Prevention of Future Deaths reports · 2015

Ronald Gittens

Regulation 28 report to prevent future deaths, reference 2015-0117, written 12 Mar 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report12 Mar 2015
Reference2015-0117
DeceasedRonald Gittens
CoronerAndrew Walker
Coroner areaLondon (North)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

. ' North London Coroners Court,
Her Majesty's Coroner for the 29 Wood Street,

Northern District of Greater London Barnet ENS 4BE

. (Harrow, Brent, Barnet, Haringey and Enfield) Telephone 0208 447 7680

Fax 0208 447 7689

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

1. Barnet Enfield and Haringey Mental health trust
Block B2,

St. Anns Hospital,

Saint Ann's Road,

London N15 3TH

NO

Department of Health
Richmond House

79 Whitehall

London

SW1A 2NS

4 CORONER

| am Andrew Walker, senior coroner, for the coroner area of Northern District of Greater
London

2 | CORONER’S LEGAL POWERS

| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

3 | INVESTIGATION and INQUEST

On the 12” April 2012 | opened an inquest touching the death of Ronald Gittens , 31
years old. The inquest concluded on the 22™ September 2014. The conclusion of the
5 inquest was “Narrative ’, the medical case of death was 1a Cerebral Hypoxia 1b
Hanging

4 | CIRCUMSTANCES OF THE DEATH

On the 5" April 2012 Mr Gittens was brought by ambulance to St
Thomas’ hospital when a passer by telephoned for an ambulance having
seen and spoken to Mr Gittens in the street.

A doctor at St Thomas’ assessed Mr Gittens and Mr Gittens agreed to an
informal admission and was placed on one-to-one observation. Had no
bed been available at Chase Farm Hospital where Mr Gittens was to be
transferred Mr Gittens would have been admitted to St Thomas’

Mr Gittens was transferred to Chase Farm Hospital where he was
assessed again and the plan was for an informal admission. Mr Gittens
was left to wait for a bed and intermittently monitored. Staff at Chase

Her Majesty’s Coroner for the

Northern District of Greater London
(Harrow, Brent, Barnet, Haringey and Enfield)

Farm Hospital did not know that Mr Gittens had been on one-to-one
observation prior to his transfer.

Mr Gittens left the hospital before being admitted.

Mr Gittens was found on the 7" Apri! 2012 at his home having hanged
himself using a length of rope from the loft hatch handle.

The delay in admitting Mr Gittens and the fact that Mr Gittens was not on
one-to-one observation whilst waiting to be admitted contributed to Mr

Gittens leaving the hospital, and bearing in mind Mr Gittens state of mind,
to his death.
5 | CORONER’S CONCERNS

|

During the course of the inquest the evidence revealed matters giving rise to concern. In
my opinion there is a risk that future deaths will occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

* The use of CRHTT as a filter to prevent patients in need of a bed from
having access to a bed.

6 | ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you

* The transfer of acute psychiatric patients when no bed is available and
[AND/OR your organisation] have the power to take such action.

7 | YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by Thursday 7" May 20165. |, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out
the timetable for action. Otherwise you must explain why no action is proposed.

8 | COPIES and PUBLICATION

i

1

t

i

i

t

‘

|

| | have sent a copy of my teport to the Chief Coroner and to the following Interested
| Persons;-

Representatives of the family and the Mental Health Trust.
i
|
HW

1am also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it useful
or of interest. You may make representations to me, the coroner, at the time of your
response, about the release or the publication of your response by the Chief Coroner.

9 12 Margh 2645

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Department of Health (PDF)
age From Rt Hon Alistair Burt MP
Minister of State for Community and Social Care

Department
of Health
Richmond House
79 Whitehall
London
SWIA 2NS
POC3000935580 Tel: 020 7210 4850
Mr A. Walker
North London Coroners Court
29 Wood Street
Barnet
ENS 4BE

20 MAY 2015
ous Wr Welle _

Thank you for your letter of 12 March 2015 following the inquest into the death of
Ronald Gittens. I was very sorry to hear of Mr Gittens’ death and wish to extend my
sympathy and sincere condolences to his family.

You raise two matters of concern:

e The transfer of acute psychiatric patients when no bed is available and;
e The use of a Crisis Resolution Home Treatment Team (CRHTT) as “a
filter to prevent patients in need of a bed from having access to a bed”.

You have also sent your report to the Barnet, Enfield and Haringey Mental Health
Trust. The concerns you raise are properly matters for the local Trust and I would
expect them to respond appropriately to you. We give Trusts the freedom and
discretion to arrange these matters in ways that best meet the needs of patients.
However we insist that all patients receive timely, high-quality care. Where that
does not happen, as in this case, Trusts must take action to put things right.

I appreciate that the issue of inter-trust transfers of at-risk psychiatric patients is
indeed one relevant to all Mental Health NHS Trusts. However, the responsibility for
decision making in this area resides with the local NHS rather than the Department
of Health.

The Department of Health is committed to improving the care and support of people
in mental health crisis. In February 2014, we launched the Crisis Care Concordat.
The Concordat is a national commitment, agreed between all services and agencies
that come into contact with people in crisis. It sets out how they will work together

and be involved in the care and support of people in crisis, and how they ensure that
these people get the support they need, when they need it.

A key ambition of the Concordat is for every local area to agree and deliver its own
Mental Health Crisis Action Plan to improve crisis care in that area. Every locality in
England now has such a plan in place. These plans include proposals for reviewing
the provision of home treatment teams, hospital places of safety (so that people in
mental health crisis are not detained in police celis), and round the clock telephone
helplines for people in crisis.

NHS England is one of the signatories to the Concordat to improve the system of
care and support for people in crisis. Their work includes identifying the causes of
crises, and putting prevention and early intervention plans in place whenever
possible.

I am grateful to you for bringing the circumstances of Mr Gittens’ death to my
attention and I hope that you find this reply helpful.

ALISTAIR BURT

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