Prevention of Future Deaths reports · 2015

Jacqueline Williams

Regulation 28 report to prevent future deaths, reference 2015-0421, written 2 Nov 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report2 Nov 2015
Reference2015-0421
DeceasedJacqueline Williams
CoronerCaroline Beasley-Murray
Coroner areaEssex
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.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

The Chief Executive Officer

East Lancashire NHS Foundation Trust
Trust Headquarters

The Royal Blackburn Hospital
Haslingden Road

Blackburn BB2 3HH

CORONER

I am Michael Singleton, Senior Coroner for the Coroner area of Blackburn, Hyndburn & Ribble
Valley.

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.

INVESTIGATION and INQUEST

On the 28" January 2018 I commenced an investigation onto the death of Jacqueline Williams
aged 42. The investigation concluded at the end of the Inquest which was concluded on the
28" October 2015. The conclusion of the Inquest was that Jacqueline Williams had committed
suicide.

CIRCUMSTANCES OF THE DEATH

On the evening of Monday 26" January 2015 Jacqueline Williams was conveyed by ambulance
to the Royal Blackburn Hospital where she was triaged and assessed to be at moderate risk of
self-harm. A decision was made that she should be referred directly to the Mental Health Liaison
Team. Due to a breakdown in communication between the triaging nurse and the Mental Health
Liaison nurse no actual referral was accepted by the Mental Health Liaison Team. Having been
placed in a cubicle within the emergency department at the Royal Blackburn Hospital Jacqueline
Williams hanged herself from the central observation light using the electrical cord tied around
her neck.

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 further deaths will occur unless action is taken. In the circumstances
it is my duty to report to you the MATTER OF CONCERN is as follows: -

That the process of referral to the Mental Health Liaison Team was subject to human error and

that the systems in place failed to provide for such mistakes to be easily identified and rectified.

In particular there was no opportunity for staff in the emergency department to see confirmation

that a referral had been accepted, the time of that referral and the expected time when a

mental health assessment would take place. Likewise the Mental Health Liaison Team did not

have a process that whereby they were able to identify those patients that the staff in the
department believed had been referred and were awaiting assessment.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I 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 21% December 2015. I, the Coroner, may extend this 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
I have sent a copy of my report to the Chief Coroner and to the following interested person,
namely:

Lancashire Care NHS Trust

Tam 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.

02 November 2015

Signed by: ...ccccscceleeKeDiCacctratgeastteePoagscerssessen

H M Senior Coroner for Blackburn,
Hyndburn & Ribble Valley

tv

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:
The Chief Executive Officer
Lancashire Care NHS Trust

The Innovation Centre

1 Evolution Park

Haslingden Road

Blackburn BB2 2FD

CORONER

I am Michael Singleton, Senior Coroner for the Coroner area of Blackburn, Hyndburn & Ribble
Valley.

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.

INVESTIGATION and INQUEST

On the 28" January 2018 I commenced an investigation onto the death of Jacqueline Williams

aged 42. The investigation concluded at the end of the Inquest which was concluded on the
28" October 2015. The conclusion of the Inquest was that Jacqueline Williams had committed
suicide.

CIRCUMSTANCES OF THE DEATH

On the evening of Monday 26'" January 2015 Jacqueline Williams was conveyed by ambulance
to the Royal Blackburn Hospital where she was triaged and assessed to be at moderate risk of
self-harm. A decision was made that she should be referred directly to the Mental Health Liaison
Team. Due to a breakdown in communication between the triaging nurse and the Mental Health
Liaison nurse no actual referral was accepted by the Mental Health Liaison Team. Having been
placed in a cubicle within the emergency department at the Royal Blackburn Hospital Jacqueline
Williams hanged herself from the central observation light using the electrical cord tied around
her neck.

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 further deaths will occur unless action is taken. In the circumstances
it is my duty to report to you the MATTER OF CONCERN is as follows: -

That the process of referral to the Mental Health Liaison Team was subject to human error and
that the systems in place failed to provide for such mistakes to be easily identified and rectified.
In particular there was no opportunity for staff in the emergency department to see confirmation
that a referral had been accepted, the time of that referral and the expected time when a
mental health assessment would take place. Likewise the Mental Health Liaison Team did not
have a process that whereby they were able to identify those patients that the staff in the
emergency department believed had been referred and were awaiting assessment

6 ACTION SHOULD BE TAKEN j

In my opinion action should be taken to prevent future deaths and I believe 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 21% December 2015. I, the Coroner, may extend this 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 Chief Coroner and to the following interested person,
namely:

