Information for families following a bereavement
This information has been prepared with the support of families, trusts and other stakeholders.
We are very sorry for your loss
If you have been given this information, you have experienced the death of someone close to you. We are very sorry for your loss and we know that this can be a very difficult and distressing time.
We hope this information will help you understand what you can expect from Lincolnshire Partnership NHS Foundation Trust (LPFT).
This information also aims to explain what happens next, including about how to comment on the care your loved one received and what happens if a death will be looked into by a coroner.
It also 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.
Contacting us
In addition to this information, you should also have received a letter from us either in advance, or accompanying this information.
The letter should have included the details of someone in the Trust who you can contact for support and if you have any questions. Please do get in touch with them 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 Quality and Safety Team on 01522 309549.
Carers Support Service
You may be feeling distressed at this time and want to know where to seek support for yourself.
At LPFT, we have a dedicated carers service to support how you are feeling and to signpost you if needed to other services for support. Please do get in touch with them if you think you need support. Their email address is lpft.carers@nhs.net.
The email address is monitored Monday - Friday, 9am - 5pm, and someone will respond to your email as soon as possible during these times.
Understanding what happened
As a family member, partner, friend or carer of someone who has died whilst in the care of LPFT, 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 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 the Quality and Safety 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.
Practical information, support arrangements and counselling
We can provide you with information about bereavement support services and practical advice about the things you may need to do following a bereavement.
Please let us know if we can be of any help regarding these or other issues. The Gov.uk website (www.gov.uk/after-a-death) also provides practical information on what to do following a death.
We also know that the death of a loved one can be very traumatic for families, 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 may prefer to access.
Some examples of organisations that may be able to help you are included below.
Organisations who can help following your bereavement
Learning from Deaths Lead at LPFT
Telephone: 01529 222213
Survivors of Bereavement by Suicide (SOBS)
National helpline: 0300 111 5065
Email: email.support@uksobs.org or bereaveMENt@uksobs.org
Punjabi Speaking Women’s Group – Contact: birmingham@uksobs.org or 07376 303 438
Samaritans
Telephone: 116 123
Lincolnshire Centre for Grief and Loss
Telephone: 01522 546 168
Email: email@lcgl.org.uk
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, 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.
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.
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, died in a maternity setting, or died 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
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 review of care and treatment will be undertaken.
The purpose of an 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 undertaken, 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 LPFT. 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 and be invited to contribute. This includes commenting on the drafts of investigation reports before they are signed off and prior to sending to the commissioners and CQC. Your comments should be incorporated in the reports.
After the final report has been signed off, the 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. Please see details of independent organisations that may be able to help by clicking here, or finding them further down the page. 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. For more information, please read the Duty of Candour leaflet or visit:
www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-20-duty-candour
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. We will inform you if we have referred the death to the coroner.
If we do not refer a death to the coroner but you have concerns about the treatment we provided, you can ask the coroner to consider holding an inquest. It is a good idea to do 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.
We can provide you with contact details for the appropriate coroner’s office. If you are seeking or are involved in an inquest, you may wish to find further independent information, advice or support.
You can find details of organisations that can advise on the process, including how you can obtain legal representation here, or by scrolling further down the page.
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 the things we are doing right and need to continue, and 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, the Quality and Safety team at LPFT are the best group to answer your questions and concerns. They can be contacted on 01522 309549.
However, if you would prefer to speak to someone who was not directly involved in your loved one’s care, our Patient Experience/Patient Advice and Liaison Service (PALS) team will be able to help and can be contacted on 01529 222265.
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 do 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 state 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. For more information, visit: www.legislation.gov.uk/uksi/2009/309/pdfs/uksi_20090309_en.pdf 8
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) (www.ombudsman.org.uk).
Please note you do not have to wait until an investigation is complete before you complain as 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. Visit: www.ombudsman.org.uk/publications/my-expectations-raisingconcerns-and-complaints
Please see the frequently asked questions section here, or at the end of this page for more information on what to do if you are not happy with the responses you receive from us.
Independent information, advice and advocacy
If you raise any concerns regarding the treatment we gave your loved one, we will provide you with information and support and do our best to answer the questions you have.
However, we understand that it can be very helpful for you to have independent advice. We have included details below on where you can find independent specialist advice to support an investigation into your concerns. These organisations can also help ensure that medical or legal terms are explained to you.
Some of the independent organisations may be able to find you an ‘advocate’ if you need support when attending meetings. They may also direct you to other advocacy organisations that have more experience of working with certain groups of people, such as people with learning disabilities, mental health issues, or other specialist needs.
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. If you would like to use this service, please contact them.
