Prevention of Future Deaths reports · 2015

Andrew Frost

Regulation 28 report to prevent future deaths, reference 2015-0119, written 12 Feb 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report12 Feb 2015
Reference2015-0119
DeceasedAndrew Frost
CoronerMary Hassell
Coroner areaInner North London
CategoryCommunity health care and emergency services related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

Regulation 28:  Prevention of Future Deaths report 

Andrew Elliot FROST (died 25.09.14) 

THIS REPORT IS BEING SENT TO: 

1.  Ms Wendy Wallace 
Chief Executive 
Camden & Islington NHS Foundation Trust 
4th Floor, East Wing 
St Pancras Hospital  
4 St Pancras Way 
London  NW1 0PE 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

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

3 

INVESTIGATION and INQUEST 

On 30 September 2014, I commenced an investigation into the death of 
Andrew  Elliot  Frost,  aged  34  years.  The  investigation  concluded  at  the 
end of the inquest yesterday.   

I made a determination that Andrew Frost took his own life. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Frost jumped in front of an underground train early in the morning on 
25 September 2014. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 The  day  before  his  death,  he  had  three  separate  encounters  with  the 
authorities,  the  first  with  police;  the  second  with  police,  paramedics, 
general practitioner and crisis team; the third with police and paramedics. 

On  each  occasion,  concern  was  shown  for  Mr  Frost  and  attempts  were 
made to assist him. 

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.  

During  the  second  encounter  on  24  September  2014,  whilst  police  and 
paramedics  were  at  Mr  Frost’s  home,  Mr  Frost  and  his  general 
practitioner spoke on the telephone.   

The  general  practitioner  was  worried  about  Mr  Frost  and  made  an 
immediate referral to the Islington Crisis Team at Highgate Mental Health 
Centre.  He was told that the team did not have sufficient resources to go 
out to see Mr Frost that afternoon, but that someone would ring him. 

1.  There  was  no  shared understanding  between  the  crisis  team and 

the GP about what the crisis team could and could not do.   

The GP thought that the crisis team’s telephone call would include 
a  conversation  sufficiently  detailed  to  allow  the  crisis  team  to 
decide  whether  to  conduct  a  mental  health  act  assessment  that 
afternoon,  whereas  the  crisis  team  simply  intended  to  arrange  an 
appointment for the following day.   

The GP regarded the crisis team as an emergency service, which 
the team leader told me in court is not the case.   

It  seems  that  this  GP,  his  partners,  and  the  other  general 
practitioners who refer patients to crisis teams, would benefit from 
a very specific piece of training and education from the crisis team 
about their service, including its limitations. 

2.  The crisis team’s records did not reflect some valuable information 

that was passed to them.   

For example, that police and paramedics were with Mr Frost at the 
time of the GP’s call.  This information was communicated by the 
GP and by Mr Frost’s partner.  If the crisis team had considered  

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 this  information,  they  could  have  advised  Mr  Frost’s  partner  he 
should tell the paramedics that the crisis team were not coming out 
that day, which may have assisted paramedics’ decision making. 

3.  The pager messaging service used by the crisis team simply takes 
the  name  of  the  patient  and  a  telephone  number  to  call,  nothing 
more.   

This  means  that  valuable  time  was  wasted  by  the  crisis  team, 
trying  to  track  down  the  police  officer  who  had  rung  to  find  out 
more detail, most especially Mr Frost’s address.   

This is time that could be used treating patients. 

I  did  not  hear  evidence  that  led  me  to  conclude  that  different  action  by 
healthcare  professionals  on  24  September  would  have  changed  the 
outcome for Mr Frost, but it might for someone else.  

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that you 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  11  May  2015.    I,  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 have sent a copy of my report to the following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
  Care Quality Commission for England 
  Professor Dame Sally Davies, Chief Medical Officer for England 
 

, Mr Frost’s partner 

I  am  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 

3 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

12.02.15 

4
Also filed under 2015-0119: Frost-2015-0119.pdf
Regulation 28:  Prevention of Future Deaths report 

Andrew Elliot FROST (died 25.09.14) 

THIS REPORT IS BEING SENT TO: 

1. 

