We would like to express our condolences to you, your family, and friends during this extremely sad time.
When someone dies there are many decisions and arrangements to be made which can be upsetting at what is already such a sad time.
The days following a bereavement can be extremely hard but there are formalities which must be dealt with promptly. We hope that you will find this booklet helpful the arrangements that need to be made. It is designed to provide practical advice and guidance on who can help and where further information can be obtained, as well as explaining procedures such as registering a death and arranging a funeral.
This booklet also aims to explain what happens next, including information related to Medical Examiner and Coroner referrals, we welcome feedback from you. The booklet provides details of the processes involved if you have any significant concerns or compliments regarding the care and support, we provided to your loved one and your family.
Guidance and who to turn to
If you are unclear about any matter, please ask for help or support from any of the following people: the ward staff and clinical teams who cared for your loved one, hospital chaplains, your GP, or our Patient Experience Team. Funeral directors are extremely helpful and will guide you as much as they can.
Contacting us via the Patient Experience Team
Telephone: 0151 556 3093 / 3091
Email: wcft.patientexperienceteam@nhs.net
Write: Patient Experience Team, Sid Watkins Building, The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool, L9 7LJ
Please note if your loved one died over a weekend, the team should be contacted on the next Monday morning.
Understanding what happened
As a family member, partner, friend, or carer of someone who has died whilst in the care of The Walton Centre, 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 do not worry if you are not ready to ask these questions straightaway, or if you think of questions later. You will have the opportunity to raise these with us when you are ready through the Patient Experience Team.
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.
What to do first
In the first instance, the ward staff will advise you to contact the critical care administration team after 10am the next working day to discuss the contact details of the person you wish the team to communicate with. Our staff will explain what you need to do next and help with any immediate questions you may have.
Contact details: Tel: 0151 556 3462
Office hours: 9.00am to 4.00pm Monday to Friday (excluding Bank Holidays).
All deaths are reported either to the Medical Examiner or HM Coroner by the medical team. The ward staff will inform you which referral is required.
When the referral is received, the Medical Examiner Team or Coroner’s’ officer will contact you and inform you of the suggested cause of death. Once verified, they will provide you with the contact details for you to make an appointment with the Liverpool Register Office.
Please do not make an appointment with the Register Office until you have been advised the required forms have been completed.
The ‘green form’ that the funeral directors require will be emailed directly to the cemetery or crematorium office by the Register Office.
Personal items of the deceased person will be stored securely in the ward area/hospital safe. You will need to contact the ward to arrange an appointment for the collection of these items.
Contact details
The Walton Centre NHS Foundation Trust: 0151 525 3611
The body of the deceased is held within the Aintree University Hospital Mortuary until the death has been registered at the Liverpool Register Office and arrangements have been made with your chosen Funeral Director. The mortuary does not have a Chapel of Rest but does have a designated area for viewing and identification.
Requests for appointments for viewing by family and friends should be made by calling 0151 529 3482 Mon to Fri 9.00am to 4.30pm.
The Medical Certificate of Cause of Death (MCCD)
The team who looked after your loved one will complete a referral to the Medical Examiner or HM Coroner and complete a Medical Certificate of Cause of Death, the MCCD is a legal document which enables a death to be registered and a formal death certificate to be issued. The certificate can only be issued by a doctor who knows the cause of death.
The Medical Examiner
The Medical Examiners (ME) are senior doctors who have received specialist training in the clinical and legal elements of the death certification processes. The ME is always independent of the case and will not know or have treated the deceased person on which they are conducting scrutiny of the circumstances of death.
They will :
• Complete a review of the medical, nursing, therapy, and diagnostic records.
• If necessary, speak with the attending doctor.
• Contact the nominated next of kin (by phone) to explain the cause of death and establish if you have any concerns with the care the deceased received that could have impacted or led to the death.
This is your opportunity to have an open and honest conversation with a professional not involved in providing care to the person who died. However, it is voluntary, and you do not have to speak to them.
Registration of death
The ME team will advise you when the MCCD has been forwarded to the Liverpool Registrar’s office and how to make an appointment to register the death. This will be a face-to-face appointment (see death registration by declaration). Deaths should be registered within five days (including weekends and bank holidays).
If available, you will need to take:
• The deceased‘s NHS Medical Card (if possible).
You will also need the following information.
• Full name and usual address (birth name if applicable).
• Date and place of birth.
• The date and place of death.
• Occupation and occupation of spouse if married/civil partnership.
• Details of any public sector pension e.g. civil service, teacher or armed forces.
• Details of State Pension and benefits received.
• The name and date of birth of any surviving widow/widower or civil partnership.
