Bereavement-Booklet.-incorporating-information-for-families-following-a-bereavement-Dec.19

Bereavement Booklet Information about the process following a death at Norfolk & Norwich University Hospital INCORPORATING “Information for families following a bereavement – July 2018” December 2019 Contents Introduction Immediate Arrangements The Hospital Bereavement Team Registering a Death Arranging a Funeral Medical Examiners Care in the Mortuary Deaths referred to HM Coroner Post Mortem Examinations Understanding what happened 10 Review of deaths in our care 10 Investigations 11 Providing feedback, raising concerns and/or making a complaint 12 Grief 13 The Hospital Chapel 14 Organ and Tissue Donation 14 Frequently Asked Questions (FAQ) 15 Information for families following a bereavement – July 2018 17 Support Organisations & Counselling Services 20 Useful telephone numbers and websites 21 Comments and Feedback 22 Acknowledgment and thanks 22 Introduction Many different staff will have been involved in the care of your relative or friend while they were a patient at the Norfolk and Norwich University Hospital On behalf of all of them we wish to express our condolences, sympathy and concern for you at this time We know this can be a very difficult and distressing time and we hope this booklet will help you understand what you can expect from Norfolk & Norwich NHS Hospitals Trust This booklet has been prepared to offer you guidance in making the immediate arrangements It describes the important tasks such as registering the death, and provides other useful practical information The booklet also aims to explain what happens next; including information about how to comment on the care your loved one received and what happens if a death will be looked into by the Coroner It also provides details of the process involved if you have significant concerns about the care provided and gives you practical advice, support and information In addition to this booklet, you should receive a letter from us in the post The letter should have included the details of someone in the trust who you can contact if you want to provide comments; ask questions; or raise any concerns If you need to speak to someone immediately and have not yet received a letter from us, please contact the Bereavement Office At the end of the booklet there is information on grief including contact numbers for local and national organisations that may be able to provide help and support over the days and weeks to come Please be aware that bereavement can leave people feeling very isolated, so don’t be afraid to ask for help and advice: any question or query is important Immediate Arrangements The practical things to following a death are contacting the Funeral Director and hospital Bereavement Office The Funeral Director There is no need to wait until you have registered the death before contacting the Funeral Director as you will find they will be able to guide you in every detail in making the funeral arrangements and offer general advice and guidance You may wish to approach more than one Funeral Director to get an estimate of their costs before making your choice You can find names and contact details in the local telephone book or via the internet e.g www.yell.com; www.yourfuneralchoice.com or www.beyond.life/nhs Alternatively your bereavement advisor can provide you with names of funeral directors within your chosen area, but they are not able to make any personal recommendations The Hospital Bereavement Team The Bereavement Advisors are pleased to offer help, advice and support for relatives and carers of those who have died in our care They will help you make arrangements to collect the Medical Certificate of Cause of Death and will explain the procedures for the registration of death and collecting personal belongings if you have not already been given these from the ward Please not come to the office without a previously arranged appointment as this means that the certificate may not ready for collection and a Bereavement Advisor may not be available The Bereavement Office is open for telephone calls and appointments from 9.00am 4.00pm, Monday to Friday except for Bank Holidays Please telephone (01603) 287165; 287166; 287465; or 289440 to leave your telephone details and the name of your loved one, together with any funeral arrangements if known If you are connected to the answerphone it is because the advisors are either with a family or speaking on the telephone to another family We aim to call you back on the same day as your message has been left, or within working days Unless referred to a HM Coroner, the doctor responsible for the care of the patient will complete the Medical Certificate giving the cause of death and this process usually takes two or more working days Once the medical certificate is ready, your Bereavement Advisor will offer you an appointment to collect this and any property held by the hospital Relatives with a Bereavement Office appointment are advised to report to or East Outpatient Reception Level or East In-Patient Reception, Level (Car Parks L or M) The reception staff will call the bereavement office to advise that you have arrived and they will come and collect you Registering a Death All deaths, except those referred to the Coroner, must be registered within days The Bereavement Advisor will explain how you should this and who may register a death Hospital deaths can be registered at any of the Norfolk offices and it is possible to register a death anywhere within England & Wales Please ask for details It may be possible to register the death at the hospital with the Duty Registrar, but these appointments are limited Please be prepared to make alternative arrangements outside of the hospital to register the death The Registrar Offices operate an appointment only system To make an appointment you can either phone Norfolk County Council Customer Service Department 