In reviewing the first edition of the publication, the National Nurse Consultant Group (Palliative Care), with Hospice UK, sought the advice and expertise of 60 organisations to ensure the revised guidance has relevance for all care settings, including mental health services and prisons.
The guidance recognises that not all dying is planned for or expected, and covers what to do following sudden deaths, as well as ‘expected’ deaths.
Where dying is expected, the guidance aims to help ensure that care after death is as planned for as well as care before death.
For example, if people are transferred across care settings in their dying period to a “preferred place of death” consideration should be given to the skills of professionals in the new care setting.
Care professionals will need to be able to verify death in a timely manner, communicate knowledgeably about the patient (eg their wishes about tissue donation) and understand relevant factors about their physical care, such as infections and any implantable devices.
Doctors will also need to complete formal paperwork – such as medical certificate of the cause of death – in a manner that is helpful to families.
Key to ensuring we succeed in “our one chance to get it right” for care after death are professionals who are knowledgeable, able to communicate with the multi-disciplinary team and co-ordinate the processes of care.
But there is a need to ensure the wellbeing of these professionals, and the guidance calls for a focus of training in this area of care, and for the opportunity of a debriefing to be available, if required, for all staff after a death.
In this second edition, the flowchart of all who contribute to care after death has been revised, and we would recommend that local commissioners and practitioners (doctors, nurses, mortuary staff, porters, ambulance staff, bereavement officers, specialist liaison workers, police, social care staff, funeral directors, pathologists, coroners, healthcare chaplains and faith workers) consider how to best make use of the guidance in their localities.
The updated guidance, which can be downloaded from Hospice UK’s website, has been endorsed by many of the UK’s leading health and care organisations, including the Royal College of General Practitioners (RCGP), the Royal College of Nursing (RCN), NHS Improving Quality, the Royal College of Pathologists and the National Council for Palliative Care (NCPC).