Prevention of Future Deaths reports · 2016

Alan Stead

Regulation 28 report to prevent future deaths, reference 2016-0261, written 22 Jul 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report22 Jul 2016
Reference2016-0261
DeceasedAlan Stead
CoronerAndrew Haigh
Coroner areaStaffordshire (South)
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
THIS REPORT IS BEING SENT TO:

1. Care UK, Hawker House, 5-6 Napier Court, Napier Road, Reading,
Berkshire RG1 8BW

CORONER

| am Mr Andrew Haigh senior coroner for the coroner area of Staffordshire South

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 22 January 2016 | commenced an investigation into the death of Alan George
Stead aged 49 years. The investigation concluded at the end of the inquest on 20
July 2016. The conclusion of the inquest was natural causes with the cause of death
being given as la Haemopericardium Ib Thoracic aortic dissection lc Ruptured
atheromatous plaque.

| CIRCUMSTANCES OF THE DEATH

Mr Stead was a serving prisoner at HMP Dovegate who was taken ill in his cell late
evening on 20 January 2016. He was taken to Queens Hospital Burton shortly after
midnight but was certified dead there soon after arrival. Death resulted from
bleeding from a major vessel near his heart.

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) The medical review has identified delays with the taking and testing of blood
samples from prisoners at HMP Dovegate. This was not something included
in a recommendation in the PPO report but was expressed as a concern by
the family at the Inquest. This could have serious consequences in some
cases. | wonder if you have looked at this and have done or can do anything
to improve the situation with this at HMP Dovegate and indeed at any other
prisons where you provide healthcare if this is an issue.

for)

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.

7 | YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this
report, namely by 16 September 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: Mr Stead’s family, DWF Solicitors, the PPO and the IMB at HMP
Dovegate.

| 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 caroner, at the time
of your response, about the release or the publication of your response by the Chief
Coroner.

DATE 22 July 2016
SIGNED BY CORONER

haa. | Ke

Andrew A Haigh
HM Senior Coroner
Staffordshire (South)

Coroner's Office

No 1 Staffordshire Place
Stafford

ST16 2LP

Tel No: 01785 276127
Fax No: 01785 276128

www.staffordshire.gov.uk
sscor@staffordshire.gov.uk

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 Care UK (PDF)
Cofe

Care UK
Hawker House
5-6 Napier Court
Napier Road
F . Reading
HM Senior Coroner Andrew Haigh Berkshire RG18BW

Staffordshire (South)
Coroner’s Office

No 1 Staffordshire Place
Stafford www.careuk.com
ST16 2LP

T 0333 999 2570
F 0333 200 4063

09 September 2016

Dear Sir,
Regulation 28: Prevention of Future Deaths report, Alan George STEAD

Thank you for your Regulation 28 Prevention of Future Deaths Report issued to Care UK
following the inquest into the death of Alan George Stead Deceased. Care UK would like to
express its condolences to Mr Stead’s family and friends.

Care UK is the provider of healthcare services at HMP Dovegate and has been since October
2014. Care UK provide a 24 hour healthcare service at HMP Dovegate.

Our response to your matter of concern, and action taken, is set out below.

Matter of Concern: The medical review has identified delays with the taking and testing of
blood samples of prisoners at HMP Dovegate. This was not something included in a
recommendation in the PPO report but was expressed as a concern by the family at the
inquest. This could have serious consequences in some cases. | wonder if you have looked at
this and have done or can do anything to improve the situation with this at HMP Dovegate and
indeed at any other prisons where you provide healthcare if this is an issue.

Response:

On Tuesday 8 December 2015 Mr Stead was seen by an advanced nurse practitioner, having
reported that he had occasionally been experiencing palpitations in his chest and a dull, left-
sided pain when breathing. The nurse examined Mr Stead thoroughly, took his observations
and checked his chest. As everything was clear, she decided to carry out an ECG, as well as
Mr Stead’s blood pressure, pulse rate and rhythm and respiration rate to see if this would
establish the cause of the palpitations. A prison GP reviewed the results of the ECG but found
nothing significant.

The nurse also referred Mr Stead for blood tests to check his thyroid function, vitamin

B12 levels and his ferritin level to rule out anaemia. Healthcare staff were unable to obtain a
suitable blood sample due to Mr Stead having poor veins, and so they booked an appointment
for Mr Stead to see a healthcare member of staff trained in Phlebotomy on Friday 11
December. Mr Stead was told to contact healthcare staff if he experienced any further
symptoms in the meantime.

Care UK Limited. Registered in England No 1668247
Registered Office: Connaught House, 850 The Crescent, Colchester Business Park, Colchester, Essex CO4 90B

The appointment on Friday 11 December did not take place. Healthcare records show that this
was a “No Access’ visit which means that the prison were unable to move Mr Stead to the
healthcare centre. However, the appointment was rescheduled for the next available blood
testing appointment which was on Wednesday 13 January 2016. At the time there were not as
many staff in the Healthcare Team at HMP Dovegate trained to undertake blood samples.
Although this was a gap of over a month, the blood test was considered routine. Had the test
been considered urgent, another Healthcare professional, usually a Doctor, would have taken
the blood sample.

Mr Stead attended the appointment and the results of his blood test were received by
healthcare on 14 January 2016. The Doctor reviewed the results that day and his view was
that they did not warrant treatment or referral to a specialist. However, Mr Stead was advised
to speak to healthcare staff if there was a recurrence of his symptoms.

As noted by the independent clinical reviewer, this blood test would not have had an impact on
Mr Stead’s death on 21 January and an earlier test would not have resulted in Mr Stead
receiving any different treatment.

Care UK Action:

On 14 December 2015 a programme was introduced at HMP Dovegate for all nurses and
HCAs to be trained in phlebotomy. This programme was completed and all of the staff were
deemed competent and signed off in March 2016. Now, blood tests are conducted as soon as
required and on the same day whenever possible or if flagged urgent. If they are not
performed on the day, patients are added onto a waiting list of a few days. Blood samples are
sent to the hospital laboratory daily each afternoon.

More widely, the Governance team have shared the events and learning from Mr Stead’s
death as part of the National Quality and Improvement Meeting for all Regional Managers.

Healthcare Commissioning at HMP Dovegate

During the inquest, when giving evidence, FO Assistant Director of Serco was
asked if Serco commissioned the healthcare service that Care UK provide within HMP
Dovegat al responded “yes” and | am informed that this was reflected in your
summing up. | would respectfully like to take this opportunity to clarify the position as this is
incorrect. NHS England commission health services within Health and Justice and Care UK
has a contract with NHS England to provide healthcare services within HMP Dovegate. NHS
England is thus the Commissioner and Care UK the health service provider. Serco do not
feature anywhere in this contract.

Care UK is committed to providing a high quality healthcare service at HMP Dovegate and
across all of our services and | trust that the above response provides the information that you
require. However, please do not hesitate to contact me if | can be of any further assistance.

Yours faithfully

Company Solicitor
Care UK

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