0344-800-8020 (9am to 5pm, Monday to Friday) or via their website www.norfolk.gov.uk/registrationservices Their Norwich office is County Hall, The Archive Centre, Martineau Lane, NR1 2DQ or you may wish to choose to register at a local office to you Parking is available Documents and information needed to register the death The Registrars offer a Tell Us Once service which informs national & local government of the death; when you make your appointment you will be advised what information to bring with you including:  Medical Certificate of Cause of Death, which will be given to you by the hospital Bereavement Advisor, this includes the date and place of death  Full name of the deceased and maiden name (if applicable)  Date and place of birth - Birth Certificate (if available)  Home address  Details of occupation or last occupation, if retired  Full name of spouse and their date of birth (if applicable)  Medical Card (if available); passport & driving licence You will receive from the Registrar Certificate of Burial or Cremation: this certificate is green and is required by the Funeral Director before the funeral takes place Social Security Certificate (Form BD8): this should be sent to the Benefits Office together with any other benefits cards held by the deceased The Death Certificate: This is a copy of the entry in the Death Register Each copy costs £11.00 (with effect from 16 February 2019) You should discuss how many copies you may need with the Registrar Other Documentation After a death it is necessary to return certain documents and other items belonging to the deceased • Social Security payment cards • Registration documents of car, to change ownership • NHS equipment including mobility and hearing aids • Season Tickets The following people and organisations may need to know about the death: • Solicitor • Bank, Building Society, Insurance Company etc • Employers and Trade Unions • Schools, College, University attended • Any other hospital the person was attending • • Gas / Electricity / Water / Telephone / TV Licence Professional Organisations Please note most organisations will not accept a photocopy of the death certificate In addition, it may be useful to include the National Insurance Number of your relative/friend in any correspondence with government departments Arranging a Funeral If the deceased person has made a will, this may contain important information about their wishes for their funeral Once you have registered the death and collected the green Certificate of Burial or Cremation, your Funeral Director will be able to make detailed arrangements for the funeral in accordance with the family’s wishes The Mortuary requires your chosen Funeral Director to bring a signed form authorising them to collect and take responsibility for the deceased on your behalf In the event that a death is referred to the Coroner, the Coroner’s office will advise you on what to Your Funeral Director will liaise with the Coroner on your behalf You may want to discuss the funeral with your religious representative, or you may prefer for the Funeral Director to this on your behalf They can also arrange a nonreligious funeral if this is your wish Cremation By law, Doctors have to follow the Cremation (England and Wales) Regulations 2008 To process the additional cremation documentation from the hospital medical staff through to the final check by an independent doctor at the crematorium (the medical referee) it can take working days The Bereavement Advisors will commence this process when they are advised the funeral will be a cremation Cremation fees and guidance The completion of cremation certificates does not fall within the NHS duties of a doctor Advice issued by the British Medical Association (BMA), stipulates that the fees applicable for forms completed by doctors have been agreed with the National Association of Funeral Directors, NAFD, the National Society of Allied and Independent Funeral Directors, SAIF, and Co-operative Funeralcare) Doctors at this Trust follow the above guidance A link to the guidance is provided below:https://www.bma.org.uk/advice/employment/fees/cremation Paying for a funeral If you arrange for a funeral, you are responsible for paying the costs involved It is advisable to check if there are sufficient funds to cover the costs If you receive certain kinds of benefit/s or if for any other reason you not have enough money to pay for the funeral, you should seek advice from the Department of Work and Pensions Notification of a death in a newspaper You may wish to ask the Funeral Director to guide you on wording and arrangements Your chosen Funeral Director will be able to place the notification in a newspaper on your behalf Medical Examiners Medical Examiners are independent senior doctors whose roles are to ensure that death certificates accurately reflect the cause of death, that cases are referred appropriately to the Coroner and most importantly, that the family have the opportunity to ask questions and raise any concerns about the care your loved one received You should expect the Medical Examiner or the Medical Examiners’ Officer to make contact, as this will eventually be standard practice The Medical Examiner service is being rolled out across the country from 1st April 2019 The NNUH has already established a service which will develop over the course of time You can make an appointment to speak to one of our Medical Examiners by contacting the Bereavement Advisors A representative of the family may view the forms completed by the doctors Please advise your Funeral Director if you want to this and they will ensure this is recorded on the documentation This may cause a delay in the funeral and a charge may be made for this option Care in the Mortuary When the deceased is in the care of the Mortuary staff, they will be looked after with dignity and respect in a safe environment Viewing arrangements - Arranging to see