Case study:

23 January 2009

Raising awareness in end of life care and bereavement issues at Bart's and The London Trust

Key points

The appointment of a bereavement co-ordinator at Barts and the London Trust is helping to raise staff awareness of bereavement issues following the death of a patient.

Staff working in this area of care, from nursing assistants to senior nurses, now receive training from the co-ordinator. In addition they have access to a bereavement intranet site, ward-based resource folders and a last offices checklist.

The feedback from staff has been extremely positive and there is regular praise for the last offices checklist. One comment which crops up frequently is they would like more time on the subject.

The new service follows a survey of 51 wards at University Hospital Birmingham NHS Trust in 2003 which highlighted a widespread view among staff that they needed more training and support in dealing with relatives following a patient’s death as well as the related paperwork. This was underlined by the 2007 Healthcare Commission report revealing that 56% of complaints were the result of a poor experience around the time of a patient’s death.

The bereavement intranet site includes relevant guidelines, policies and checklists to help staff when dealing with end of life care. There are also links to other associated intranet sites and a comprehensive list of support groups. The resource folders contain all the relevant nursing information on last offices and are designed to complement the intranet site.

The last offices checklist, which is now being introduced to all wards, can also be used in conjunction with the bereavement intranet site. Once completed a signed copy is placed in the patient’s notes. The checklist is also printable from the intranet site.

The co-ordinator is hoping to extend the teaching to student nurses in due course. It is also planned to audit the use of the last offices checklist in 2009.