Bereavement Care in Cumbria and Lancashire
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Wendy Lewis-Cordwell Macmillan Network Bereavement Lead 15 th November 2012 - PowerPoint PPT Presentation

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Bereavement Care in Cumbria and Lancashire Palliative Link Nurse Study Day ‘ Crooklands Hotel’, Kendal, LA7 7NW. Wendy Lewis-Cordwell Macmillan Network Bereavement Lead 15 th November 2012. What is the project?.

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Wendy Lewis-Cordwell Macmillan Network Bereavement Lead 15 th November 2012

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Bereavement Care in Cumbria and LancashirePalliative Link Nurse Study Day‘Crooklands Hotel’, Kendal, LA7 7NW

Wendy Lewis-Cordwell

Macmillan Network Bereavement Lead

15th November 2012

What is the project?

To encourage the development of and equitable and high quality bereavement service across the whole of Lancashire & South Cumbria Network area building on existing good practice and national guidance

NW End of Life Care Model



First days

Advancing disease

Increasing decline



1 year

6 months

1 year

Grief / Bereavement can begin at the diagnosis of any life-limiting disease

Develop Bereavement Services in Cumbria and Lancashire

  • Map current level of services

  • Undertake a gap analysis of such provision

  • Identify improvements in services and environments

  • Introduce agreed minimum standards

  • Encourage collaborative working

  • Respond & Implement National Guidance

  • Develop Education/Training

  • Identify and share Best Practice

  • Be accessible to patients, families, carers, visitors, staff as the project demands
















Kirkby Lonsdale



























20.054 deaths per annum – Cumbria & Lancs

(Source: Office for National Statistics and Research Agency – 2010)

Suicide facts …Above National Average in Cumbria (data published by Demos 2011)

2009 England – 4,390

16.1 Suicides for every 100,000 males

4.08 Suicides for every 100,000 females

One death by suicide every 2 hours

Data Supplied by PCT’s & Coroner’s

Central Lancashire 32.5 per annum

Cumbria 52 per annum

North Lancashire 38.7 annum

Cancer patients………the risk of suicide increases by more than TEN times in the week after diagnosis.

Scope the area…….The Bereavement Services Directory

Scope the area…….5 Localities

Scope the area…….The Bereavement Services Directory

Network Specification for Bereavement Services in Hospitals

Standards of bereavement care that should be in place, to support the development of an equitable, high quality coordinated service across all hospitals

Gap Analysis sent to all five acute trusts for completion

Key recommendations:

Senior Managerial support

Bereavement Office


Chaplaincy Service

Mortuary Service


Policy and Procedure

Monitor and Measure the Service

When a person dies - October 2011Guidance for professionals on developing bereavement services

There is some value in locating bereavement centres within a mortuary

Salisbury NHS Foundation Trust

Providing - One stop

Hospital mortuary and bereavement services can also be available for advice to professionals

Provide a quiet, dignified and respectful environment

Information and advice given, improving the quality of the experience

Reducing the overall amount of time taken in completing and issuing the relevant certificates

Principles of good practice

  • Privacy & Dignity

  • Time to mortuary

  • Communication

  • Work in Partnership - with families and with others e.g. coroners, religious representatives & voluntary organisations

  • Environment and Facilities

  • Staff Training and Development

  • Staff Support and supervision

  • Review and Audit

Who is involved when a person dies?

‘For you in Your Loss’ Questionnaire Responses

Staff on the ward have many challenges but they handle all with patience, skill and compassion

The booklet helped me to focus. Guiding me in how to do the practicalities

I was allowed to stay longer than other visitors. The ward staff were wonderful, I will never forget their kindness

Maybe a simpler way of getting into the hospital at night

Forget ‘confidentiality’ obsession and tell one’s loved one how ill their relative is

Unexpected delay in being able to register the death, doctor not available to sign medical certificate cause of death – on night duty!

Network Specification for Bereavement Services in Hospitals

Standards of bereavement care that should be in place, to support the development of an equitable, high quality coordinated service across all hospitals

Gap Analysis sent to all five acute trusts for completion

Key recommendations:

Senior Managerial support

Bereavement Office


Chaplaincy Service

Mortuary Service


Policy and Procedure

Monitor and Measure the Service

Network Specification for Bereavement Services in Care Homes

Every care home should embrace the principles of dignity and respect, when providing a bereavement service and include the following:

Gap Analysis sent to all care homes for completion

5 Key recommendations:

Policy and Procedures

Care After Death

Information and Support

Quality of care after death, audit and review

Training and Education

Small Changes ….Make a big difference......