your relative/friend within the Hospital Some people have the opportunity to see their relative in the ward/department where they have died When this is not possible, the Mortuary can provide the bereaved relative with a peaceful and private facility to view their relative/friend although many people prefer to view their relative when they are in the care of their chosen Funeral Director Please discuss this with your chosen Funeral Director if this is your preference If you would like to view your relative in the Mortuary’s viewing suite then this can be arranged by contacting the Mortuary You will also be able to view your loved one at the Funeral Director if you prefer Please be aware that if the deceased has been referred to the Coroner a viewing is not permitted until we receive permission from the Coroner Permission to view the patient is not usually received until after the completion of any examination procedures In the event that pre-examination viewing is permitted, the viewing will be supervised throughout by a member of the Mortuary team Viewing within the Mortuary’s Viewing Suite is strictly by appointment only and normally arranged between 2pm – 4pm Monday – Friday Please telephone the Mortuary personnel directly on (01603) 287192 to arrange a time and date to attend Outside normal opening hours the department has an emergency on call service in which it may be possible to accommodate a viewing To request this out of hours emergency service contact the hospital switchboard (01603 286286) and ask for the emergency on call Mortuary Technologist If you attend a viewing in the Mortuary you will be met by a member of the team and accompanied to the Mortuary viewing suite The suite is a private, calm and quiet room located within the Mortuary department Trained staff will be there to support relatives through this process Please understand that in some cases there may be small changes evident in the appearance of the deceased patient The Mortuary staff will prepare you as much as they can and will be available to answer any questions or concerns throughout your viewing On occasion when there have been a significant number of deaths in the community and Hospital, it may not be possible to accommodate some deceased patients within the permanent Hospital Mortuary facilities In these circumstances you should be aware that it may be necessary for us to transfer the deceased patient to a designated Funeral Director or other temporary facility You have our assurance that this process is carefully managed and that the transfer and facilities of the Funeral Directors ensure continuation of care, dignity and respect for the deceased patient Your designated Funeral Director will be able to collect directly from these facilities as required Deaths referred to HM Coroner By law, if the doctor is not able to issue a death certificate (for example, if someone dies suddenly and unexpectedly in hospital or following an accident or other unnatural event), they are legally required to inform the Coroner The Coroner is a lawyer working with a team of Officers to investigate unnatural, unexpected or sudden deaths Having been informed of the death, the Coroner will decide whether the doctor can issue the Medical Certificate of Cause of Death or whether a Post Mortem examination is required to establish the cause of death The Coroner does not require the consent of relatives or carers for this examination to be performed, but does have a duty to notify relatives when and where the examination will take place If we not refer a death to the Coroner and you have concerns about the treatment we provided, you can ask the Coroner to consider holding an inquest It is a good idea to this as soon as possible after your loved one has died as delays in requesting an inquest may mean that opportunities for the coroner to hold a post mortem are lost Inquests and formal identification of the deceased patients The Coroner is represented by the Coroner’s Officers, who may need to talk to you about the circumstances leading up to your relative’s death They will advise you when the cause of death has been established and when they have issued their documentation to the Registration Service at County Hall, Norwich, so that you can make the appointment with the Registrar to register the death Sometimes it is necessary to hold an inquest after a death In this case the Coroner can normally issue a burial or cremation certificate once the post-mortem examination is complete A formal identification of the deceased prior to the post-mortem examination is required The relative assisting with this will be accompanied to the viewing and the procedure will be explained by the mortuary staff Some deaths are referred to the Coroner, for example where the cause of death is unknown, or the death occurred in violent or unnatural circumstances When a death is referred to the Coroner they may request a Post Mortem examination The Coroner will then decide whether an Inquest is required, to establish the cause of the death An Inquest is a ‘fact finding’ exercise which normally aims to determine the circumstances of someone’s death If you are seeking or involved in an inquest, you may wish to find further independent information, advice or support There are details of organisations that can advise on the process, including how you can obtain legal representation, at the end of this leaflet Contacting the Coroner and Coroner’s Officers The main telephone number for the Coroner’s office is Norwich (01603) 276493 There is an answerphone for leaving a message if the line is busy or personal are unavailable Contacting the Funeral Director We recommend that you make early contact with your Funeral Director, advising them that the death has been referred to the Coroner They will be able to liaise with the Coroner’s department about releasing the deceased patient into their care in plenty of time before the funeral