General Practitioner 
Killick Street Health Centre 
75 Killick Street 
London  N1 9RH 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

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

3 

INVESTIGATION and INQUEST 

On 30 September 2014, I commenced an investigation into the death of 
Andrew  Elliot  Frost,  aged  34  years.  The  investigation  concluded  at  the 
end of the inquest yesterday.   

I made a determination that Andrew Frost took his own life. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Frost jumped in front of an underground train early in the morning on 
25 September 2014. 

The  day  before  his  death,  he  had  three  separate  encounters  with  the 
authorities,  the  first  with  police;  the  second  with  police,  paramedics, 
general practitioner and crisis team; the third with police and paramedics. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 On  each  occasion,  concern  was  shown  for  Mr  Frost  and  attempts  were 
made to assist him. 

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.  

During  the  second  encounter  on  24  September  2014,  whilst  police  and 
paramedics  were  at  Mr  Frost’s  home,  you  and  he  spoke  on  the 
telephone.   

You were worried about Mr Frost and made an immediate referral to the 
Islington  Crisis  Team  at  Highgate  Mental  Health  Centre.    You  were  told 
that the team did not have sufficient resources to go out to see Mr Frost 
that afternoon, but that someone would ring him. 

However, there was no shared understanding between you and the crisis 
team about what the crisis team could and could not do.   

You  thought  that  the  crisis  team’s  telephone  call  would  include  a 
conversation  sufficiently  detailed  to  allow  the  crisis  team  to  decide 
whether  to  conduct  a  mental  health  act  assessment  that  afternoon, 
whereas  the  crisis  team  simply  intended  to  arrange  an  appointment  for 
the following day.   

You  regarded  the  crisis  team  as  an  emergency  service,  which  the  team 
leader told me in court is not the case.   

It seems that you, your partners, and other general practitioners who refer 
patients  to  crisis  teams,  would  benefit  from  a  very  specific  piece  of 
training and education from the crisis teams about their service, including 
its limitations. 

I  did  not  hear  evidence  that  led  me  to  conclude  that  different  action  by 
healthcare  professionals  on  24  September  would  have  changed  the 
outcome for Mr Frost, but it might for someone else.  

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that you have the power to take such action.  

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date 
of  this  report,  namely  by  11  May  2015.    I,  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 have sent a copy of my report to the following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
  Care Quality Commission for England 
  Professor Dame Sally Davies, Chief Medical Officer for England 
 

, Mr Frost’s partner 

I  am  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 
interest.  You  may  make 
representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

it  useful  or  of 

find 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

12.02.15 

3

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 Killick Street Health Centre (PDF)
Killick Street Health Centre
75 Killick Street, London N1 9RH

We t: 020 7833 9939
Sal 22,2 f 020 7427 2740
1) oe ig www.killickstreet.co.uk

Miss Mary Hassle

St Pancras Coroner’s Office and Court
Camley Street

London

N1C 4PP

Tel: 020 7974 4545
Fax: 020 7383 2485

Following your requirement for our service to meet with the Crisis Team, | can confirm that we have now
met with them on the 19"" March and discussed the service provision with the Crisis Team. | met up with

He both senior Managers at the Crisis team. Following discussion about the
service we have decided to meet on a more regular basis to discuss the Crisis Team service provision with
all the GP’s at the practice and also to enable us to discuss individual clients.

We fully understand how the crisis service works. They are an urgent care service that has a requirement
to meet a client within 24 hours of referral. However, if someone is too unwell to await this amount of
time then the step is to call the Police or the Ambulance service.

We are meeting as a clinical service with the Crisis team on the 11" of May at 1.30pm for a meeting to
discuss service and clients. We hope to maintain this every 6 months minimum.

The Crisis team will be doing their own report to you but | can state that they already invite all GP’s to
meet with them on the regular basis and have a relatively low take up on this. They will continue to send
invites out, it is up to individual practices whether they meet with them or not. We have agreed to meet
with the Crisis team on the regular basis.

: h e
| hope this letter fulfils the requirements set out in your report dated 12" February 2015. If you require

any further information please do not hesitate to contact me.
Many thanks.

Yours sincerely,

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