Background In 2018, the National Quality Board published national guidance aiming to improve how we engage with and support families/carers after death. The guidance requires trusts to ask if families had any concerns about the care their relative received.

Method LTHT formed a multi-professional working group to implement the guidance. A new process was tested and implemented in June 2019 in which families/carers who attend the Bereavement office to collect the medical cause of death certificate (MCCD) are asked if they have any questions or feedback about the care of the person who died. This information is collected and any questions are sent to the Patient Advice and Liaison Service (PALS) to liaise with the relevant department to make contact. If any questions cannot be resolved they are escalated through the formal complaints process. Families are given contact details if they have questions at a later date. All feedback is collated by the end of life care team and fed back to clinical teams on a monthly basis.

Results Since the process was implemented, there were 943 adult deaths. Of those:

• 46 families (4.8% of deaths) had questions which were referred to PALS

• 279 families (29.5% of deaths) had positive comments about care

• 307 families (32.5% of deaths) had no comments

• 49 families fed back areas for improvement but did not want to be referred to the clinical teams through PALS.

Data is being collated to determine how many PALS escalate to a formal complaint and to establish if this new process results in fewer complaints.

Conclusions An unexpected consequence of implementing the new process has been the wealth of positive comments about the care dying patients and their families have received. Further analysis will be needed to monitor the impact on complaints and whether we are better meeting the needs of bereaved families.