Post Mortem Examinations Most post mortems are requested by HM Coroner, as a legal requirement, to ascertain an unexpected cause of death Sometimes a request for a post-mortem examination is made by the relatives or by the doctor treating the deceased patient This may be requested in order to increase medical knowledge and the effect of any treatment received The relatives may also wish to request this in order to gain a better understanding of what happened The written permission of the next of kin will be obtained by one of the Doctors, Mortuary Team or Bereavement Advisors who will also fully explain the nature of the procedure The consent form is designed to be flexible and any subsequent examination of the patient can be restricted or limited if you wish The hospital will issue the Medical Certificate of the Cause of Death prior to the request of a hospital/consented post-mortem examination A post-mortem examination should not delay the funeral arrangements Understanding what happened As a family member, partner, friend or carer of someone who has died whilst in the care of the Norfolk & Norwich University NHS Foundation Trust, you may have comments, questions or concerns about the care and treatment they received You may also want to understand more about the reasons for their death The staff who were involved in treating your loved one should be able to answer your initial questions However, please not worry if you are not ready to ask these questions straight away, or if you think of questions later - you will still have the opportunity to raise these with us (the trust) when you are ready through your named contact at the trust (see above) It is also important for us to know if you don’t understand any of the information we provide Please tell us if we need to explain things more fully The Gov.uk website (https://www.gov.uk/after-a-death) provides practical information on what to following a death We also know that the death of a loved one can be very traumatic for families This can be even more so when concerns have been raised, or when a family is involved in an investigation process Some families have found that counselling or having someone else to talk to can be very beneficial You may want to discuss this with your GP, who can refer you to local support Alternatively, there may be other local or voluntary organisations that provide counselling support that you would prefer to access Some examples of organisations that may be able to help you are included later in this leaflet Reviews of deaths in our care Case note reviews (or case record reviews) are carried out in different circumstances Firstly, case note reviews are routinely carried out by NHS trusts on a proportion of all their deaths to learn, develop and improve healthcare, as well as when a problem in care may be suspected A clinician (usually a doctor), who was not directly involved in the care your loved one received, will look carefully at their case notes They will look at each aspect of their care and how well it was provided When a routine review finds any issues with a patient’s care, we contact their family to discuss this further 10 Secondly, we also carry out case note reviews when a significant concern is raised with us about the care we provided to a patient We consider a ‘significant concern’ to mean: (a) any concerns raised by the family that cannot be answered at the time; or (b) anything that is not answered to the family’s satisfaction, or which does not reassure them This may happen when a death is sudden, unexpected, untoward or accidental When a significant concern has been raised, we will undertake a case note review for your loved one and share our findings with you Aside from case note reviews, there are specific processes and procedures that trusts need to follow if your loved one had a learning disability; is a child; or died in a maternity setting or as a result of a mental health related homicide If this is the case, we will provide you with the relevant details on these processes Investigations In a small percentage of cases, there may be concerns that the death could be or is related to a patient safety incident A patient safety incident is any unintended or unexpected incident, which could have, or did, lead to harm for one or more patients receiving healthcare Where there is a concern that a patient safety incident may have contributed to a patient’s death, a safety investigation should be undertaken The purpose of a safety investigation is to find out what happened and why This is to identify any potential learning and to reduce the risk of something similar happening to any other patients in the future If an investigation is to be held, we will inform you and explain the process to you We will also ask you about how, and when, you would like to be involved We will explain how we will include you in setting the terms of reference (the topics that will be looked at) for the investigation Investigations may be carried out internally or by external investigators, depending on the circumstances In some cases, an investigation may involve more care providers than just the Norfolk & Norwich University Hospitals NHS Trust For example, your loved one may have received care from several organisations (that have raised potential concern) In these circumstances, this will be explained to you, and you will be told which organisation is acting as the lead investigator You will be kept up to date on the progress of the investigation be invited to contribute This includes commenting on the draft investigation report before it is signed off Your comments should be incorporated in the report After the report has been signed off, the 11 trust will make arrangements to meet with you to further discuss the findings of the investigation You may find it helpful to get independent advice about taking part in investigations and other options open to you Some people