What happens when someone dies in hospital? The first days, step by step

What happens when someone dies in hospital?

In the first hours very little is asked of you, because the ward team looks after the person and tells you what happens next, and Citizens Advice explains that hospital staff will contact the family. Marie Curie adds that the staff caring for the person check their care plan for any religious or cultural wishes and should explain the next steps, and that you can tell them if there is something you would like to be part of, although it may not always be possible.

The two bereavement offices quoted below ask families to ring on the next working day, so if the death happens at night or at a weekend the next practical step can usually wait until then. You do not need to ring a funeral director or the register office straight away, and in England and Wales you do not have to collect any paperwork yourself, because the hospital and the medical examiner's office deal with the certificate and send it on.

If tissue donation may be possible, NHS Blood and Transplant's guidance on tissue donation says one of its specialist nurses may phone the family within a few hours of the death to offer the option, and that donation will not delay the funeral arrangements, although in Scotland this is handled by the Scottish National Blood Transfusion Service.

If the person died in a hospice rather than a hospital, the steps are broadly the same, because GOV.UK says medical examiner scrutiny in England and Wales applies to deaths in any health setting that are not referred to a coroner, and Marie Curie notes that hospice staff, like hospital staff, should explain what happens next.

What does the hospital bereavement office do?

The bereavement office is the hospital team that guides families through the paperwork and practical arrangements after a death, and it is usually your main contact in the first few days. Each hospital runs its own process, so it is worth asking the ward for the office's number before you leave, but the published guidance of two NHS trusts gives an example of how it works.

Leeds Teaching Hospitals NHS Trust's bereavement guidance asks families to phone the bereavement office after 10am on the next working day, when staff explain the next steps and take some details. Once the medical certificate of cause of death is complete, the team arranges an appointment with the family, and the certificate is sent electronically to the local registrars. Kingston and Richmond NHS Foundation Trust's bereavement support page similarly asks families to ring the office as soon as they can, ideally the next working day, and to say who the next of kin is and who will be arranging the funeral, so that the right person is kept informed.

Collecting the person's belongings is arranged through the bereavement team or the ward, depending on the hospital. At Leeds, belongings are held for five days before the bereavement team offers an appointment to collect them, and families can ask for anything they do not want returned to be disposed of or donated to the hospital charity, whereas at Kingston the ward staff pack the person's things and families arrange a time to collect them with the ward. In Northern Ireland, nidirect's guide to a death in hospital or a care home says hospital staff keep the person's belongings safe until whoever is dealing with the estate arranges collection, and give a receipt when they do.

Who confirms the cause of death after a hospital death?

In England and Wales a doctor who cared for the person proposes the cause of death on the medical certificate of cause of death (MCCD), and since 9 September 2024, unless the death is referred to a coroner, a medical examiner must independently review it before the death can be registered. GOV.UK's guide to what to do after someone dies explains that the medical examiner is a senior doctor who was not involved in the person's care, and that their office will contact you to explain the cause of death and answer any questions about it, or about the care the person received before they died. The conversation is voluntary, so you do not have to take part, although it is a chance to ask anything you want to know.

The National Medical Examiner's guidance for England and Wales says this conversation should be spoken rather than written, by phone, in person or by video, and that scrutiny of straightforward cases should normally be finished within 24 hours of the office being told about the death. GOV.UK also notes that the doctor's part, which comes first, can take a few days, so it may be a little while before you hear. Once the review is complete the certificate is sent to the registrar and you are told that you can now register the death, although in some areas the register office contacts you to book the appointment.

You do not need to collect the certificate or take it to the register office yourself, because it is sent on for you. Our guide to how to register a death explains the medical examiner's role and the registration appointment in more detail.

What happens if the death is referred to the coroner?

If the cause of death is unclear, or the death may not have been from natural causes, the doctor or the medical examiner refers it to the coroner, who decides whether further enquiries are needed, and the paperwork and timing then change. GOV.UK's guidance on deaths reported to a coroner sets out the main routes: if the coroner decides not to investigate, the medical examiner will contact you to confirm you can register; if the coroner is satisfied about the cause, they send a certificate to the registrar, who then contacts you; and if an inquest is needed, you can ask the coroner for an interim death certificate while it is under way.

Our guide to what to do when someone dies at home explains how coroner referrals work in more detail, and our guide to the interim death certificate covers what it can be used for. In England and Wales the Coroners' Courts Support Service offers free, independent help on 0300 111 2141, Monday to Friday 9am to 7pm and Saturday 9am to 2pm. In Scotland, deaths that need investigating are reported to the procurator fiscal rather than a coroner.

