Prevention of Future Deaths reports · 2015

Richard Green

Regulation 28 report to prevent future deaths, reference 2015-0456, 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
Reference2015-0456
DeceasedRichard Green
CoronerDavid Roberts
Coroner areaCumbria
CategoryState Custody 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)

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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
RE: RICHARD SCOTT GREEN Deceased
THIS REPORT IS BEING SENT TO:

1. Secretary of State for Justice
2. Chief Executive of National Offender Management Service

CORONER

|'am David Llewelyn Roberts, Senior Coroner for the coroner area of Cumbria.

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.

INVESTIGATION and INQUEST
On 14" May 2014 an investigation was commenced into the death of Richard Scott
Green, aged 23 years. The investigation concluded at the end of the inquest on 23rd
October 2015. The conclusion of the inquest was

1 (a) Death by Hanging

Open Conclusion

CIRCUMSTANCES OF THE DEATH

The deceased was found hanged in his cell at Haverigg Prison on 9"" May 2014. He had
made a ligature from a torn bed sheet and had used the narrow gap at the top of the
door leading to his en-suite shower room as a ligature point. The Jury found that
bullying and debt had contributed to his death. Whilst satisfied he had placed the noose
about his neck, the Jury were not satisfied so as to be sure that he intended to kill
himself. Evidence also showed he had, apparently unjustly, been refused a family day
visit on 27" May. He had a well documented history of self-harm and apparent suicide
attempts.

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. —
| was clear that serious incidents of self-harm/suicide attempts from 2007 and 2013

were recorded on his SystmOne records. These do not appear to have been
recognised or acted upon by various medical professionals in the prison system.

This meant that a nurse at screening had not read the records, neither had a GP or
a mental health nurse who later carried out an assessment. The result was that
throughout his prison term at Haverigg no one was aware of the history and the risk
he presented. As a result, there were missed opportunities which might have made
a difference. Evidence showed that

a) there appeared to be no reliable tool to help assess depression in a prisoner
(community tools being unsatisfactory).

b) Although entries were there to be seen on System One, none of the clinicians
saw them. Pressure of work and the time needed to check were reasons
cited, together with lack of resources.

It seems SystmOne was not easy to use, some staff being unaware they
could “search” and an absence of a way to clearly flag important historical
information to ensure it was at the clinicians’ finger tips.

ACTION SHOULD BE TAKEN
Minister of Justice and Head of Prison Service.
Action to be taken to consider the development of:

1) A tool or process to help clinical staff better assess and predict those prison
inmates who are at greatest risk of deliberate self-harm or suicide.

2) Improvements to the SystmOne clinical records to make them more fit for
purpose so that important entries relating to deliberate self-harm or suicide are

easily accessible and staff have requisite training so they can use the system
efficiently and to best advantage.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 28" December 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.

COPIES and PUBLICATION

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

= igg

Denby & Co Solicitors

The Government Legal Department
Cumbria Partnership NHS Foundation Trust
Greater Manchester NHS Trust

| have also sent it to

Prison and Probation Ombudsman

| 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 | 2" November 2015 [SIGNED BY CORONER]

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 NHS England (PDF)
OFFICIAL-SENSITIVE  PERSONAL 

r4't:kj 
England 

NHS England 
Birch House 
Ransom Wood Business Park 
Southwell Road West 
Mansfield 
Nottinghamshire
NG210HD 

29th December 2015 

Mr David Roberts 
Senior HM Coroner 
Fairfield 
Station Road 
Cockermouth 
Cumbria 
CA13 0QT 

Dear Mr Roberts, 

Re:  Death of Mr Richard Scott Green at HMP Haverigg on 9 May 2014 

Thank you for your letter dated 2nd November 2015 regarding this sad case which 
was passed onto me by the Ministry of Justice. 

Nationally, it is recognised that identification of mental health problems, particularly 
depression and anxiety disorders, is poor within prisons1  due to the high incidence of 
co-morbities and dual mental health problems. It is also recognised that current 
evidence based tools, such as the PHQ9, are not reliable tools for assessing anxiety 
or depression within the prison population. 

NICE are currently developing guidelines on the identification and assessment of 
mental health of adults in contact with criminal justice system which includes prison. 
These guidelines will include identifying people at risk of developing and those with a 
mental health problem (including formal  identification tools). A key concern for this 
guidance will be adapting existing NICE recommendations to the criminal justice 
system. The draft guidelines will be consulted on  in June 2016 with an anticipated 
date for publication of November 2016. 

The current NHS England service specification, which healthcare providers are 
commissioned to deliver, states that all prisoners must undergo an  initial health 
screen on receipt into establishment to identify any immediate health needs or risk, 
particularly in relation to suicide or self-harm. The Mental Health service specification 
requires all patients assessed by mental health services should use a suitable 
screening tool which adheres to national standards, such as National Service 
Framework for Mental Health (1999). 

1 

NICE DRAFT Guidelines on Mental Health of adults in contact with the criminal justice system. 

https //www.nrce.org . uk/guidance/indevelopment/gid-cgwave0726 

Health and high quality care for all, now and for future generations 

 
 
 OFFICIAL-SENSITIVE  PERSONAL 

HMP Haverigg mental health provider, Greater Manchester West Mental Health 
Foundation Trust have commissioned an in-trust review of all of the available 
assessment tools to ascertain if there is anything better placed for use in the prison 
setting. The review is expected to be completed by the end of January 2016. 

In relation the second recommendation  NHS England are re-procuring the 
healthcare electronic healthcare system, SystmOne. This system will include 
improvements on the current system such as the sharing of risk indicators (e.g. 
'increased risk of suicide') between healthcare &  NOMS and there is a joint 
commitment between NHS England and NOMS to implement the interface to show 
that proactive steps are being taken to address this issue in the longer term. The 
implementation of the new system will include a full training programme along with 
regular training updates undertaken. 

Cumbria Partnership Trust within  HMP Haverigg are looking at the use of protocols 
to be used on SystmOne to pick up some key words within patient records, such as 
intoxication, intoxicated, illicit, spice, NPS, psychosis, self-harm, suicide that will be 
highlighted on the system and flag that there is a risk. The work is being carried out 
in consultation with other providers in the prison and  in collaboration with NECs with 
the intention of putting protocols in place as soon as practicable. 

Yours sincerely 

National Clinical Quality Lead 

Health and high quality care for all, now and for future generations

Related reports

Other reports by David Roberts

See all →

More reports categorised “State Custody related deaths”

See all →

Track State Custody related deaths

See every Prevention of Future Deaths report matching State Custody related deaths, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.