will also benefit from having an independent advocate to accompany them to meetings etc Please see details of independent organisations that may be able to help, later in this leaflet You are welcome to bring a friend, relative or advocate with you to any meetings Where the death of a patient is associated with an unexpected or unintended incident during a patient’s care, staff must follow the Duty of Candour Regulation/Policy (https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-20dutycandour) AvMA (Action Against Medical Accidents (https://www.avma.org.uk/) has produced information for families on Duty of Candour which is endorsed by the Care Quality Commission Providing feedback, raising concerns and/or making a complaint Providing feedback: We want to hear your thoughts about your loved one’s care Receiving feedback from families helps us to understand (i) the things we are doing right and need to continue; and (ii) the things we need to improve upon Raising concerns: It is also very important to us that you feel able to ask any questions or raise any concerns regarding the care your loved one received In the first instance, the team that cared for your loved one should be able to respond to these After this, your named contact at the [insert name of trust] is the best person to answer your questions and concerns However, if you would prefer to speak to someone who was not directly involved in your loved one’s care, our Patient Advice Liaison Service (PALS) team will be able to help Making a complaint: We hope that we will be able to respond to any questions or concerns that you have Additionally you can raise concerns as a complaint, at any point If you this we will ensure that we respond, in an accessible format (followed by a response in writing where appropriate to your needs), to the issues you have raised The NHS Complaints Regulations (http://www.legislation.gov.uk/uksi/2009/309/pdfs/uksi_20090309_en.pdf) state that a complaint must be made within 12 months of the incident happening or within 12 months of you realising you have something to complain about However, if you have a reason for not complaining to us sooner we will review your complaint and decide whether it would still be possible to fairly and reasonably investigate If we decide not to investigate in these circumstances you can contact the Parliamentary and Health Service Ombudsman (PHSO (https://www.ombudsman.org.uk/)) 12 Please note you not have to wait until an investigation is complete before you complain - both processes can be carried out at the same time For example, a complaint can trigger an investigation, if it brings to light problems in the care that were not previously known about However, if both the complaint and investigation are looking at similar issues, a complaint could be paused until the associated investigation is complete If you are not happy with the response to a complaint, you have the right to refer the case to the Parliamentary and Health Service Ombudsman PHSO has produced ‘My expectations for raising concerns and complaints for users of health services, it sets out what you should expect from the complaints process https://www.ombudsman.org.uk/publications/my-expectations-raisingconcernsand-complaints Please see the frequently asked questions section at the end of this leaflet for more information on what to if you are not happy with the responses you receive from us Grief Grief occurs after any loss, but is felt most strongly after the death of someone we love, regardless of the length of time we have known them It is a natural process, which takes time to get through, and which cannot be hurried In the first days following a death it can be difficult to believe the death has occurred and there may be a feeling of numbness The practical aspects of making contact with relatives and friends, organising and attending the funeral can be helpful in coming to terms with the death, even though they may be painful to In the days and weeks following the death a wide range of emotions may be felt, including: • Yearning for the return of the person who has died • Anger at the person who has died or at those who were caring for them • Guilt - feeling you could have done more for the person who had died, or at what had, or had not, been said Other natural, understandable and common things you may notice: • It may be difficult to concentrate or relax • Sleep patterns may be altered and some people experience very vivid dreams • Abrupt changes of emotion are normal and an essential part of coming to terms with the death • Sudden outbursts of tears which can be embarrassing • Being quiet and withdrawn, perhaps remembering the good and bad times with the deceased patient 13 In time the pain of early bereavement fades, the depression lessens and it is possible to look again to the future However, the sense of having lost part of oneself never goes away entirely, but as time goes by it is possible to start a new sort of life and feel whole again, even though a part is missing Different cultures deal with death in their own ways The feelings experienced by bereaved people in different cultures may be similar, but their ways of expressing them are very different Children & adolescents The grief of children and adolescents, and their need for mourning, should not be overlooked when a member of the family has died Children feel loss in much the same way as adults, even though their understanding of what death means is different from that of adults Including them in the funeral arrangements including viewing, at a level where they are comfortable, is part of their grief process too Support for children can be accessed through their local religious group, the GP or school The Hospital Chapel The Hospital Chapel, situated on Level 1, Centre Block, is always open for patients, relatives and staff It is a peaceful place where you can sit quietly, think and relax away from