Can you see the person after they have died in hospital?

Yes, families can usually arrange to see the person, although later visits are normally by appointment. Kingston and Richmond's guidance, for example, asks families to ring the hospital to book a visit, and notes that a funeral director can also arrange one at their own premises once the person is in their care. Where a death has been referred to the coroner, Kingston explains that the coroner's office has to give permission first.

It is entirely your choice whether to visit, and you do not have to decide straight away.

When can a funeral director collect the person from hospital?

A funeral director can collect the person once the hospital has agreed to release them, which it does when its own paperwork is complete, and you can choose who to use in your own time. Kingston and Richmond's process is one example: you give the bereavement office the name of your chosen funeral director, and the team completes a release form and passes it on so that the funeral director can collect the person. Citizens Advice, writing about England, says the family is asked to arrange for a funeral director to collect the person and to collect their belongings at around the same time.

Some faiths have their own requirements about how soon a funeral should take place, and because the national medical examiner guidance asks offices to respect requests for urgent release, it helps to tell the ward or bereavement office early and let your faith leader or funeral director advise, with our guide to Islamic funerals in the UK covering timings and paperwork for Muslim families.

Otherwise the decision does not usually have to be made on the first day. nidirect, for example, explains that in Northern Ireland the hospital keeps the person in its care until the family or their chosen funeral director collects them, which gives you time to compare options and costs, and the bereavement office can tell you how its own hospital handles this. In England and Wales, after you register the death you will be given a certificate for burial or cremation (often called the green form), and GOV.UK says it must be given to the funeral director, crematorium or burial authority before the funeral can take place.

How long do you have to register a death after it happens in hospital?

In England and Wales you register within 5 days of the medical examiner's office confirming you can, and GOV.UK says those 5 days include weekends and bank holidays, so you should tell the register office straight away if you need longer. A relative normally registers the death, but if a relative cannot, GOV.UK says it can be done by someone who was present at the death, by the person arranging the funeral, or by an administrator from the hospital where the person died.

The rules in Scotland and Northern Ireland are slightly different:

• Scotland:mygov.scot's guide to registering a death says a death should be registered within 8 days of the death where possible, at any registration office in Scotland. The doctor normally sends the MCCD to the registrar, so you may need to find out which office has received it. If the death has been referred to the procurator fiscal, registering within 8 days may not be possible.

• Northern Ireland: nidirect says a death should be registered within five days, unless it has been referred to the coroner, and that you can register at any district registration office in Northern Ireland. The doctor or hospital sends the medical certificate electronically to the General Register Office for Northern Ireland, and the registrar will normally contact you to arrange the registration, which can be done by phone.

When you register, it is worth buying several certified copies of the death certificate, because banks and other organisations usually want to see one. Our guide to how many death certificates you need helps you decide.

What does Tell Us Once do after a hospital death?

Tell Us Once lets you report the death to most government departments in one go, and in England, Scotland and Wales the registrar will usually offer it when you register. GOV.UK says the reference number must be used within 28 days, and because the person died in hospital you will also be asked for the hospital's name and address and whether they had been there for 28 days or longer. Our guide to Tell Us Once explains what it reaches and what it leaves out.

Tell Us Once is not available in Northern Ireland, where you report the death to the Department for Communities Bereavement Service on 0800 085 2463, which tells each office that paid the person a benefit, including the State Pension.

What to do next

1. Ask the ward for the bereavement office's number, then ring it on the next working day and tell them who the next of kin is and who is arranging the funeral.

2. In England and Wales, expect a call from the medical examiner's office, and use it to ask anything you want to know about the cause of death or the person's care.

3. Choose a funeral director when you feel ready and give their name to the bereavement office, mentioning any faith requirements early.

4. Ask how the hospital returns belongings, and arrange a time to collect them from the ward or the bereavement office.

5. Register the death once you are told you can, and buy enough certified copies of the death certificate.

6. Use Tell Us Once within 28 days to tell government departments, or the Bereavement Service in Northern Ireland.

Once the death is registered, the person's private accounts, such as their bank, energy supplier, phone provider and subscriptions, will need to be told as well, because Tell Us Once does not reach them, but none of that has to happen in the first few days and it can wait until you are ready. When you are, Legacy Trail's free notification service can let those companies know on your behalf, which leaves one less thing to deal with.