Local/regional organisations
Total Voice
A partnership between VoiceAbility, Barnardo’s and Age UK Lincoln. Total Voice delivers free, independent and confidential advocacy. Advocacy can be vital for people who cannot speak up for themselves or people who feel that they do not have the power to do so.
Telephone: 0300 303 1660
Email: helpline@voiceability.org
Website: www.voiceability.org
Carers First
Support for people who look after a relative or friend who could not manage without their help. Carers First provide emotional and practical support, advice, information and guidance.
Telephone: 0300 303 1555
Email: hello@carersfirst.org.uk
Website: www.carersfirst.org.uk
Cruse Bereavement Centre
Support, advice and information to children, young people and adults when someone dies. Cruse offer face-to-face, telephone, email and website support.
Telephone: 07900 317732
Email: Lincoln@cruse.org.uk
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 be arranged. It can also refer to other specialist sources of advice, support and advocacy or specialist solicitors where appropriate.
Website: www.avma.org.uk
Telephone: 0845 123 23 52
Advocacy after Fatal Domestic Abuse
Specialises in guiding families through inquiries including domestic homicide reviews and mental health reviews, and assists with and represents on inquests, Independent Office for Police Conduct (IOPC) inquiries and other reviews.
Website: www.aafda.org.uk
Telephone: 07768 386 922
Email: info@aafda.org.uk
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.
Website: www.childbereavementuk.org
Telephone: 0800 028 8840
Email: support@childbereavementuk.org
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. The service uses a translation service to support those for whom English is not a first language.
Volunteers who staff the helpline are all bereaved parents, and are supported and trained by professionals.
Website: www.childdeathhelpline.org.uk
Telephone: 0800 282 986
Cruse Bereavement Care
Offers free confidential support for adults and children when someone dies. Contact by telephone, email or face-to-face.
Website: www.cruse.org.uk
Telephone: 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.
Website: 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’.
Website: www.inquest.org.uk
Telephone: 020 7263 1111 (option 1)
National Survivor User Network
A network of mental health service users and survivors to strengthen user voice and campaign for improvements. The website also has a useful page of links to user groups and organisations that offer counselling and support.
Website: 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. The service can also help you make a complaint to the CQC.
Website: www.patients-association.org.uk
Telephone: 0800 345 7115
Email: helpline@patients-association.org.uk
Respond
Supports people with learning disabilities and their families and supporters to lessen the effect of trauma and abuse, through psychotherapy, advocacy and campaigning.
Website: www.respond.org.uk
Telephone: 020 7383 0700
Sands
Supports those affected by the death of a baby before, during and shortly after birth, providing a bereavement support helpline, a network of support groups, an online forum, and a message board.
Website: www.sands.org.uk
Telephone: 0808 164 3332
Email: helpline@sands.org.uk
Support after Suicide Partnership
Provides helpful resources for those bereaved by suicide and signposting to local support groups and organisations.
Website: www.supportaftersuicide.org.uk
Other organisations that may be 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 the Trust, 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.
Website: www.ombudsman.org.uk
Telephone: 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 do not investigate individual complaints.
Website: 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 that reports are not investigated or responded to.
Website: www.england.nhs.uk/patient-safety/report-patientsafety-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
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. More information can be found within the ‘Concerns about nurses or midwives’ section on their website.
Website: www.nmc.org.uk
General Medical Council (GMC)
Clinical Commissioning Groups pay for and monitor services provided by NHS Trusts. Complaints can be made to the relevant CCG instead of the Trust, if you prefer. Please ask us for contact details of the relevant CCG(s) or visit: www.england.nhs.uk/ccg-details
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.
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 by visiting: www.england.nhs.uk/wp-content/uploads/2018/08/learning-from
Please speak to your named contact at the Trust, which will be the staff involved in the treatment of your loved one, or contact 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.
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 do 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 do their best to minimise any delay to funeral arrangements.
You can speak directly to the local coroner’s office about having a post mortem and/or inquest.
Neither patient safety investigations nor complaints will establish liability or deal with compensation, but they can help you decide what to do 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.
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 here.
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.
Need to contact us after a bereavement?
If you have not received a letter from us and need to speak to us immediately, please contact:
Quality and Safety Team
Phone: 01522 309549
Feeling like you need support?
We have a dedicated carers service to help support you. You can contact them using the details below:
Carers Support Service
Email: lpft.carers@nhs.net
Want to speak to someone who wasn't involved your loved one's care?
Our Patient Experience/Patient Advice and Liaison Service (PALS) team will be able to help and can be contacted using the details below:
Patient Advice and Liaison Service (PALS)
Phone: 01529 222265
Looking for information on organisations who may be able to offer support?
There is a list of organisations on this page here, or you can scroll further down.