the ward Some find it helpful to pray or light a candle or to place a name on our prayer board The space is open to everyone whatever their faith or belief It is a nondenominational, multi faith facility and welcomes those of all faiths or none The Hospital Chaplains are available every day from 8am until 6pm and are on call during the night if there is an emergency They are there to listen to patients or their families and to offer comfort You not have to have a religious faith to call upon a chaplain They also have a list of leaders from many different faiths who are willing to come in to the hospital The hospital recognises that spiritual care is significant especially at times of bereavement, so please ask for a chaplain if you wish Organ and Tissue Donation Most people are aware that hundreds of lives are saved every year by donated organs, such as hearts and kidneys They may not realise that donated tissues such as eyes (corneas), skin, bone, tendons or heart valves can dramatically improve the quality of life for others and may even save lives 14 Anyone can be considered as a tissue donor and a specialist from the hospital may contact you Corneal donation must take place within 24 hours following death The decision of donation is a very personal one and we must stress, it is only an option, it is not expected of you and your preference will be respected either way A family member may consent on behalf of the deceased, even if they were not previously registered as a donor or carried a donor card For further information contact The East Anglian Eye Bank team via the hospital switchboard Frequently Asked Questions (FAQ) What should I if I have concerns about my relative/friend’s treatment contributing to their death? Please speak to your named contact at the trust; the staff involved in the treatment of your loved one; or the Patient Advice and Liaison Service (PALS) If necessary, you can ask for an investigation You can also make a formal complaint, either to the trust directly or to the relevant clinical commissioning group (CCG) – please see below for more information Who orders a post mortem or inquest? In some cases we refer deaths to the coroner and in some cases the coroner may then order a post mortem to find out how the person died Legally, a post mortem must be carried out if the cause of death is potentially unnatural or unknown The coroner knows this can be a very difficult situation for families and will only carry out a post mortem after careful consideration A family can appeal this in writing to the coroner, giving their reasons, and should let the coroner know they intend to this as soon as possible However, a coroner makes the final decision, and if necessary, can order a post mortem even when a family does not agree Please note that the body of your loved one will not be released for burial until it is completed, although a coroner will their best to minimise any delay to funeral arrangements You speak directly to the local coroner’s office about having a post-mortem and/or inquest What should I if I think the treatment was negligent and deserving of compensation? Neither patient safety investigations nor complaints will establish liability or deal with compensation, but they can help you decide what to next You may wish to seek independent advice from Action against Medical Accidents (see the section on ‘Independent information, advice and advocacy’) They can put you in touch with a specialist lawyer if appropriate Please note: There is a three-year limitation period for taking legal action What should I if I think individual health professionals’ poor practice contributed to the death and remains a risk to other patients? 15 Lapses in patient safety are almost always due to system failures rather than individuals However, you may be concerned that individual health professionals contributed to the death of your loved one and remain a risk If this is the case, you can raise your concerns with us or go directly to one of the independent health professional regulators listed below Where can I get independent advice and support about raising concerns? Please see the section on independent information, advice and advocacy, which details a range of organisations Other local organisations may also be able to help Other organisations that may be of help: • Clinical commissioning groups (CCGs): Clinical commissioning groups pay for and monitor services provided by NHS Trusts Complaints can be made to the relevant CCG instead of us, if you prefer Please ask us for contact details of the relevant CCG(s) or visit www.england.nhs.uk/ccgdetails • Parliamentary and Health Service Ombudsman (PHSO): The PHSO make final decisions on complaints that have not been resolved by the NHS in England and UK government departments They share findings from their casework to help parliament scrutinise public service providers They also share their findings more widely to help drive improvements in public services and complaint handling If you are not satisfied with the response to a complaint, you can ask the PHSO to investigate www.ombudsman.org.uk - 0345 015 4033 • Care Quality Commission (CQC): The CQC is the regulator for health and social care in England The CQC is interested in hearing about concerns as general intelligence on the quality of services, but please note that they not investigate individual complaints Visit: www.cqc.org.uk • National Reporting and Learning System (NRLS): Members of the public can report patient safety incidents to the NRLS This is a database of incidents administered by NHS Improvement, which is used to identify patient safety issues that need to be addressed Please note though that reports are not investigated or responded to www improvement.nhs.uk/resources/report-patient-safety-incident/ • NHS England – Specialised Services: Specialised services support people with a range of rare and complex conditions They often