Quality statement 14: Care after death – bereavement support

Quality statement

People closely affected by a death are communicated with in a sensitive way and are offered immediate and ongoing bereavement, emotional and spiritual support appropriate to their needs and preferences.

Quality measure

Measures from End of life care strategy: quality markers and measures for end of life care (Department of Health 2009).

See also quality measures and national indicators for further information.

Structure:

a) Evidence of a local needs assessment for bereavement services, detailing specialist support needs for all sections of the community including vulnerable groups such as children and those with learning difficulties.

b) Evidence that a local service specification for bereavement services has been developed in partnership with acute, community, voluntary and private sector providers and local authorities, which includes the provision of specialist support for groups identified in the needs assessment.

Outcome: People closely affected by a death feel that information and support was available to them around the time of death and afterwards, which was appropriate for them and offered at the right time.

See the overview for overarching outcomes.

What the quality statement means for each audience

Service providers ensure that systems are in place for people closely affected by a death that include sensitive communication and provision for immediate and ongoing bereavement, emotional and spiritual support appropriate to their needs and preferences.

Health and social care workers communicate sensitively with people closely affected by a death and offer them immediate and ongoing bereavement, emotional and spiritual support appropriate to their needs and preferences.

Commissioners ensure they commission services for people closely affected by a death that include sensitive communication and provision for immediate and ongoing bereavement, emotional and spiritual support appropriate to their needs and preferences.

People closely affected by a death are communicated with in a sensitive way and offered bereavement, emotional and spiritual support appropriate to their needs and preferences. This may include information about practical arrangements and local support services, supportive conversations with staff, and in some cases referral for counselling or more specialist support.

Source guidance

Department of Health quality markers and measures for end of life care 1.15, 1.31, 3.10, 3.11, 3.12, 3.15, 3.16, 5.10, 6.10, 8.8 and 9.5.

NHS National End of Life Care Programme draft Spiritual support and bereavement care quality markers and measures for end of life care: bereavement care 1, 3, 4 and 5.

Data source

Structure:

a) Local data collection.

b) Local data collection.

Outcome: Local data collection. Office for National Statistics (ONS) National bereavement survey (VOICES) includes questions on whether enough help and support was provided by the healthcare team to the family or carer at the actual time of death, whether staff dealt with them in a sensitive manner, and whether they have since talked to anyone from health and social services or from a bereavement service, about their feelings about the person's illness and death.

Definitions

People closely affected by a death may include care home residents, staff and volunteers, staff from a variety of health and social care organisations, as well as family members and carers, including children. Children may need particular tailored support.

Families and carers of people who have died suddenly or in an unexpected way, as well as those who were expecting the death, should have access to information and support appropriate to their circumstances.

Draft Spiritual support and bereavement care quality marker 2 on bereavement support recommends that bereaved people are offered support at the time of death that is culturally and spiritually appropriate, immediate, and available shortly afterwards.

Bereavement support may be not be limited to immediately after death, but may be required on a longer-term basis and, in some cases, may begin before death.

A stepped approach to emotional and bereavement support may be appropriate, which could include but is not limited to:

  • information about local support services

  • practical support such as advice on arranging a funeral, information on who to inform of a death, help with contacting other family members and information on what to do with equipment and medication

  • general emotional and bereavement support, such as supportive conversations with generalist health and social care workers or support from the voluntary, community and faith sectors

  • referral to more specialist support from trained bereavement counsellors or mental health workers.

See quality statement 6 for a definition of spiritual support.

A model of bereavement support is detailed in NICE cancer service guidance recommendation 12.30. Further guidance on bereavement support is available from When a patient dies: guidance for professionals on developing bereavement services (Department of Health 2005).

People closely affected by a death should be able to access all support within an appropriate physical environment that facilitates sensitive communication.