Prevention of Future Deaths reports · 2016

Joanne French

Regulation 28 report to prevent future deaths, reference 2016-0004, written 7 Jan 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report7 Jan 2016
Reference2016-0004
DeceasedJoanne French
CoronerElisabeth Bussey-Jones
Coroner areaWest Sussex
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedSussex Partnership NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

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:

1. The Chief Executive - Sussex Partnership NHS Foundation Trust.

—

7 | CORONER

| am Elisabeth Bussey-Jones, Assistant Coroner, for the Coroner's area of West Sussex.

a
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 23 November 2015 I commenced an investigation into the death of
Joanne Michelle French (otherwise known as Joanne Michelle Hay), aged 38
years. The investigation concluded at the end of the inquest on 1‘ December
2015. The conclusion of the inquest was suicide and the medical cause of death
was la) hanging. The short form conclusion of suicide was supplemented by a
narrative conclusion in the following terms : “Joanne French made a serious
attempt on her life on the 2" December 2014 by cutting her throat. She was
taken to hospital where she was treated for her injury. She was admitted
voluntarily to the psychiatric ward at Meadowfield Hospital on 3" December
2014. She was discharged from that ward on the 11" December 2014. There
were communication errors made in the assessment and decision making process
for her discharge which related to obtaining views of members of Joanne 's
family and the accuracy of information recorded as being provided by the family.

Had those communication errors not existed, it is likely that Joanne would not

L _|

have been discharged on the 11" December 2014”.

CIRCUMSTANCES OF THE DEATH
1) Joanne French first went to see her GP concerning depression in September
2014. Her GP prescribed anti-depressants. She had no prior history of

depressive illness.

2) On the 2™ November 2014 she suffered a form of breakdown which resulted in
her family taking her to A and E at the Royal Sussex County Hospital. She was
not admitted to hospital on that occasion but it did mark the start of her
engagement with the Crisis Resolution Home Treatment Team. She was seen
at home daily by that team, with slightly reduced contact towards the end of the

first month.

3) Joanne French was seen on the 1°' December 2014 by a psychiatrist with the
Crisis Team, who altered her medication as she was not showing the anticipated

improvement.

4) Without any obvious warning signs, Joanne made a significant attempt on her life
on the 2™ December 2014, cutting her throat and narrowly missing major
arteries. She was admitted to the Royal Sussex County Hospital and then to
Meadowfield Hospital. It was not necessary for a decision to be made to detain

her under the Mental Health Act as Joanne agreed to voluntary admission.

5) Joanne French was discharged from Meadowfield Hospital on the aw"
December 2014, which the Psychiatrist making the decision to discharge her
described as an ‘exceptional course’. The Psychiatrist gave evidence to the
effect that he expected the family’s views to be canvassed in the discharge
assessment and that his decision on supported discharge would be influenced
by the family’s views. The importance of that aspect of the assessment to the
decision maker was not understood or communicated to the nurse carrying out

the assessment for discharge. Although the nurse carrying out the assessment

spoke over the telephone to Joanne's husband) at some point
during the assessment process, she did not specifically ask his views and the
discussion was in the presence of Joanne French. The nurse conducting the
assessment was unaware that the psychiatrist who would be making the

discharge decision specifically wanted to know the family’s views.

6) The psychiatrist believed that before making the discharge decision he had
spoken directly to the nurse undertaking the assessment of Joanne for suitability
for discharge but that was disputed by the nurse who undertook the
assessment. She denied speaking directly to him and said he was not at the
ward at the time. The psychiatrist was therefore reliant on the written notes of

that assessment.

7) The notes made of the assessment were inaccurate in that they reported views

of EEE wien in fact those were the views of the patient.

8) Joanne's husband and twin sister were taken by surprise with the decision for
her early discharge. They were not aware that the person who would make the
decision as to discharge wanted their imput. They had no experience of the
procedure and did not understand that their views were relevant to the

discharge process, the discharge being presented as a foregone decision.

9) ae made an arrangement to discuss Joanne French's condition
with the psychiatrist on the morning of 12"" December 2014 but in light of her

early discharge, that appointment never took place.

10) In the early hours of the morning on 14" December 2014 Joanne French
was found by a passer-by at Southwick Recreational Ground to be hanging by a
scarf attached to her neck and a climbing frame. Emergency Services were
called and CPR commenced on their arrival. She was unable to be revived and
was transferred to Royal Sussex County Hospital where she was formally

pronounced to have died.

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) When taking what was described as an ‘exceptional course’ in deciding to
discharge the patient at an early stage, there was lack of clarity and
understanding as to what the person making the decision to discharge
required to be covered in the discharge assessment process.

(2) Factors that the person making the decision for early discharge required
to be covered in the assessment process were not brought to the attention
of the person who was to carry out that assessment.

(3) The assessment notes were not completely clear and accurate in recording
the information to be provided to the person making the decision to
discharge.

(4) Consent permitting, there was no process by which the unqualified family
members who would be instrumental in caring for the discharged patient
could imput their views and/or information for those making the decision
on early discharge and by which they could understand the reasons for

discharge.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe your
organisation has 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 4" March 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons EEE and solicitors representing the Family

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

The Chief Coroner may publish either or both ina 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.

DATE : 7" January 2016 SIGNED : Ga Wb ecice

Pp r Elisabeth Bussey-Jones

iz

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