East Lancashire Healthcare NHS Trust

Tam 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 02 November 2015 SIQMed by! ..rcoccssseseccccseccnesscnsssersersvansvencues ones

H M Senior Coroner for Blackburn,

Hyndburn & Ribble Valley
Also filed under 2015-0421: Pooley-2015-0431.pdf
ANNEX A 

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS (1) 

NOTE: This form is to be used after an inquest. 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

South Essex Mental Health Partnership Trust 

1 

CORONER 

I am Mrs Caroline Beasley-Murray,  HM SENIOR Coroner, for the area of Essex 

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 21st May 2015 I commenced an investigation into the death of David John Pooley. 
The investigation concluded at the end of the inquest on 30th October 2015. The cause 
of death was 1a) Hanging. The conclusion of the inquest was a Narrative Conclusion;-  
David Pooley killed himself whilst suffering from depression.  David John Pooley’s risk of 
self harm/suicide was not properly and adequately assessed and reviewed. 
CIRCUMSTANCES OF THE DEATH 

4 

Mr Pooley who was 66 years old, was admitted to Basildon Hospital on the 5th May 2015 
following an attempt to hang himself in his own home.  He spent time in the Mental 
Health Assessment Unit and he was then transferred to Gloucester Ward.  He was 
found hanging in the toilet on the ward and his death was confirmed at 6:38am on the 
20th May 2015. 

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.  –  

1.  Contrary to the trust’s policy, there was no named nurse allocated until the day 
before Mr Pooley’s death. The role of the named nurse had not therefore been 
carried out – this entails the devising of a risk assessment, care plans, one to 
ones, contact with the patient’s family etc. 

2.  The appropriate assessments and reviews were therefore not carried out. 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe 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 15th January 2016. 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 Chief Coroner and to the following Interested 
Persons. 

Mr Pooley’s Family. 

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 or the publication of your response by the Chief Coroner. 

9 

3rd November 2015                                              Mrs Caroline Beasley-Murray 

2

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 Lancashire Care NHS Trust (PDF)
Lancashire Care INHS|

NHS Foundation Trust

Lancashire Care NHS Foundation Trust
Sceptre Point

Sceptre Way

Walton Summit

Preston

PR5 6AW

' Tel: 01772 695360

Mr. Michael Singleton
Senior Coroner
Coroner's Office
Blackburn Central Library
Town Hall Street
Blackburn

BB2 1AG

30 November 2015

Dear Mr. Singleton,

Jacqueline Williams (deceased) — Regulation 28 report to prevent future deaths

The Trust acknowledges receipt of your letter dated 2 November 2015. In the regulation 28 report
you raise the following concerns:

1. The process of referral to the Mental Health Liaison Team is subject to human error
2. The referral process does provide opportunity for staff in the emergency department to see
conformation that a referral has been accepted and when they can expect an assessment

to take place
3. The Mental Health Liaison Team do not have a process to identify patients that the staff in

the emergency department believe they have referred for assessment.

Following this incident we undertook a joint investigation with East Lancashire Hospitals NHS
Trust. This resulted in the development of an action plan to implement measures to improve safety
and prevent such a tragic event from recurring. We continue to implement this action plan and
work closely with East Lancashire Hospitals NHS Trust and the commissioning groups for East
Lancashire and Blackburn with Darwen.

Below are details of the actions that have been taken to date and those that are planned that
address the concerns of your regulation 28 report.

In the immediate term, we have briefed all staff on the referral process to ensure they fully
understand that process and shared the learning from our joint investigation.

We have also met with East Lancashire Teaching Hospitals NHS Trust to explore in detail how we
can improve the referral process.

S vovortins Health and Wellbeing Ys

MINDFUL,
EMPLOYER

Lancashire Care |NHS|

NHS Foundation Trust

Within the Emergency Department they use the CRISP board to record the referrals made to
specialists teams and we are looking to utilise this technology.

A further option we are exploring is the development of a system whereby East Lancashire
Hospital NHS Trust staff email the Mental Health Liaison Team with the patient's details and a brief
reason for referral. The Mental Health Liaison Team would then acknowledge receipt of the email
and also give approximate time of assessment. The referral information is already recorded within
the Mentai Health Liaison referral log book, however this approach we are looking to implement
will ensure that positive confirmation is provided to Emergency Department staff.

| hope this addresses your concerns and wish to assure you that we are keen to implement
systems to prevent similar incidents in the future.

Should you require any further information the Trust will be more than willing to assist.

Yours sincerely

Ba, Cad

Dee Roach
Executive Director of Nursing and Quality

Swovorting Health and Wellbeing ys

\)
say

MINDFUL
EMPLOYER

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