Musgrove Park Hospital Paediatric Bereavement Booklet
Somerset NHS Foundation Trust would like to offer you our sincerest condolences at this difficult time. We know that the death of a baby or child is very distressing.
The Children’s Bereavement team, together with the Bereavement & Medical Examiner Office staff of Somerset NHS Foundation Trust are available to help and guide you through the next few days and to ensure that the practical arrangements are handled in a sensitive and timely manner. This booklet aims to explain what happens next; including information about how to comment on the care your child received and what happens if a death is followed up by His Majesty’s Coroner.
It provides details of the processes involved if you have any significant concerns about the care we provided and gives you practical advice, support and information. You may wish to share this with other members of your family so that they have the information.
Initial Advice
Telephone the Bereavement & Medical Examiner Office at your respective hospital after 10am the next working day following the death or after 11am following a Bank Holiday. Our number is:
Musgrove Park Hospital - 01823 343753
Yeovil Hospital – 01935 384746
We are here 10am to 4pm, Monday to Friday, except Bank Holidays.
We apologise if you connect to an answer phone when you call us or if the line is engaged for long periods, we may be talking to another bereaved family. Leave a message and we will return your call as soon as possible.
We advise you not to make a date for the funeral or an appointment with the Registrar until you have spoken to us. You may wish to speak to a Funeral Director.
It is helpful for us to know if the funeral will be a cremation or a burial, as this makes a difference to the paperwork we complete. We do understand this may not have been decided when you first contact us. You can call back to inform us of your decision.
Medical Examiner Service and Medical Certificate of Cause of Death
Somerset NHS Foundation Trust provides a Medical Examiner (ME) Service, which is a national system for reviewing deaths that occur in hospital and in the community. The ME is a senior doctor working in the Trust, who is independent and was not involved in the patient’s care and treatment.
With the assistance of trained Bereavement and Medical Examiner Officers (B&MEO), they will review all deaths within the hospital and the community to establish the cause prior to the issuing of the Medical Certificate of Cause of Death (MCCD). Following this review, the ME or one of the B&MEOs, will contact you. This will be a routine call which will give you the opportunity to discuss the care and treatment your loved one has received and share any feedback you may have. The B&MEOs are able to answer any questions you may have on further practical steps you need to follow in the days to come.
Following discussion with the ME, the doctor who cared for and treated your child will endeavour to complete the MCCD as soon as possible.
Sometimes this can take a little longer due to the availability of the doctor and, in some cases, the ME or the treating doctor may need to speak to HM Coroner before we can issue the MCCD. The B&MEO will be able to explain if the coroner is needed to be involved and why. They will also keep you up to date should any delays occur.
There is further information on Coroner’s referrals on page 8.
Can I donate any of my child’s tissue?
Every year the lives of many people are changed with the help of donated tissue. You may not realise that donated tissue, such as eyes, skin, bone, and heart valves can save or dramatically improve the quality of life for others.
Dependent on the circumstances your child may be able to donate one or more different tissues, offering invaluable help to others.
Tissue donations are best undertaken within 24 - 48 hours of death. We recognise that a decision such as this is personal, and there is absolutely no pressure or need to discuss this if you do not wish to do so. If you would like more information about donations, speak with a member of staff as soon as possible.
Spiritual Care
Irrespective of your faith group or religion, the Hospital Chaplains can offer support to you and your family, if you would like it. They are available seven days a week and can be contacted on:
Musgrove Park Hospital
Level 1 of the Duchess Building
Telephone: 01823 342515
Yeovil Hospital
Level 4
Telephone: 01935 384357
The Chaplains can put you in touch with officiants of other religions.
Paying last respects
Unfortunately, neither Musgrove Park Hospital or Yeovil Hospital have any viewing facilities however we may be able to facilitate a viewing in extenuating circumstances. Please contact the Bereavement & Medical Examiner Office if this is something you would like to request, but please note this cannot be guaranteed.
If you wish to see your child again before the funeral you may feel that a Funeral Director’s Chapel of Rest would be a more appropriate place to do so.
If HM Coroner is, or is likely to be, involved in your child’s case, then we are unable to facilitate a viewing without the permission of HM Coroner and it would need to be discussed with HM Coroner’s Officer who is dealing with your child’s case.
How do I obtain my child’s death certificate?