‘In Your Loss’ Folder

Bereavement Folder to be given to all families / carers with the MCCD in Cumbria and Lancashire

50,0000 to be distributed to Hospitals, Hospices, GP’s, Care Homes, Registrars, etc

Initial supply delivered Nov 2012

Feedback from organisations Dec 2012

Further supply February 2013 (Each organisation will receive two years supply)

Organisations can insert their contact details plus any additional local information

‘When Someone has Died’

‘In Your Loss’ Folder - Distribution

Dignity, Respect, Sensitivity, Communication!

Are we still leaving bereaved families without information about what to do next!!!

Cumbria and Lancashire Bereavement Forum

  • Inaugural meeting 10th August at Preston Business Centre

  • Role of the group:

    • Promote Consistency across all localities

    • Identify opportunities of integrated working

    • Learn from others and share best practice

    • Influence local and national development of bereavement across ALL sectors

    • Meet 4 times per year (meetings to be rotated across Cumbria and Lancashire)

    • Next meeting Friday 23rd November 2012at Eden Valley Hospice, Carlisle

National Issues………..

Liverpool Care Pathway: Norman Lamb Health Minister will listen to concerns – BBC News 01.11.2012


  • Mr Lamb also defended the practice of paying hospitals for using the pathway

  • I want to hear where things have gone wrong. I want to ensure we address that absolutely, but a lot of good things have happened in recent years to improve the experience at the end of life.“

  • ‘Where there have been problems, I would say that it has not been with the LCP but due to lack of communication

  • Conservative Peer Baroness Knight, is calling for an inquiry into suggestions the LCP has accelerated some people’s death, said she had heard of cases where people were deprived of water without consent

Views sought on strengthening

NHS Constitution………………

Proposals to strengthen the NHS Constitution are set out for public consultation today, with the NHS, patients and public are all being asked to respond

  • Patients, their families and carers should be fully involved in all discussions and decisions about their care and treatment, including their end of life care

  • The closing date for comments is 28 January 2013

  • Responses to the consultation will feed into a revised version of the NHS Constitution, which will be published by April 2013


New NHS Mandate – 13.11.2012 identifies EoLC as a priority area……...

The first Mandate between the Government and the NHS Commissioning Board, setting out the ambitions for the health service for the next two years, has been published today

The NHS will be measured, for the first time, by how well it achieves the things that really matter to people.

  • Preventing people from dying prematurely

  • Enhancing the quality of life for people with long-term conditions

  • Helping people to recover from episodes of ill health or following injury

  • Ensuring that people have a positive experience of care

  • Treating and caring for people in a safe environment and protecting them from avoidable harm

Death Certification Reform ….

People, Process & Technology in the Current System

Death Certification Reforms - Issues

  • April 2014 - new date for implementation of service instead of October 2013

  • Transfer old payments to the new system and simply add burials

  • Will the public perceive this as imposing a ‘death tax’

  • How will the LA’s cope with ‘non payment’- will bailiffs be used?

  • Pilots in hospitals, community, urban and rural area have been successful

  • Extend pilots on 2 sites - to include the sensitivities of neonatal and child deaths

Will the new reforms improve death statistics?

National Working Alliance For Bereavement

  • The Alliance brings together professional and volunteer organisations operating across all sections of the bereavement service workforce including:

  • NHS Bereavement officers

  • Medical Examiner officers

  • Mortuary and pathology staff

  • Hospital chaplains

  • Coroner officers

  • Hospice bereavement coordinators

  • Bereavement researchers

  • Bereavement volunteers

  • Experts in the field

  • The Alliance had been proposed to provide an overarching body for the relevant professional and volunteer organisations working with bereaved people in order to provide a shared view.

  • The Alliance will provide a collective voice to the Government, other professionals and to members of the public.

Gold Standard Bereavement Care Training for Professionals

  • Gold Standard Bereavement Care Training

  • Health and Social Care Professionals who come into contact with the bereaved

  • Roll out as a national programme

  • Build on the previously delivered

    • BSA ‘When a patient dies’ training

    • Cruse Bereavement Awareness and Support Training

  • Good practice benchmark

  • Initial pilot plus 5 additional pilots

  • Completed by March 2013

The Bereavement PathwayWebsite?

Care of the Dying is ‘URGENT CARE’

Dignity, Respect, Sensitivity

  • Treat the deceased with the dignity and respect – as you would have done when alive particularly when moving / handing them

  • Is there any specific information needed from the families / carers / others close to the patient i.e. religious practices?

  • Be aware of your own attitude, behaviour, and the words you use

  • Be aware that issues and incidents around death and dying impact the grieving process


  • When someone dies you only get ONE change to get it right.

  • Get it wrong and the family will remember what has gone wrong forever.

Any Questions

Thank you……

Further information

Please contact :

Wendy Lewis-Cordwell

Macmillan Network Bereavement


T: 01772 647 037/041

M: 07766137210


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