Prevention of Future Deaths reports · 2016

Laura McRory

Regulation 28 report to prevent future deaths, reference 2016-0223, written 13 Jun 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report13 Jun 2016
Reference2016-0223
DeceasedLaura McRory
CoronerNadia Persaud
Coroner areaEast London
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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. John Brouder, Chief Executive, North East London Foundation Trust,
Goodmayes Hospital, Barley Lane, Goodmayes, Ilford, Essex, IG3 8XJ

1 | CORONER

| am Nadia Persaud, Senior Coroner for the Eastern Area of Greater London

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.
http://www. legislation.gov.uk/uksi/2013/1629/part/7/made

3 | INVESTIGATION and INQUEST

On the 24" June 2015 | commenced an investigation into the death of Laura Theresa
McRory. The investigation concluded at the end of the inquest on the 6" June 2016. The
conclusion of the inquest was a narrative conclusion:

Mrs Laura McRory suffered from severe anxiety and associated alcohol misuse. She
was noted to be deteriorating in her mental state and alcohol misuse in the weeks
leading up to her death. On 20" June 2015 she was taken to hospital by her sister in the
hope of receiving help. After assessment by a registered mental nurse, she was
discharged home, without any immediate follow up or continued observation. The
following day her husband found her intoxicated and later unresponsive. She died from
alcohol and mixed drug consumption. The evidence does not reveal her intention at the
time of. consuming the fatal mix of drugs and alcohol.

4 | CIRCUMSTANCES OF THE DEATH

Laura McRory was a 40 year old lady who had a past medical history of recurrent
episodes of anxiety and depression, associated with alcohol misuse. She worked for the
North East London Foundation Trust (NELFT). In the weeks leading up to her death, she
suffered a deterioration in her mental state and increase in alcohol consumption. She
was taken to Whipps Cross Hospital A&E on the 20" June 2015. She was assessed by
the NELFT psychiatric liaison team (a Registered Mental Nurse). Mrs McRory made it
clear that she did not want to be assessed by staff working for the same Trust as her.
The RMN in his statement to the Court stated:

“A voluntary psychiatric admission was not the direction Mrs McRory wanted to go, not
least because it would have meant further assessment by the Home Treatment Team for
consideration; the very same service that she worked in, which would have been utterly
humiliating”

Mrs McRory was discharged from hospital, following the psychiatric team’s assessment.

The following day Mrs McRory was found by her husband to be unresponsive.
Paramedics were called, but she could not be resuscitated. Post mortem investigations
revealed a cause of death of alcohol and mixed drug consumption.

| heard evidence during the course of the inquest fro ME He confirmed his
opinion that a more robust safety plan should have been in place at the end of the
psychiatric consultation on the 20" June 2015. In particular, he considered that there
should have been a request for Mrs McRory to be admitted under the medical team for
observation. An admission under the medical team may well have been acceptable to
Mrs McRory as this was not the Trust for whom she worked. It was clear from the
evidence of her sister that the A&E staff had considered that Ms McRory
required admission. also considered that a protocol was required, to deal
with the issue of referral out to a neighbouring Trust, where a member of NELFT staff
requires mental health care.

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. —

e Mrs McRory was employed by the North East London Foundation Trust. She
was clearly concerned about providing thorough and detailed information to
NELFT staff, concerning her mental state and alcohol misuse.

e The evidence revealed a need for a clear process to be in place when NELFT
staff require mental health care and express reservations about sharing
information with colleagues.

e The Trust's investigation report found that there were no care or service delivery
problems. The report however did not analyse to any degree the issues relating
to the complexities surrounding NELFT employees seeking help for mental
health conditions. The report also did not to any extent consider whether there
was an adequate safety plan in place on discharge.

¢ [HE cic not consider there to be an adequate safety plan in place for Mrs
McRory. He also considered that there needed to be a system in place for staff
to be promptly referred to a different Trust where they present with mental
health difficulties and request services from a different Trust. ENGid
confirm that he was in the process of drafting a protocol to deal with this issue.
A copy of the draft protocol was not provided.

e In light of the length of time that has elapsed since the date of Mrs McRory’s
death and the inadequacies of the Trust’s internal investigation, | consider it
necessary to write a Regulation 28 Report to ensure that the Trust considers the
system in place for prompt referrals to be made to another Trust, where
necessary, for members of NELFT staff who require mental health care. If a
protocol is to be drafted, | would like the Trust to confirm how this will be
disseminated to frontline staff.

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 8" August 2016. |, 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:

BS (4.sb2nc), EE (Mother) ancl (Sister). |
am also forwarding a copy of the report to the Care Quality Commission and to
, Director of Public Health — who may find it useful or of interest.

| am also under a duty to send the Chief Coroner a copy of your response. | will also
disclose your response to the above, interested persons.

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.

[DATE] [3-6 (lo [SIGNED BY CORONER] icne=

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 North East London NHS Foundation Trust (PDF)
NeLet WG

Best care by the best people NHS Foundation Trust

Sent by email to: Nadia.Persaud@walthamforest.gov.uk

PRIVATE & CONFIDENTIAL Trust Head Office
Ms Nadia Persaud Goodmayes Hospital
Senior Coroner Barley Lane
Walthamstow Coroners Court Ilford
Queens Road 1G3 8XJ
Walthamstow

London

E17 8QP

Tel: 0300 555 1298

3rd August 2016
Dear Mss Persaud,

Re: Regulation 28 report following the inquest touching the death of Mrs Laura McRory
| refer to your Regulation 28 report dated 13th June 2016.
The Trust has carefully considered your report and is fully cognisant of the issues you have raised.

The Trust is committed to continuously review its service for the purposes of improving quality of
care and patient safety and | am grateful for bringing these issues to my attention.

Please find enclosed the Trust’s action plan to prevent the reoccurrence of the shortcomings
identified in your Regulation 28 report.

Yours sincerely,

oar com

Chief Executive

www.nelft.nhs.uk

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