You can obtain a copy of the death certificate following the registration of their death with Somerset Registration Service. You can only register a death once the Medical Certificate of Cause of Death (MCCD) has been issued. The team caring for your child or the staff in the Bereavement & Medical Examiner Office will contact you when the MCCD is completed and explain what your next steps are.
If your child’s death is being investigated by HM Coroner, then your child’s doctor will not be able to issue the MCCD. In these circumstances, HM Coroner’s Office will advise you when and how you can register your child’s death and obtain the death certificate.
Choosing a Funeral Director
You do not have to wait until you have the Medical Certificate before you speak to a Funeral Director. We would ask you not to confirm any date for the funeral until you know an appointment has been made for you to collect the paperwork.
When choosing a Funeral Director, you should feel comfortable and confident with them. Funeral Directors can manage all or part of the funeral arrangements. They can give advice on available options and provide support to help you make decisions.
Bereaved parents no longer pay the cost of their child’s burial or cremation. The Children’s Funeral Fund for England opened on 23rd July 2019 and covers costs for children under 18 and stillbirths after the 24th week of pregnancy. The scheme is open to all regardless of a family’s income. Through the scheme, funeral providers are reimbursed for burial and cremation costs and for providing a coffin, shroud or casket so that parents do not have to worry about those expenses.
Parents can claim through the scheme themselves if they choose not to use a Funeral Director.
The Funeral Director needs to know and discuss with you:
• The name, age and religion of the child who has died
• The place of death
• Any requests left by the child who has died
• Whether you would like a burial or cremation
• The style of coffin
• The type of service, hymns, cars, flowers, newspaper notices (if any), etc.
A list of Funeral Directors in the Somerset area is provided on pages 28-32.
Registering the death
The death must be registered at any Registry Office in Somerset. Call 01823 282251 to book an appointment directly with the Registry Office.
The person registering the death must be one of the following:
• a relative of the deceased, present during the last illness
• a person who was present at the time of death
• a person making the funeral arrangements
The person registering the death will be required to show ID such as a driving licence or passport.
The Registrar will ask you for the following information regarding the person who has died:
• The date and place of death and their usual residential address
• Full name
• Date and place of birth
• Occupation if they were old enough to be in employment.
• Whether an allowance from public funds was being paid.
The
Registrar will give you
• Certified copies of the Death Certificate
The Somerset County Council leaflet within this pack provides details of who may require a certified copy of the Death Certificate and information about the Tell Us Once service. This leaflet is for guidance only and you should still check for other people you need to contact independently.
• Form BD8 (white form)
Only applicable if not using the ‘Tell Us Once’ service.
• A certificate for burial or cremation (green form)
This allows a burial/cremation to take place and should be handed to your Funeral Director as soon as possible
Coroner’s Referrals
Under certain circumstances the involvement of His Majesty’s Coroner may be necessary. Examples are:
• all sudden and unexplained deaths
• where the cause of death is unknown and a doctor cannot issue a certificate
• any death through unnatural or suspicious causes, for example suicide, violence, poisoning, accidents
• if the death occurred resulting from an operation or procedure
HM Coroner for Somerset is an independent judicial officer who enquires into those deaths that fall into the above categories.
HM Coroner’s Officers are independent representatives and work to the guidance of HM Coroner. They will be contacted by the doctor and HM Coroner who will decide one of 3 things:
• that the death was from natural causes and the doctor is permitted to issue the Medical Certificate of Cause of Death
• the cause of death is unknown, and a post-mortem examination is required
• the cause of death is unnatural, and an inquest is to be held
Post Mortem Examination
HM Coroner is legally empowered to request a post-mortem, and your consent is not required. You will be informed if a postmortem is necessary by the HM Coroner’s Officer responsible for your child’s case. If you have any concerns, you can discuss these with him/her. Your child may need to be moved to another hospital so that a specialist paediatric pathologist can carry out the examination on behalf of HM Coroner. If so, this will be discussed with you before it occurs.
Following the outcome of the post-mortem, HM Coroner’s Officer will contact you to inform you of the result. They may ask which Funeral Director you intend to use and whether burial or cremation is to be arranged.
Inquest
If the death is from unnatural causes, or there is need for further enquiry following a post-mortem, HM Coroner will open an inquest into the medical cause and circumstances surrounding the death. HM Coroner’s Officer will explain the details to you at the time. The inquest will be adjourned and re-opened at a later date. In this situation, HM Coroner will normally issue an interim Death Certificate which will enable you to register the death and make funeral arrangements. Following the inquest HM Coroner will send HM Coroner’s Certificate to the Registrar to allow the death to be formally registered and the full death certificate to be issued accordingly.
