Prevention of Future Deaths reports · 2015

Mark Foley

Regulation 28 report to prevent future deaths, reference 2015-0204, written 1 Jun 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report1 Jun 2015
Reference2015-0204
DeceasedMark Foley
CoronerJohn Pollard
Coroner areaManchester South
CategoryService Personnel related deaths
Sourcejudiciary.uk record · original PDF
Responses published2

The report

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

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1. 
2. 

Minister of Defence 
The Army 

CORONER 

1 

I am Philip Alan Sharp, Assistant Coroner, for the coroner area of Cumbria 

2 

CORONER'S LEGAL POWERS 

I  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 11th June 2014 I commenced an investigation into the death of Sgt Mark Colin Foley who was 
born on the 3rd August 1982. The investigation concluded at the end of the inquest on 1st
May 2015. The conclusion of the inquest was that Mark died from  

(1) Multiple injuries and his death was an accident 

4 

CIRCUMSTANCES OF THE DEATH 

On the 4th June 2014 at a local Army training area an RMWIK converted Land Rover was 
being driven by 
  It went out of his control due to his inexperience in driving 
the vehicle.  The deceased who was commander of the vehicle and a front seat passenger 
was ejected from the vehicle as it left the road he having not put on his safety harness.  He 
landed  in  front  of  the  vehicle  which  proceeded  to  roll  over  him  causing  the  fatal  multiple 
injuries.    I concluded  that the  accident was  caused by  the  inexperience  of  the  driver  and 
Sgt Foley’s death was caused by the failure to wear a safety harness.  I concluded that Sgt 
Foley’s failure to wear a safety harness was as a result of a combination of a discretion to 
given to commanders of vehicles not to wear safety harness, a failure to enforce standing 
orders by senior officers requiring the wearing of safety harnesses. 

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. 

1 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 6 

The  MATTERS OF CONCERN are as follows:- 

1. Although the Army has taken action following a land accident prevention and investigation 
team report I was concerned although 
was qualified to drive the vehicle he 
had insufficient experience in encountering difficulties in controlling the vehicle. 

2.   Although standing orders had been in place following a previous similar accident there 
was a practice among commanders of vehicles not to wear safety harnesses and failure to 
enforce such standing orders by senior officers. 

7 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you to take such 
action.  I my view therefore you should consider: - 

1. Some form of additional training for inexperienced drivers, under safe conditions, to test 
them in dealing with a loss of control of the vehicles in which they are learning to drive. 

2.  To devise a system and/or audit procedure to check that :- 

(a)  Commanders are abiding by the rules on the wearing of safety harnesses and  
(b)  Senior officers are enforcing and checking the compliance with the standing orders. 

8 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the Report namely by 27th 
July 2015.  I, the Coroner, may extend the period. Your response to this and details of action 
taken or proposed to be taken setting out the timetable for action.  Otherwise you must 
explain why no action is proposed. 

9 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested Persons 
namely: 

the widow of Sgt Mark Colin Foley. 

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

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 10 

DATE :     1st June 2015                                                       

 Signed by Coroner: Philip Alan Sharp                                P.A                            

3
Also filed under 2015-0204: Lester-2015-2015-0204.pdf
REGULATION 28: REPORT TO PREVENT FUTURE DEATHS

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: The Secretary of State for Health.

1 | CORONER

| am John Pollard, senior coroner, for the coroner area of South Manchester

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 22" December 2014 | commenced an investigation into the death of Elizabeth
Anne Lester dob 17" June 1945. The investigation concluded on the 14" May 2015 and
the conclusion was one of Misadventure. The medical cause of death was 1a
Pulmonary Embolus 1b Deep vein thrombosis 1¢ Immobility due to right total
knee replacement for osteoarthritis

4 | CIRCUMSTANCES OF THE DEATH

This lady underwent a total knee replacement at Tameside General Hospital on the
23" November last. She needed to be readmitted thereafter as an emergency and
because of the badly constructed algorithms used by the Ambulance Service,
there was a significant delay in properly prioritising her transportation to hospital.

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. —

As per National practice, the North West Ambulance Service uses Advanced
Medical Dispatch System to prioritise calls, based on the answers to scripted
questions. During the first call the call-handler asked the relevant questions and
followed the “breathing difficulties” card. This card does not include any question
as to whether the patient is suffering any chest pains. The call was allocated a
green response and the “high volume script” was also given. In fact the patient
was short of breath AND did have chest pains, but this was never enquired about.
On the second call to the Ambulance service, this aspect was asked about and the
call was escalated to a Red response.

It is my firm belief, having come across this same issue in a number of inquests,
that there is an omission in the ‘card’ for ALL breathing difficulties and it MUST be
amended to include a question about chest pain. Breathing difficulties are
frequently as a result of compromised heart and/or lung function and this should
be queried.

| am told that the local ambulance service cannot alter the wording used but that
this must be done by the suppliers of the software.

ACTION SHOULD BE TAKEN

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

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 24" July 2015. |, 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons ‘ane (3017 of the deceased) and North West Ambulance
Service.

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

The Chief Coron: jay publish either or both in a complete or redacted or summary
form. He ay, copy of this report to any person who he believes may find it useful

or of interest. You fnay 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.