Where to register the death
The death must be registered at the Register Office for the district where death occurred, no matter where the deceased lived.
Contact details:
Liverpool Register Office
St Georges Hall
St Georges Place L1 1JJ
To make an appointment to register a death please ring 0151 233 3004.
Hours of attendance Monday-Friday 9.15am - 4.15pm.
Email: registrar@liverpool.gov.uk
Alternatively, you can book online at www.liverpool.gov.uk and navigate to the section on births, marriages, deaths.
Who can register the death?
A relative should register the death.
If a relative cannot register the death, you can nominate another person to complete if:
• they were there at the time of death.
• they are an administrator from the hospital (if the person died in hospital).
• they are responsible for making funeral arrangements.
The death certificate will be issued on the day of the appointment. Please note if English is not your first language you may need to take someone with you to interpret.
Registering a death by declaration
By UK law, a death must be registered at the Register Office in the district where the death occurred. If you are not able to travel to Liverpool Register Office, you can contact your local Register Office to enquire about making registering the death by declaration. This applies to England and Wales.
The Isle of Man (IOM) is outside of UK law and a death of an IOM resident in England or Wales cannot be registered by declaration. We understand this may require a relative to stay in Liverpool to attend the register office and this may cause you further distress at a difficult time.
Please speak to the staff who looked after your loved one – we will try to assist you with the registration process.
If the death is referred to HM Coroner
Under certain circumstances (see below) the doctors at The Walton Centre will not be able to issue an MCCD, in such cases the doctor must refer to HM Coroner.
Such circumstances are:
• All sudden and unexplained deaths, where the cause of death is unknown.
• Where the cause of death is unnatural, e.g. suicide, accidents, poisoning.
• If the death occurred while the patient was undergoing a medical procedure or has had surgery within 24 hours.
• If the deceased was initially admitted to hospital because of a trauma (including falls).
• If the death was caused by an industrial disease.
• Custodial death, arrested by the police, detained in prison or under the Mental Health Act.
If the death is to be reported to the coroner, they may ask the team who cared for the deceased for more information, and they will also contact you. The coroner will decide what happens next. The involvement of the coroner may cause some delay. It is important to advise your funeral director as soon as possible if a coroner referral has been made.
Coroners post-mortem examination
The coroner may decide a post-mortem examination is required to determine the exact cause of death. If so, this is a legal obligation and there is no right of refusal. In such circumstances, a certificate of death required to register the death will be issued by the coroners’ office and sent directly to the Registrar’s office.
Contact details for HM Coroner
0151 233 5770 or 0151 233 0141
Monday-Friday 8.30am - 4.15pm
Address: Liverpool Coroner’s Office, Gerard Majella Courthouse, Boundary Street, Liverpool L5 2QD.
If an inquest is held
The death cannot be registered until after the inquest, however the coroner can give you an interim death certificate to prove the person is dead. You can use this to let organisations know of the death and you will be able to hold the funeral.
At some time in the future, the inquest will be convened. The family can listen to all the evidence with the coroner and ask any questions they like. At this stage, documentation will be sent to the Registrar of Births and Deaths and a death certificate issued.
Hospital post-mortem
There are occasions when the clinical team involved in the care of the deceased may ask for consent to conduct a hospital postmortem examination. You will be given every opportunity to discuss the circumstances with a clinician before making your decision and sign the necessary forms.
The post-mortem examination is carried out sympathetically and should not delay the funeral arrangements and the findings may assist in the treatment of other patients in the future.
The results may be obtained from the deceased’s GP.
* By consenting to this examination, you are still able to collect the Medical Certificate of Cause of Death, register the death and make the funeral arrangements. There is no delay in arranging the funeral.
Reviews of deaths in our care
All hospitals are required to review the care of people who have died in hospital.
A specialist doctor who was not directly involved in the deceased patient’s care will conduct a detailed case note review. They will look at every aspect of care and how it was provided. When a routine review finds any issues with a patient’s care, we will contact the family to discuss this further.
When conducting a case note review, we also consider any concerns raised by family, friends or staff regarding the care we provided to a patient. We consider a concern to be:
• any concerns raised by the family that cannot be answered at the time; or
• anything that is not answered to the family’s satisfaction, or which does not reassure them.
Investigations
All hospitals have a duty to be open and honest in the event of any incident where harm may have been caused to a patient. 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 patient’s receiving healthcare. Where there is a concern that a patient safety incident may have contributed to a patient’s death, a safety investigation will 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.