A Bereavement & Medical Examiner Officer will tell you if your child’s case needs to be referred to HM Coroner and why. If we do not refer a death to HM Coroner, but you have any concerns relating to the treatment that has been provided by the Trust, you can ask HM Coroner to consider holding an inquest. Do this as soon as possible after your child has died as delays in requesting an inquest may mean that any opportunity for HM Coroner to hold a post-mortem is lost.
The local Coroner’s Office can be contacted via:
His Majesty’s Coroner, Old Municipal Buildings, Corporation Street Taunton Somerset TA1 4AQ
Telephone: 01823 359271
Email: coroner@somerset.gov.uk
If you are seeking, or involved in, an inquest, independent information, advice or support is available. Details of organisations that can advise on the process, including how you can obtain legal representation, are listed on pages 22-25.
Why were the police and Children’s Social Care called when my child died?
If your child has died suddenly and unexpectedly it is routine practice to inform the police so that they can fully investigate the circumstances of the child’s death, on the behalf of HM Coroner. Usually, shortly after your child has died, a senior police officer will speak with you to understand the circumstances of your child’s death. Ask the duty staff if you wish to have a member of the nursing or medical team with you for support during this discussion.
It is routine practice to inform the local Children’s Social Care (CSC) of every child that dies, who normally resides within their locality. This is because CSC will be a part of the Child Death Review process, a normal pathway followed after the death of a child.
What is the Child Death Review process?
It is important that there is a review of every child’s death to learn as much as possible. This review is designed to support you and other members of your family in understanding why your child died. It will try to prevent other children dying from the same cause. There are some elements that take place for every child death, and some that may not be needed depending on the circumstances. Sometimes, other reviews are undertaken alongside the Child Death Review.
The Child Death Review process is split into four stages:
• Immediate response – sharing information between relevant organisations about the circumstances of your child’s death, safeguarding and supporting bereaved families.
• Information gathering – this may be in the form of a multiagency meeting and/or information sharing to have a full understanding of the circumstances of the child’s death, including the outcome of any relevant local investigations, and post-mortem reports.
• Child Death Review Meeting – a multi-agency meeting of professionals known to the child and family to undertake a local review to identify local learning and review the support available to the child’s family.
• Child Death Overview Panel – a regional anonymised review of the case to identify trends, themes, and learning for child deaths across a specific geographical region.
For further information on the child death review process, please visit the National Child Mortality Database guide: www.ncmd.info/publications/when-a-child-dies-aguide-for-parents-and-carers/
Or scan the QR code to be taken straight to the guide.
Providing feedback, raising concerns or making a complaint
Providing feedback: We value and welcome your thoughts about your child’s care. Receiving feedback from families helps us to understand:
• what we are doing right and need to continue; and
• what we need to improve upon.
Raising concerns or complaints: It is very important to us that you feel able to ask questions and raise concerns regarding the care your child received. You can do this by informing the staff in the Bereavement Office, as they may be able to answer your concerns by reviewing the notes. If there are any serious care concerns, we will highlight these to our Learning from Deaths Lead within the Trust who will investigate these further.
If you would prefer to discuss your concerns with someone not directly involved in your child’s care, contact our Patient Advice and Liaison Service (PALS) on:
Telephone: 01823 343536 or email: pals@somersetft.nhs.uk
Who do I need to tell that my child has died?
Your child’s GP, school, or college should have been notified of your child’s death very quickly, but some families wish to contact them directly as well. There may be other professionals/services involved with your child and family, your key worker can support you in identifying and informing them.
There may be other places that have your child’s details such as banks and building societies, local groups, religious organisations, clubs, dentists, and opticians who you will need to inform at some point.
If you joined any baby or child groups, such as supermarket clubs or online clubs, you will need to tell them that you do not wish to receive any more information. Otherwise you may continue to be contacted with offers and information about your child’s expected progress. The Mailing Preference Service can help with this; you can register online at www.mpsonline.org.uk
What about my child benefit and other payments?
