contact the NAFD on 0121 711 1343.

If the deceased had previously arranged for their body to be given for medical research, you should contact the London Anatomy Office on 020 7848 8042 to inform them of the death.

17

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 name and address of the deceased is removed from mailing lists, stopping most advertising mail within as little as six weeks.

If you cannot access the internet, you can call 0333 006 8114, where you will be asked for simple information that will take only a few minutes to complete.

This free of charge service provided by the Bereavement Support Network will not only actively reduce unwanted 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. In addition 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.

18

Sources of practical advice You can obtain practical help from the funeral director, your family doctor, a solicitor, a minister of religion, your local social services department and the Citizens Advice Bureau. If the person who has died was visited by a district nurse or health visitor, he or she may be able to help.

You may wish to discuss the death and funeral arrangements with a religious leader of your own faith. If you are not sure who to contact, the hospital chaplain can always offer advice.

Call 01708 435000 and ask for the duty chaplain. If the matter is not urgent, please contact during normal working hours.

Try to ensure that any source of information is bona fide and do not give personal information to websites or social media outlets unless you are sure that they are genuine and confidential.

If you have lost a partner, be especially careful to carry out tasks that were previously his or her responsibility, like locking the house, checking that gas and electricity supplies are turned off, etc. These are often carried out by one person regularly, and can easily be forgotten when they are no longer there.

19

Financial help A death in the family can cause financial worries for those left, both in the short term and the long term. For general information about social security benefits available, you can obtain some leaflets from your local Department for Work and Pensions (DWP). If you have difficulty in obtaining these leaflets, please write to: The Leaflets Unit PO Box 21, Stanmore, Middlesex HA8 1AY Your local DWP office or a Citizens Advice Bureau should be able to explain what you are entitled to. If the deceased person was claiming benefit(s) from the DWP, you cannot legally continue to claim on his or her behalf. You will need to inform the DWP of the death as soon as possible, and they will make the necessary arrangements for payment of any entitlement you may have.

Spiritual needs In the weeks following a funeral, many people experience spiritual doubts. This is quite normal, and you may find it helpful to discuss them with either the person who conducted the funeral, or one of the chaplains at the hospital. Our Trust chaplaincy service is available to people of any faith, practising or non-practising. Chaplains from most religious denominations can be contacted. If you would like to contact the chaplaincy service, telephone the main hospital switchboard on 01708 435000 and ask to speak to the duty chaplain.

20

Children and bereavement Try to tell children of all ages what has happened as honestly as you can. Be prepared to answer their questions truthfully and simply.

You may also find these websites useful for support: Hope Again Hope Again is the youth website of Cruse Bereavement Care. It is a safe place, where young people who are facing grief can share their stories with others. www.hopeagain.org.uk Winston's Wish Winston's Wish was the first UK childhood bereavement support charity, and have been supporting bereaved children since 1992. www.winstonswish.org Child Bereavement UK Child Bereavement UK supports families during bereavement and when a child is facing a bereavement. www.childbereavementuk.org

21

Your bereavement is a personal journey After a loss, we need to grieve, which can be painful. Its effects can sometimes be alarming, so you may find the following advice helpful.

Grief following the death of someone very dear or where there was emotional involvement, is the hardest bereavement of all. It is like a journey which can at times be lonely, very painful and long.

It is hard to accept the loss, so you may find yourself trying to deny the reality of what has occurred. You may think you see or hear the person who has died. It takes time for the full realisation to sink in. For a long time, you may feel tired, lethargic, unable to make decisions, strained and physically run down. It may be difficult to eat or sleep. Grief is time consuming and exhausting.

You may feel times of despair and depression. You may lose interest in many things you would normally enjoy doing.

If you have lost a husband, wife or partner and are alone, you may feel pointless about your day-to-day life. All these feelings are natural.

Also, you may experience guilt, panic and anger - even anger at the person who has died. Do not try to hide these feelings; try to share them with a sympathetic listener. Well-meaning friends may feel that after a few weeks you will be “back to normal”. Others may be afraid to speak to you and avoid you.

You may have to make the first move. Let them know you need their support and the comfort of their friendship.

22

It may be tempting to think that if you change your environment you will feel better, but it is unwise to make big decisions about your life too soon. At first your grief will be with you wherever you are. Kind friends may want to distract you and “cheer you up”. You may also need times of quiet, stillness and solitude to do your grieving. It is very tiring to be constantly pulled away from your true feelings, and unless you do have time and space in which to feel your sadness, your journey of grief will be harder.

Sometimes you will feel it is like snakes and ladders; there will be better days and then something unexpected will send you to the bottom again.

Eventually, the pain will ease, and memories will become comforting. When you feel ready to remake your life and take up old pursuits, do not feel that you are being disloyal to the person who has died. It is alright to enjoy yourself again.

Your grieving will be individual to you. It will take as long as it takes. It is important to allow yourself to grieve, and to take a break from grieving and eventually to put it aside when sorrow remains. You will never put aside the memories and influence of the person you loved.

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Notes ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... ......................................................................................................................................................... .........................................................................................................................................................

King George and Queen’s Hospitals Charity is a registered charity which aims to improve patient and staff welfare and enhance the hospital environment at Barking Havering and Redbridge University Hospitals NHS Trust. Our work benefits patients, staff and visitors. For more information please visit www.supportyourhospital.org or call 01708 504335.

Review Date: May 2028 Publication Date: May 2026

24

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.

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