In some cases, an investigation may involve more care providers than just The Walton Centre. For example, your loved one may have received care from several organisations. After the draft report has been agreed, the trust will plan to meet with you to discuss the findings of the investigation. to identify if anything could have been done differently and if the care provided was timely and appropriate.
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 booklet. You are welcome to bring a friend, relative or advocate with you to any meeting.
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 (www.cqc.org.uk/guidanceproviders/all-services/regulation-20-duty-candour).
Action Against Medical Accidents, (www.avma.org.uk) has produced information for families on Duty of Candour which is endorsed by the Care Quality Commission.
Who needs to be told about the death
You will probably want to let the family, friends and neighbours know of the death right away. There are several other people who may also need to know. These are:
Done
The Priest, Vicar or Minister of other Faiths
Family Doctor
The Benefits Agency (pensions, benefits)
The Bank, Giro, Credit Cards, Building Society
Social Services (home helps, home care)
Schools, College or University attended
Place of Work (occupational pension)
Executors of the Estate (Will)
Solicitor
Insurance Companies
Library service
Inland Revenue
Residential or Nursing Home
Landlord, Housing Department
Council Tax Offices
Electricity, Gas, Telephone, Water Companies
Post Office (redirect mail)
D. V. L. C. Swansea
Careline
Cancel any appointments
The deceased may have been living alone so you will need to ensure that their home is secure and remove all signs that indicate no-one is there. You may wish to collect spare keys from other relatives, friends and neighbours.
Tell Us Once
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.
Tell Us Once is an optional free service that lets you report a death to most government organisations and council departments in one go. This means you won’t need to contact individual organisations or send copies of death certificates.
When you register a death, the registrar will ask if you want to use the Tell Us Once service. If you do, they will give you a unique reference number to access the service online or over the phone.
The deceased may have been living alone so you will need to ensure that their home is secure and remove all signs that indicate no-one is there. You may wish to collect spare keys from other relatives, friends and neighbours.
Sample letters
On the following page is an example of a letter that you may find useful when informing people about the death.
Please note if you are writing to a solicitor, bank, building society or insurance company you will need to include a copy of the death certificate. Photocopies are not accepted for insurance or legal reasons. You may need to include the relevant account and policy numbers if available.
[Your Name] [Your Address] [Your Postal Code] [Your Telephone Number]
Date:
[Address to whom you are writing] [Name] [Department] [Company] [Road] [City] [Postal Code]
Dear Sir/Madam,
I wish to inform you of the death of [name of deceased and date of birth].
Please find enclosed with this letter the documentation/papers which need to be returned to you.
[Name of deceased] died on or at [hospital name or home address] on [date].
If you require any further information please contact me at the above address.
Yours faithfully [Your name]
Stopping Junk Mail to the recently deceased
By registering with the free service www.stopmail.co.uk the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks. If you cannot access the internet you can call 0808 168 9607, where you will be asked for very simple information that will take only a few minutes to complete.
This free of charge service provided by the Bereavement Support Network will actively reduce the 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. Additionally 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.
Grieving
Bereavement is something which most of us experience at some time in our lives and loss can be distressing and hard to accept. We may feel confused and overwhelmed by sadness or other strong emotions. Certainly, in the beginning, there are a few reactions that should be considered as unusual.
Initially when someone you know dies it may be hard to accept. You may feel shocked or numb, or on the contrary, you may experience everything with increased sensitivity. It is also not unusual to feel as if nothing is different at this moment in time.
Some cultures have strong rituals during this period or in the period immediately prior to death. Rituals differ – some encourage people to display their grief, others to focus grief inwardly. It is important that you and those around you find your own ways of expressing your feelings and continuing with your lives.
Sometimes people who are grieving are concerned that they are losing their mind. It may be that you will look for the person in a crowd or think you have seen them or heard their voice. You may also have dreams where you are searching for them – this can often happen when you are longing to hear or see someone again.
If you have lost someone who has been a big part of your life, your home may seem very empty, and the feeling of isolation can be painfully strong. You may also find that friends and neighbours sometimes avoid you probably because they find it difficult to know what to say to you. It may be helpful if you can take the first step. Let them know that you miss their friendship and support as they might miss yours.
With the passage of time, you may find that painful memories happen less often and that you are able to remember the person who has died without becoming too distressed.
The end of the grieving period has come when you can continue to live your own life in a good way, and you have been able to give the deceased an appropriate place in this next phase of your life.
The process of grieving
When someone close dies, feelings of shock, denial, sadness, anger and depression may follow.
Often at times these feelings are accompanied by physical symptoms like a lack of energy, knotted stomach, loss of appetite and feeling disorientated.
Recognising that these symptoms are normal responses to the death of someone close to you is the first step in the process of grieving.
