If you would like to report the death of a person with learning disabilities, please use this form.

The LeDeR Programme is moving to a new web-based platform for recording reviews. If you notify a death between the 1 March and the 31st May 2021, the notification will be transferred to the new web platform when it is launched on the 1st June, and the reviewer will contact you after that date. Please be assured that your notification has been acknowledged and a LeDeR review will still be completed within 6 months.

 

If you need any help with this form, please contact the LeDeR Team:

Phone: 0300 7774 774

 

Email: leder-team@bristol.ac.uk

 

Thank you for notifying the death of a person with learning disabilities aged 4 years and over to the LeDeR programme.

Please complete as much of the form as you can. It doesn't matter if you can't answer all of the questions; just answer those that you can.

The information will be sent to a reviewer so that an initial review of the person's death can be conducted. If you would like to contribute information to the review, please make sure to add your contact details at the end of this form.

Thank you.

If you have already told us about a death, but want to give us some more information about that person then please click on this link.

We are allowed to receive confidential information, see below for more details.

The LeDeR programme has approval under Section 251 of the National Health Service Act 2006 to allow confidential information about a person to be shared with the LeDeR programme. For more information about Section 251 approval please see: http://www.hra.nhs.uk/about-the-hra/our-committees/section-251/

For a copy of the approval relating to the LeDeR programme please email the LeDeR Team at
leder-team@bristol.ac.uk.

 

 

Notification of death

Details about the person who died

Dates need to be in the format 'DD/MM/YYYY', for example 27/03/1980.

(dd/mm/yyyy)

Dates need to be in the format 'DD/MM/YYYY', for example 27/03/1980.

(dd/mm/yyyy)

Information about the person's death

9.9. Where did the person die?
Who else has been notified about the death? (Please tick all that apply)

Further information about the person and their death that might help the review, if it is available

15.15. Gender of the person who died:
17.17. Can you tell us the marital status of the person who died?

Please can you provide the name and contact details of the person's GP:

Please can you provide the name and contact details of next of kin or someone who knew the person well:

Person 2:

Contact Details

Please provide your contact details (if you are happy to be contacted):

25.25. Please confirm that you have included all the information that you wish to provide, and you are ready to submit it. Required