If you have received benefits for your child, either in payments or equipment, these will usually continue for some weeks after your child has died, but the timing differs for different types of benefits. It is up to you to contact the agencies that provide your benefits. Do not delay this or you may be overpaid and have to repay any overpayments.
This can be difficult to do, so it might be a task you ask someone to help you with.
Child benefit is paid for up to eight weeks after a child dies, but you will need to ensure that you have informed the child benefit office. You can do this either online through the www.direct.gov.uk website or by contacting the child benefit office on 0300 200 3100.
What about my child’s social media pages?
If there are photos of your child on social media you may wish to reconsider your privacy settings. These could be reused without your permission if they are publicly accessible.
If your child had their own social media accounts, you can either deactivate them, turn them to a ‘memorialised’ account or leave them as ‘live’ accounts. To change the accounts, you will need to provide proof of your relationship and your child’s death certificate to the social media provider.
Facebook, Instagram and Twitter
Access the Help Centre and search ‘deceased family member’. You have the option to memorialise or remove the account. You will need to upload a copy of the death certificate.
What support is there for me as a bereaved parent?
The death of a child is the most traumatic experience that a parent can face. There is no normal or right way to feel or behave, and most people experience a range of emotions. Many parents experience feelings of sadness and despair, guilt, numbness and emptiness, and even a sense of relief in certain circumstances. Parents and family members often grieve in different ways and process their grief at different rates. Talking to family and friends about your child and your grief is often helpful, but many parents feel they need additional support.
There are several local and national organisations listed at the end of this booklet who can support you.
Returning to work
Returning to your place of employment might not be something you can consider at this stage. From April 2020 in the UK, employed parents are entitled to two weeks paid bereavement leave to be taken within 56 weeks of the date of death of their child. Your employer may make their own decision regarding any additional compassionate leave you may be entitled to.
You can self-certify sickness absence for the first week, and then you will need to visit your GP for a ‘fit note’ to continue to take sick leave. Contact your workplace, or ask someone else to, if you need more information about your employer’s position and your right to paid leave.
How can other family members and friends support me?
Bereaved parents often find it difficult to talk about their grief and to ask for help or support. You can share this page with family and friends to guide them as to how they may be able to support you.
What do I say?
Often people are worried about saying the right or wrong thing to a bereaved parent. Acknowledging their bereavement and saying “I am sorry” as soon as possible after the death of the child or saying “I don’t know what to say” is better than avoiding the subject completely.
Be guided by the individual, some parents wish to talk about their child, others may prefer not to. Use the child’s name and do not be afraid to share any memories you may have. Do not assume to know how they feel or what they need.
Be patient with them. Bereaved parents experience a whole range of emotions and it may sometimes feel as if you cannot say or do anything right. Knowing you are still there to support them when they are ready, whether that is in weeks, months, or years is important.
What can I do?
Ask the parent what they need and be honest with them and yourself about what support you can offer.
Practical support, such as preparing a meal, offering lifts to school for other siblings or appointments, and finding information can be very helpful for some families. Emotional support such as, listening, giving a hug and, remembering special days and anniversaries is just as important.
How do I tell my child’s siblings, and what support is there for them?
Children’s understanding of death changes as they grow and develop a greater understanding of the world in which they live. Like adults, children grieve in many ways and may experience a range of emotions following the death of a loved one.
Infants
Infants have no understanding of death but from an early age will sense that an important person is missing. They may cry more, and older infants may search for the person who has died.
Pre-school age children
Young children begin to develop an interest in the idea of death but cannot understand the permanence of it. They may show a lack of emotion or ask lots of questions. They often ask when the person who has died will return as they expect them to do so. Young children may have disrupted sleep, show changes in behaviour and regression in development.
Primary school age children
Children of this age begin to understand that death is permanent and irreversible. Not being given sufficient information can lead children to ‘fill in the gaps’ with their imagination. They can become anxious about their own and other’s safety.
At this age children need honest answers which can be built upon over time. They need opportunities to express their concerns and feelings to a trusted adult.
Teenagers
Teenagers have an adult understanding of death but may have their own strong beliefs. Bereaved young people often struggle to ask for support and can feel extremely isolated. Some young people may become withdrawn whilst others may become disruptive or increase their risk-taking behaviours.
All infants, children, and young people
Regardless of their age, bereaved children benefit from having a key person who they can trust, talk to, and be reassured by. It is important to give children age-appropriate honest information following the death of a loved one and to include and involve them in the funeral, memorials, and any decision making. Maintaining a routine, including school attendance, and ‘normal’ boundaries is helpful for grieving children.