involve treatments provided to patients with rare cancers, genetic disorders or complex medical or surgical conditions Unlike most healthcare, which is planned and arranged locally, specialised services are planned nationally and regionally by NHS England If you wish to raise a concern regarding any specialised services commissioned in your area, please contact NHS England’s contact centre in the first instance Email: england.contactus@nhs.net or telephone 0300 311 22 33 • Nursing and Midwifery Council (NMC): The NMC is the nursing and midwifery regulator for England, Wales, Scotland and Northern Ireland It has introduced a new Public Support Service that puts patients, families and the public at the centre of their work The service is already providing support and a full service will be up and running by 16 autumn 2018 More information can be found within the ‘Concerns about nurses or midwives’ section on their website: www.nmc.org.uk • General Medical Council (GMC): The GMC maintains the official register of medical practitioners within the United Kingdom Its statutory purpose is to protect, promote and maintain the health and safety of the public It controls entry to the register, and suspends or removes members when necessary Its website includes ‘Guides for patients and the public’, which will help you decide which organisation is best placed to help you More information can be found within the ‘Concerns’ section at: www.gmcuk.org • Healthcare Safety Investigations Branch (HSIB): HSIB’s purpose is to improve safety through effective and independent investigations that don’t apportion blame or liability HSIB’s investigations are for patient safety learning purposes Anyone can share cases with HSIB for potential investigation (but an investigation is not guaranteed) www.hsib.org.uk Information for families following a bereavement – July 2018 The following information has also been provided by information for families following a bereavement – July 2018, with the support of families, trusts and other stakeholders, https://www.england.nhs.uk/wp-content/uploads/2018/08/information-for-familiesfollowing-a-bereavement.pdf The list below does not include every organisation but the ones listed should either be able to help you themselves, or refer you to other specialist organisations best suited to addressing your needs In addition all local authorities (councils) should provide an independent health complaints advocacy service, which is independent of the trust, that people can access free of charge We may also be able to provide you with details of other organisations and services that provide local support, and if relevant, we would be happy to talk these through with you National organisations • Action against Medical Accidents (‘AvMA’): An independent national charity that specialises in advising people who have been affected by lapses in patient safety (‘medical accidents’) It offers free advice on NHS investigations; complaints; inquests; health professional regulation and legal action regarding clinical negligence Most advice is provided via its helpline or in writing but individual ‘advocacy’ may also be arranged It can also refer to other specialist sources of advice, support and advocacy or specialist solicitors where appropriate www.avma.org.uk - 0845 123 23 45 • Advocacy after Fatal Domestic Abuse: Specialises in guiding families through inquiries including domestic homicide reviews and mental health reviews, and assists with and 17 represent on inquests, Independent Police Complaints Commission (IPCC) inquiries and other reviews www.aafda.org.uk - 07768 386 922 • Child Bereavement UK: Supports families and educates professionals when a baby or child of any age dies or is dying, or when a child or young person (up to age 25) is facing bereavement This includes supporting adults to support a bereaved child or young person All support is free, confidential, has no time limit, and includes face to face sessions and booked telephone support www.childbereavementuk.org – 0800 0288840 • Child Death Helpline: Provides a freephone helpline for anyone affected by a child’s death, from pre-birth to the death of an adult child, however recently or long ago and whatever the circumstances of the death and uses a translation service to support those for whom English is not a first language Volunteers who staff the helpline are all bereaved parents, although supported and trained by professionals www.childdeathhelpline.org.uk – 0800 282 986/0808 800 6017 • Cruse Bereavement Care: Offers free confidential support for adults and children when someone dies, by telephone, email or face-to-face www.cruse.org.uk - 0808 808 1677 • Hundred Families: Offers support, information and practical advice for families bereaved by people with mental health problems, including information on health service investigations www.hundredfamilies.org • INQUEST: Provides free and independent advice to bereaved families on investigations, inquests and other legal processes following a death in custody and detention This includes deaths in mental health settings Further information is available on its website including a link to ‘The INQUEST Handbook: A Guide For Bereaved Families, Friends and Advisors’ www.inquest.org.uk – 020 726 3111 option • National Survivor User Network: Is developing a network of mental health service users and survivors to strengthen user voice and campaign for improvements It also has a useful page of links to user groups and organisations that offer counselling and support www.nsun.org.uk • Patients Association: Provides advice, support and guidance to family members with a national helpline providing specialist information, advice and signposting This does not include medical or legal advice It can also help you make a complaint to the CQC www.patients-association.org.uk - 020 8423 8999 • Respond: Supports people with learning disabilities and their families