Prevention of Future Deaths reports · 2017

Janet Williams

Regulation 28 report to prevent future deaths, reference 2017-0218, written 11 Sep 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Sep 2017
Reference2017-0218
DeceasedJanet Williams
CoronerMary Hassell
Coroner areaInner North London
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedEast London NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

Regulation 28:  Prevention of Future Deaths report 

Janet WILLIAMS (died 08.03.17) 

THIS REPORT IS BEING SENT TO: 

1. 

Medical Director 
East London NHS Foundation Trust 
Trust Headquarters 
9 Alie Street 
London  E1 8DE 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On 13 March 2017 I commenced an investigation into the death of Janet 
Williams, aged 54 years. The investigation concluded at the end of the 
inquest on 10 September 2017.  I made a determination as follows. 

Janet Williams’ death was the result of suicide.  She hanged herself  at 
home  whilst  suffering  late  onset  paranoid  schizophrenia.    This  had 
developed a little over a year before her death.  During that time, despite 
very  significant  efforts  by  family  members,  there  was  a  healthcare 
professional failure properly to monitor and therefore to assess and treat 
Ms Williams appropriately. 

4 

CIRCUMSTANCES OF THE DEATH 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Ms Williams became ill in early 2016 and was referred to mental health 
services  by  her  general  practitioner.    She  was  admitted  to  Brick  Lane 
Ward at the Tower Hamlets Centre for Mental Health on 9 March 2016 
as a voluntary patient and discharged to the home treatment team on 8 
April.  She was under the care of the home treatment team until 29 April, 
and then again from 16 September until 11 October 2016. 

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.  Ms Williams’ care plan approach (CPA) was not recorded on the 
computer  system  and  so  there  were  no  automatic  alerts 
generated when she was not seen for review at the appropriate 
times.  The lack of computer record of her CPA was never noted. 

2.  Ms  Williams  told  her  care  co-ordinator  that  she  was  no  longer 
hearing voices, but her daughter raised concerns that this was not 
true.  Ms Williams’ care co-ordinator did not at any point in April 
2016  or  afterwards  raise  this  with  Ms  Williams,  but  instead 
accepted Ms Williams’ narrative as accurate. 

3.  Ms Williams was not reviewed in accordance with the protocol for 
a  person  on  a  CPA.    A  medical  review  with  her  consultant 
psychiatrist scheduled for 12 May 2016 was cancelled by her care 
co-ordinator.    The  reason  given  was  that  the  psychiatrist  was 
unwell, though in fact she was not. 

4.  A meeting was then scheduled three months’ away, for 9 August 
2016,  despite  the  need  for  medical  review  and  the  lack  of  any 
alternative arrangement in the meantime. 

5.  Between 11 October 2016 when Ms Williams was discharged by 
the home treatment team, to 21 February 2017 when she saw her 
general  practitioner  and  her  care  co-ordinator  together,  Ms 
Williams’ care co-ordinator did not meet with her. 

6.  Between 11 October 2016 when Ms Williams was discharged by 
the  home  treatment  team,  and  her  death  on  8  March  2017,  Ms 
Williams’ care co-ordinator did not arrange for a medical review 
by the psychiatrist. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 7.  When  Ms Williams’  family  attempted  to  raise  concerns  with  her 
care  co-ordinator,  at  times  their  calls  were  not  returned  and  at 
other times their concerns were simply not acted upon.  She had 
recently  been  diagnosed  with  a  very  serious  mental  health 
condition,  but  she  was  not  monitored  with  sufficient  care  or  in 
some  instances  at  all,  and  she  was  therefore  not  assessed  or 
treated appropriately.   

8.  Finally,  as  I  know  you  are  aware,  the  care  co-ordinator  made 
several retrospective entries in the medical records that she did 
not  record  as  being  made  retrospectively.    These  entries  were 
made up to eleven months after events, and were made after Ms 
Williams’ death and mostly after my request for a statement from 
the care co-ordinator in preparation for the inquest. 

I attach to this report a copy of the report I made to you on 26 July 2017 
concerning  the  death  of  Songul  Bozdag.    You  will  see  that  there  are 
themes common to both deaths. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that 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 6 November 2017.  I, the coroner, may extend 
the period.   

As I have indicated, I wrote to you about similar matters on 26 July 2017 
in respect of the death of Songul Bozdag on 9 February 2017.  Given the 
parallels, I hereby extend the period for your response to my earlier letter 
from 26 September 2017 to 6 November 2017, so you may send both 
responses at the same time. 

Your responses 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 following. 

  HHJ Mark Lucraft QC, the Chief Coroner of England & Wales 

3 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   Care Quality Commission for England  
  The Health & Care Professions Council 
, consultant psychiatrist 
 
 
, care co-ordinator 
 
 

, sister of Janet Williams 

, London Borough of Tower Hamlets 

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

9 

DATE                                                  SIGNED BY SENIOR CORONER 

11.09.17 

4

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