Background Annually across the world a substantial number of dependent children experience the death of a parent through a life limiting illness. The death of a parent has long term implications for children’s emotional, social and physical wellbeing (Cockle-Hearne, Reed, Todd et al., 2020). If a child isn’t prepared for parental death or supported afterwards, they are more likely than their peers to have higher levels of referrals to psychiatric and specialist services and absence at school (Osborn, 2007; Niemelä, Paananen, Hakko et al., 2016). When death can be anticipated, healthcare providers have an opportunity to provide appropriate support that can reduce the impact of the loss.

Aim A survey was carried out to explore the experiences of hospital staff when supporting children whose parent or grandparent was dying. 67 staff members responded.

Results 84% of staff had not had any training in supporting children. Over 50% lacked confidence in knowing who to signpost families to and many were unable to identify local organisations who could help. 76% of staff have been left feeling distressed after caring for a dying patient with young children or grandchildren. 85% of staff felt that a child bereavement counsellor would have made things better for the children. 79% think a child bereavement counsellor would have reduced stress for staff.

Conclusion This survey supported the concerns that children are often not provided with appropriate support when a parent has a terminal diagnosis and as such are faced with the risk of future harm. It is apparent from this review that children who experienced the death of a parent have been reliant on a workforce who lacked training and confidence in this area. This has meant that families may not have been supported to have honest and open conversations to prepare for the death. Our survey also highlighted the significant impact on staff of caring for dying patients with young children. In response to these findings the trust has collaborated with a local hospice to appoint a child bereavement counsellor to work alongside colleagues in the hospital. The counsellor will provide direct support to children as needed but will also aim to improve the confidence and skill of the ward staff when working with young families. In addition, there is a commitment to recognise the emotional impact on staff and to provide increased opportunity for reflection.