and supporters to lessen the effect of trauma and abuse, through psychotherapy, advocacy and campaigning www.respond.org • Sands: Supports those affected by the death of a bereavement support helpline, a network of support groups, an online forum and message board www.sands.org.uk – 0808 164 3332 18 • Support after Suicide Partnership: Provides helpful resources for those bereaved by suicide and signposting to local support groups and organisations www.supportaftersuicide.org.uk/ Local/regional organisations • South East Advocacy Projects: Provides a range of general advocacy services across the south of England www.seap.org.uk • Swan Advocacy: Provides advocacy services in North Somerset and South Gloucestershire, Somerset and Wiltshire, including generic advocacy and independent health complaints advocacy to support people to complain about NHS services and has expertise where bereavement or end of life care are a factor www.swanadvocacy.org.uk • POhWER: Offers general advocacy services in the south and midlands and independent health complaints advocacy to support people to complain about NHS services in many London boroughs www.pohwer.net • VoiceAbility: Provides NHS complaints advocacy giving telephone/advocacy support to make a complaint about the NHS, signposting different options and providing information and contact details for one to one support to make a complaint It provides this service in Birmingham, Cambridgeshire, London, Northamptonshire, Peterborough and Suffolk www.nhscomplaintsadvocacy.org – telephone number 03003 305 454 Future updates to this information Please note that this information will be updated in the future as a result of expected new guidance and processes These include: • The outcome of the consultation on the Serious Incident Framework • The implementation of the role of the Medical Examiner • Guidance on Child Death Reviews • The ambition in the original CQC report ‘Learning from Deaths’ to include all providers of NHS commissioned care, including primary care • Further policy developments that may be of relevance 19 Support Organisations and Counselling Services Norfolk Citizens Advice Bureau (Norwich) St Crispin's House St Georges Street NORWICH Norfolk NR3 1PD 03444 111 444 The Samaritans 19 St Stephen's Square Norwich NR1 3SS 08457 909 090 http://www.samaritans.org/branches/samarita ns-norwich https://theforumnorwich.co.uk/citizensad vicenorfolk SANDS (Still Births & Neo-Natal Deaths) Child Bereavement Charity National supportline: 0808 164 3332 National supportline: 08000 288 840 https://www.uk-sands.org/ http://childbereavementuk.org/support/ The Compassionate Friends Cruse Bereavement Care – Norwich and Central Norfolk National supportline: 03451 232 304 68 St Augustine's Street Norwich Norfolk NR3 3AD http://www.tcf.org.uk/ 08088 081 677 http://www.cruse.org.uk/Norwich 20 Winston’s Wish (The Charity for Bereaved Children) National supportline: 08088 020 021 http://www.winstonswish.org.uk/ Victims Support National supportline: 08081 689 111 https://www.victimsupport.org.uk/ Useful telephone numbers and websites Norfolk & Norwich University Hospital Main Switchboard Bereavement Advisors 01603 286286 ` 01603 287165/287166/287465/289440 Chaplaincy Service 01603 287470 Mortuary 01603 287192 Other Numbers Coroner’s Office (secretary) 01603 276493 Registrar’s Office 0344 800 8020 Probate Office 01603 728267 Probate Helpline (for information pack) 0300 123 1072 Dept Works & Pensions www.dwp.gov.uk 08456 043 719 Useful Websites: The Royal College of Pathologists https://www.rcpath.org/discover-pathology/what-is-pathology/information-about-postmortems-for-friends-and-relatives-/what-happens-during-a-post-mortem.html Directgov (Coroners, post-mortems and inquests) http://www.direct.gov.uk/en/Governmentcitizensandrights/Death/WhatToDoAfterADeath/ DG_066713 Norfolk Coroner’s Service https://www.norfolk.gov.uk/births-ceremonies-and-deaths/deaths/the-coroner Norfolk and Norwich University NHS Foundation Trust Bereavement Office http://www.nnuh.nhs.uk/Dept.asp?ID=203&q=post,mortem Funeral Directors – (National) www.yourfuneralchoice.com 21 www.funeralzone.co.uk This information can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages upon request from the Bereavement Team Comments and Feedback You may wish to talk over your recent experiences with your family doctor, nurse, social worker, hospital chaplain or the Patient Advice and Liaison Service (PALS) at the hospital The Norfolk & Norwich University Hospital aims to provide the best possible service for patients and families, and welcomes feedback, both good and bad, on the service If you have any comments on the service you have experienced, you can make your comments to the person in charge of the department, or you can write or telephone: PALS Norfolk & Norwich University Hospital NHS Foundation Trust Colney Lane Norwich NR4 7UY Tel: 01603 289036 We hope that this leaflet has been useful to you during the first few difficult days following your bereavement If you have any further queries, or in need of any further advice, please not hesitate to contact the Bereavement Office at the Norfolk & Norwich University Hospital on (01603) 287165/6 If at a later date, you feel that you would like to comment upon any of our services provided by the Trust, please write to: Chief Executive Norfolk & Norwich University Hospital NHS Foundation Trust Colney Lane, Norwich NR4 7UY Acknowledgement and thanks The NHS is very grateful to everyone who has contributed to the development of this information In particular, they would like to thank all of the families who very kindly shared their experiences, expertise and feedback to help develop this resource 22 This information has been produced in parallel with ‘Learning from Deaths - Guidance for NHS trusts on working with bereaved families and carers’, which can be found at https://www.england.nhs.uk/LfDinvolvingfamilies NOTES 23