Your child’s nursery, school, or college can offer support for them in their setting. Your child’s health visitor or school nurse can support you with any behavioural changes your child may display or experience whilst grieving.
Your key worker and other professionals can direct you to specialist services to support bereaved children locally if required.
For further information about children’s reactions to grief and how to support them, visit the Child Bereavement UK website, www.childbereavementuk.org
Further information and support
Practical Do’s and Don’ts
Do
• Choose a Funeral Director with whom you feel comfortable
• Express your emotions
• Talk about what has happened with your family, close friends or a sympathetic group
• Eat properly and rest
• Guard against accidents in the home
• Make sure your home is secure
• Consult your doctor if your health is a worry
• Contact ‘Cruse’ or another group if you need extra support (contact numbers on page 22)
Don’t
• Hide or suppress your feelings
• Let family or friends hurry you into making decisions or doing things until you are ready, for example sorting out your child’s belongings before you are ready to tackle that task yourself
• Enter into any financial arrangement you do not understand
• Turn to drugs or alcohol
• Allow the funeral to be rushed or unnecessarily expensive
• Move home or make any major life changes or decisions whilst you are still grieving
• Hurry the healing process. Take it at your own pace
Bereavement is a distressing experience we all encounter during our lives. Yet it is something few of us talk about, resulting in little opportunity to learn of how to cope with the death of someone close to us. Grieving is a natural process that usually takes place after any death, but most powerfully after the death of someone that we love.
For any further information on coping with grief and the support available to you, contact the Bereavement Office.
Advice and Support
2 Wish
Providing bereavement support to all those affected by the sudden and traumatic death of a child or young adult aged 25 or under.
Supports bereaved children, teenagers and parents.
Telephone: 0800 02 888 40
Email: helpline@childbereavementuk.org
Website: www.childbereavementuk.org
Children’s Hospice Southwest
Charlton Farm (Somerset), Little Bridge House (Devon) and Little Harbour (Cornwall)
Website: www.chsw.org.uk
Citizens Advice Bureau
Telephone: 03444 889 623
Website: www.citizensadvice.org.uk
Compassionate Friends
Support for bereaved parents, of all ages, and their families.
Telephone: 0345 123 2304
Email: helpline@tcf.org.uk
Website: www.tcf.org.uk
Cruse Bereavement Care
Provides counselling and support to all bereaved people irrespective of age.
National telephone helpline: 0808 808 1677
Email: info@cruse.org.uk
Website: www.cruse.org.uk
Genetic counselling information
www.nhs.uk/conditions/genetic-and-genomic-testing
Josephine’s Star
Support to children and their families in Somerset when someone special has died. We are a charity formed by a small group of professionals who know how important it is for children to have the opportunity of support in their grief.
Email: referral@josephinesstar.org.uk
Website: www.josephinesstar.org.uk
Lullaby Trust
Supports people affected by the sudden and unexpected death of a baby. Telephone helpline and signposting to other local organisations if one-to-one support is more appropriate.
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. They have expertise where bereavement or end of life care are a factor.
Telephone: 03333 447928
Email: reception@swanadvocacy.org.uk
Website: www.swanadvocacy.org.uk
The Good Grief Trust
Practical and emotional support for anyone who has been bereaved. Over 700 support networks under one umbrella
Email: hello@thegoodgrieftrust.org
Website: www.thegoodgrieftrust.org
The Rosie Crane Trust
Support for bereaved parents through their grief after the loss of a child of any age.
This list of contacts is just a selection of what is available and is not exhaustive. If you require any specific advice or support, contact the Bereavement & Medical Examiner Office or the Chaplaincy team who can signpost you to the most appropriate agency.
Further information
If you have any questions or concerns about how your information is used, contact the Bereavement Team in the first instance. You can contact the Data Protection Officer via email: Louise.Coppin@SomersetFT.nhs.uk
More information about Data Protection and how it applies to you can be found on the Information Commissioner’s Office website at www.ico.org.uk
Taunton
Funeral Directors from the region
If any of the information contained in this pack is incorrect, for example, contact numbers and/or details, please inform the Bereavement and Medical Examiner Office on 01823 343753.
Reference: Somerset Foundation Trust Paediatric Bereavement Booklet