When to seek professional help
The following is a list of symptoms and feelings often associated with grief. Whilst these can be a normal part of grieving, if they persist and make it difficult to manage day to day tasks you may wish to seek professional help if you:
• Are always feeling exhausted, anxious, suicidal, depressed, helpless, experiencing uncontrollable anger, sleeplessness or feeling stressed.
• Are becoming withdrawn and unable to speak to or spend time with family and friends, or finding it difficult to cope at work, school, etc.
• Are becoming dependent on drugs or alcohol.
• Have little desire to get involved in activities you once enjoyed.
Your family doctor may be able to help particularly if you are worried about your own health.
Some do’s and don’ts
It is generally agreed that the following may be helpful at this difficult time.
• Do express your emotions.
• Do remember that you need time to rest, think and sleep. Try to keep fixed eating and sleeping times.
• Do let children talk about their emotions and express themselves.
• Do send children back to school and let them continue with their usual activities.
• Do be gentle with yourself. If you have had a bad day, put it behind you and have another go.
• Do allow yourself time to grieve, in the way that feels right for you. Remember, there is no right or wrong way to grieve.
• Don’t stifle your feelings.
• Don’t avoid talking about what has happened.
• Don’t forget that children experience similar feelings and need to share in the grief process.
Department of Spiritual Care
The Hospital Chaplains are here to offer support. The Hospital Chaplaincy is a multi-faith department within the hospital, representing the Christian (Church of England, Roman Catholic and Free Church), Jewish and Muslim religions. The Chaplains based in the hospital (Church of England, Roman Catholic and Free Church) offer a 24-hour service for situations where an immediate response is required.
The simplest way to contact the hospital-based chaplains is to ask any member of staff to bleep them. Alternatively, they can be contacted through the hospital switchboard and staff will contact you or help you to leave a message.
Tel: 0151 529 3611.
Counselling and support organisations
Your family doctor will be able to listen and offer emotional support but if you need more time to talk or longer-term support, a counsellor may be able to help. Some large GP practices have counsellors at their surgeries, or you may wish to contact one of the support organisations.
The Good Grief Trust
Website: thegoodgrieftrust.org
E-mail: hello@thegoodgrieftrust.org
The Good Grief Trust is run by the bereaved for the bereaved and provides practical and emotional support and signposting to a choice of tailored local and national support.
Age Concern Liverpool and Sefton
The Frances Suite
1st Floor, 151 Dale Street
Liverpool
L2 2JH
Tel: 0151 330 5678
Website: www.ageconcernliverpoolandsefton.org.uk
Works with the elderly.
Citizens Advice Bureau
Wavertree CAB Ltd
242 Picton Road
Wavertree
Liverpool
L15 4LP
Tel: 0808 278 7840
Website: www.citizensadviceliverpool.org.uk
E-mail: bureau@wavertreecab.cadnet.org.uk
Advice can be given on all legal and practical matters following a death.
The Compassionate Friends
Kilburn Grange
Priory Park Road
London
NW6 7UJ
Tel: 0345 123 2304
Website: www.tcf.org.uk
E-mail: helpline@tcf.org.uk
An organisation of bereaved parents and their families offering understanding, support and encouragement to others after the death of a child or children. We also offer support, advice and information to other relatives, friends and professionals who are helping the family.
Cruse Bereavement Care
Cruse House
PO Box 800
Richmond
Surrey
TW9 1RG
Tel: 0808 808 1677
Website: www.cruse.org.uk
E-mail: helpline@cruse.org.uk
Offers counselling, support and advice. A newsletter and extensive list of books and leaflets are published.
Independent Order of Odd Fellows
184-186 Deansgate
Manchester
M3 3WB
Tel: 0800 028 1810
Website: www.oddfellows.co.uk
E-mail: info@oddfellows.co.uk
Publish an annual survey of funeral costs.
Lesbian and Gay Bereavement Support
(London Friend)
86 Caledonian Road
London
N1 9DN
Tel: 0207 833 1674 (Evenings: 7.00pm to 10.30pm)
Website: londonfriend.org.uk
Advice and information to lesbians and gay men about bereavement. All the project’s volunteers are carefully selected and receive in-service training sessions.
Telephone Helpline offering advice and emotional support to people bereaved by the death of a same-sex partner. Support would also be given to parents, brothers and sisters, children, other family members, friends, carers, etc.
Liverpool Bereavement Service
1st Floor, Granite Building
6 Stanley Street
Liverpool L1 6AF
Tel: 0151 236 3932
Website: www.liverpoolbereavement.com
Offering one to one counselling and support groups.