29" Ma John Pollard, HM Senior Coroner

Responses

2 responses 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)
AG From Ben Gummer MP

Parliamentary Under Secretary of State for Care Quality

Department
of Health aero Whitehal
London
SWIA oe

POCS5 938155 Tel: 020 7210 4850

Mr J. Pollard

Senior Coroner 30 JUL 2015
Coroner’s Court

1 Mount Tabor Street

Stockport

SK1 3AG

Lacs Uy dlext

Thank you for your letter of 29" May 2015 following the inquest into the death of
Elizabeth Lester. I was very sorry to hear of Ms Lester’s death and wish to extend my
sincere condolences to her family.

Your concerns in this case are levelled at the clinical call handling system used by the
call handlers at the North West Ambulance Service (NWAS) to determine the
category of ambulance response time which should be allocated to emergency calls.

You consider that a vital question related to chest pain is excluded from the scripted
questions used when the patient has breathing difficulties. As a result of this, the call
handler initially failed to ask a key question in determining Ms Lester’s condition and
a significant delay was caused in prioritising her transport to hospital.

You raise the following concerns:

e You believe there is an omission in the questions that are included on the
breathing difficulties card. You ask for this to be rectified with the addition of a
question about chest pain.

e You have been told that the local ambulance service cannot alter the wording
themselves as it must be done by the software suppliers.

I understand that the call system used by NWAS is the Advanced Medical Priority
Dispatch System (AMPDS) developed by the Priority Dispatch Corporation, an
independent body. AMPDS is an international call handling system which is used by
some, but not all NHS ambulance services in England. The other system used by
providers is NHS Pathways. It is open to ambulance trusts to choose which of these
two systems to use.

Users of AMPDS must contact Priority Dispatch directly if they feel that an element
of the system needs to be reviewed and changed. I understand NWAS has responded
to your report suggesting that you write directly to the AMPDS contact at Priority
Dispatch UK asking for the changes that you have recommended to be considered. I
would support this.

I am sorry that the Departmefit cannot be of any further help in implementing the

changes you suggests However, I hope that you find this reply helpful and I am
grateful to you for biingipé/the circumstances of éster’s death to my attention.

Dr |

Pn

BEN GUMMER
Response from Ministry of Defence (PDF)
® MINISTRY OF DEFENCE
FLOOR 5 ZONE B MAIN BUILDING

5 WHITEHALL LONDON 1A 2HB
Ministry sidecases
I 3 i
of Defence Telephone: 020 7218 9000 (Switchboard)

MARK LANCASTER TD MP
PARLIAMENTARY UNDER SECRETARY OF STATE AND
MINISTER FOR DEFENCE PERSONNEL AND VETERANS

MSU/4/7/1/is Zenuly 2015

‘es [+l Sep

Thank you for your letter of 1 June in which you enclose a copy of the Regulation 28
Report following the Inquest into the death of Sergeant Mark Foley

As you will be aware, my Department takes very seriously its relationship with HM
Coroners and we fully recognise how important it is that we learn all possible lessons to
ensure that deaths under similar circumstances in the future can be prevented.

In your report you have raised concerns about the training given to inexperienced
drivers in dealing with the loss of control of vehicles, and reinforcement of the rules
iegarding the wearing of safety harnesses.

With regard to driver training, defensive driving is an integral element of all our vehicle
instructor, commander and driver training. We have reviewed the feasibility of providing
additional training for inexperienced drivers in case of the loss of control of vehicles, and
concluded that it would be exceptionally difficult to replicate such circumstances without
introducing a high degree of risk to those within the vehicle.

We are currently looking at a potential requirement to create an online defensive driver
training package to improve safety through inclusion of road awareness, vehicle control,
driving styles and vehicle technology.

As you have recognised, the policy for the wearing of seatbelts and safety harnesses is
clearly set out in Armoured Vehicle Standing Orders, which are to be complied with by
all crew members, regardless of rank. Commanders of wheeled armoured vehicle are
now taught that they are responsible for ensuring that members of their crew wear
safety harnesses at ail times uniess directed otherwise in relation to a specific tactical
situation. Commanders are taught to reassess this as soon as the tactical situation

Lt Col P Alan Sharp

HM Assistant Coroner for Cumbria
65 Duke Street

Barrow-in-Furness

Cumbria

LA14 1RW

changes. For Revised Weapons Mounted Installation Kit + vehicles, this policy has
been reinforced during new individuai driver and commander training since December
2013, and then annually through mandated currency training. | recognise that it has
taken some time to address legacy users (such as those involved in this tragic incident),
due to the number of drivers and availability of courses, however our current aim is for
all crewman of all wheeled armoured vehicles to have received the revised training by
April 2016.

As you are aware, on conclusion of the Land Accident Investigation Team investigation
into Sgt Foley’s death, a letter was sent to the Commanding Officers of all units
equipped with wheeled armoured vehicles highlighting a range of safety concerns and
directing the adoption of a number of measures to improve safe operation. Evidence
from training suggests that this direction is being followed by both the chain of command
and the user, with a negligible number of related incidents reported. Linked to changes
in course content (including placing greater emphasis on the training of commanders)
and training delivery, | am assured that the chain of command is meeting its
responsibilities for the safe and effective operation of wheeled armoured vehicles. |
would aiso like to reassure you that we are determined to ensure that the correct levels
of knowledge and skill required to operate armoured vehicle is maintained through
demanding and realistic training.

| hope that this response helps to address your concerns. | am content for you to copy
this response to the Chief Coroner and other interested persons.

rs tr

MARK LANCASTER TD MP

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