Roadpeace
3rd Floor, 3Space
International House
6 Canterbury Crescent Brixton, London
SW9 7QD
Tel: 0845 4500 355
Website: www.roadpeace.org
E-mail: info@roadpeace.org
RoadPeace offers a practical and emotional support service to the bereaved and injured through road traffic accidents.
Stillbirth and Neonatal Death Society (SANDS)
10 - 18 Union Street
London
SE1 1SZ
Tel: 0808 164 3332 (Mon-Fri, 10am- 5pm)
Website: www.sands.org.uk
E-mail: helpline@sands.org.uk
UK-wide network of local self-help groups run by and for bereaved parents.
Support After Murder and Manslaughter (SAMM)
L&DC
Tally Ho!
Pershore Road
Edgbaston
Birmingham
B5 7RN
Tel: 0121 472 2912
Website: www.samm.org.uk
Help, through befriending, for people who have suffered the loss of a child, relative, or friend, of any ages, as a result of murder or manslaughter. Contacts can be arranged through visits and letters or by telephone. Support and encouragement given to the setting-up of local self-help groups to help bereaved family members and friends meets others, similarly bereaved, for understanding and sympathy.
The Samaritans
25 Clarence Street
Liverpool
L3 5TN
Tel: 116 123
Website: www.samaritans.org
Offer a 24-hour telephone support and face to face befriending during the day at their local branches.
Survivors of Bereavement by Suicide (SOBS)
14 - 16 New Lawn Road
Ilkeston Derbyshire
DE7 5HE
Tel: 0300 111 5065 available 9am - 7pm every day
Website: www.uksobs.com
E-mail: email.support@uksobs.org
We exist to meet the needs and break the isolation of those bereaved by the suicide of a close relative or friend.
Offer emotional and practical support in a number of ways: Bereavement Packs
Group meetings (in a number of locations).
Terrence Higgins Trust
439 Caledonian Road
London
N7 9BG
Tel: 0808 802 1221 (10am - 6pm, Monday to Friday)
Website: www.tht.org.uk
E-mail: info@tht.org.uk
Provides practical support, help, counselling and advice for anyone who has lost someone due to AIDS.
Booklets, leaflets and useful addresses may be obtained from your Social Security Office or Job Centre Plus
• What to do after a death in England and Wales. Benefits Agency Booklet D49 (Jan 2002).
• Help with the costs of a funeral from the Social Fund (SF200).
• How to obtain Probate (PA2).
• A Guide to Widow’s Benefit (NAP45).
It is hoped that the information contained within this booklet will be of assistance to you, but if there is any point or problem that you may experience, which is not covered – please ask, we would very much like to help you.
We are determined to provide the best possible service to patients and other visitors to the Trust and welcome all comments on the service we provide, whether good or bad, so that we can act on these comments to continue to improve the service we provide.
If you have any comments on the service you have experienced, you can make your comments to the person in charge of the ward/ department, or you can write to or telephone:
Patient Experience Team
The Walton Centre NHS Foundation Trust Lower Lane Fazakerley Liverpool L9 7LJ
Monday - Friday: 9am - 4pm
Further help and advice: NHS 111 on Tel: 111 Website: www.111.nhs.uk
Reference: The Walton Centre Bereavement Book
Publication Date: May 2025
Review Date: May 2027
Remembering
Everyone will have their own way of remembering the person who has died. Talk about them, mention their name as often as an occasion arises and put the emphasis on the good things that happened when they were alive. Members of the family or close friends might appreciate a photograph or small object as a reminder.
Most important of all will be your own memories.
Death is nothing at all I have only slipped away into the next room. I am I and you are you. Whatever we were to each other that we are still.
Call me by my old familiar name, speak to me in the easy way which you always used. Put no difference in your tone; wear no forced air of solemnity or sorrow:
Laugh as we always laughed at the little jokes we enjoyed together. Play, smile, think of me, pray for me. Let my name be ever the household word that it always was. Let it be spoken without effort, Without the ghost of a shadow on it.
Life means all that it ever meant. It is the same as it ever was; there is absolutely unbroken continuity. What is death but a negligible accident? Why should I be out of mind because I am out of sight?
I am waiting for you for an interval, somewhere very near just around the corner. All is well. Nothing is past; nothing is lost. One brief moment and all will be as it was before.
Henry Scott Holland (1847-1918)
We wish to thank the advertisers and sponsors, without whom this publication would not have been possible.
However the hospital does not endorse any of the products or services they provide.
The Hospital would like to thank RNS Publications for publishing this information and the following pages contain some features from services o ering 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.
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