Prevention of Future Deaths reports · 2017

Mark Doyle

Regulation 28 report to prevent future deaths, reference 2017-0375, written 18 Dec 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report18 Dec 2017
Reference2017-0375
DeceasedMark Doyle
CoronerHeather Williams
Coroner areaInner North London
CategoryState Custody related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

MARK ANTHONY DOYLE (died 28 March 2017) 

THIS REPORT IS BEING SENT TO: 

1.          

, 

Acting Governor 
HMP Pentonville 
Caledonian Road 
London N7 8TT 

(See points (1) and (4)) 

2.          Mr Michael Spurr, 
             Chief Executive 
             HM Prisons and Probation Service 
             Clive House 
             70 Petty France 
             London SW1H 9EX 

             (See point (4)) 

3.          
             Managing Director 
             Care UK 
             29 Great Guildford Street 
             London SE1 0ES 

(See points (2) and (3)) 

1 

CORONER 

I am Heather Williams QC,  
Assistant Coroner 
Inner North London 
St Pancras Coroner’s Court 
Camley Street 
London N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I 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 5 April 2017 an investigation was commenced into the death of Mark Anthony Doyle, 
aged  45  years  old.  The  investigation  concluded  at  the  end  of  the  inquest  on  12 
December  2017.  The  jury  found  that  Mr  Doyle  died  on  28  March  2017  at  University 
College  London  Hospital,  as  a  result  of  injuries  earlier  sustained  when  he  suspended 
himself  from  the  bars  of  his  cell  window  at  HMP  Pentonville  with  a  ligature.  The  jury 
made  a  narrative  determination  that  his  intention  at  the  time  was  unclear;  and  that  his 
death  may  have  been  caused  or  contributed  to  by  errors  in  the  identification  and 
recording of the anniversary  of his son’s death on his ACCT; his inappropriate transfer 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 from  F  Wing;  and  an  undue  delay  in  responding  to  his  cell  bell  on  the  evening  of  21 
March  2017.  The  medical  cause  of  death  was  found  to  be:  1a  post  cardiac  arrest 
hypoxic ischaemic brain injury; 1b ligature compression to the neck. 

4 

CIRCUMSTANCES OF THE DEATH 
See section 3 above; Mr Doyle was found suspended by a ligature attached to the bars 
of his cell window on the evening of  21 March 207. Following emergency  resuscitation 
he was taken to University College London Hospital, where he remained until his death 
on 28 March 2017 from injuries sustained by his suspension with the ligature. 

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 could 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)  Although  recent  developments  regarding  multi-disciplinary  involvement  in  ACCT 
case reviews and quality assurance ACCT checks are encouraging (as described to me 
by 
, Head of Safer Custody), I remain concerned that the following failings 
were apparent in the ACCT case reviews concerning Mr Doyle conducted on 10 and 20 
March  2017,  but  are  not  addressed  /  adequately  addressed  by  the  recent  initiatives 
(including the new Weekly Quality Assurance Check): 

 

Insufficient  appreciation  of  the  importance  of  identifying  and  recording  trigger 
factors for a particular prisoner on their ACCT inside front cover; 

  Officers  undertaking  case  reviews  without  reading  recent  entries  on  the  ACCT 

daily record relevant to risk; 

  Officers  determining  the  frequency  of  observation  levels  for  an  ACCT  prisoner 

without considering relevant material in the ACCT file; 

  The  ACCT  reviewer  failing  to  appreciate  the  value  of  involving  at  least  one 

member of the prison staff who knows the prisoner; and 

  Circumstances in which a prisoner’s family could or should be contacted as part 

of the ACCT review process were poorly understood. 

(2)  Although, 
,  Head  of  Healthcare,  described  how  healthcare 
staff  have  received  recent  encouragement  to  make  entries  on  a  prisoner’s  ACCT  in 
relation  to  matters  that  could  bear  on  risk,  I  am  concerned  that  this  does  not  go  far 
enough to change past practice and ensure that relevant information is shared, in light of 
the  prison  staff’s  lack  of  access  to  System  One  records  and  the  infrequent  occasions 
that Care UK staff made entries on Mr Doyle’s ACCT daily record. 

(3)  Decisions  that  prisoners  are  fit  to  be  transferred  from  F  Wing  are  made  and 
conveyed to prison staff by the charge nurse on duty that morning annotating by hand a 
list  of  the  prisoners  on  the  Wing.  There  appears  to  be  no  clear  criteria  for  assessing 
when  a  prisoner  is  fit  for  transfer;  the  information  that  should  be  considered  in  making 
this determination is left to the discretion of the decision maker; and there is no process 
for recording the decision, the reasons for it or the identity of the decision maker in the 
prisoner’s records or otherwise.   

(4)  There  is  no  mandatory  first  aid  training  for  existing  (as  opposed  to  new)  prison 
officers. I was informed that Orderly Officers and OSGs have / are being provided with 
first aid training, but I am concerned this remains a serious lacuna.  I appreciate it is a 
nationally made resourcing decision and that it has been raised previously, but I raise it 
for further consideration; in light of the limited number of prison and nursing staff on duty 
overnight, there is a real prospect of medical emergencies arising where no trained first 
aider is available.  

2 

 
 
 
 
 
 
 
 
 
 
 
 
 6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you and/or 
your organisation 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 13 February 2018. 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. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested 
Persons  
 

, the sister of Mark Anthony Doyle (via her solicitors, 

Hickman and Rose); 

  Barnett, Enfield & Haringey Mental Health NHS Trust 

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

9 

18 December 2017                                               

3

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)
HMP Pentonville 
Healthcare Department 
Caledonian Road 
London 
N7 8TT 

HM Assistant Coroner Heather Williams QC 
Inner North London 
St Pancras Coroner’s Court 
Camley Street 
London  
N1C 4PP 

19 January 2018 

Dear Madam, 

Regulation  28:  Prevention  of  Future  Deaths  report,  Mark  Anthony  Doyle  (died  28  March 
2017) 

Thank you for your Regulation 28 Prevention of Future Deaths Report issued to Care UK  on 18 
December  2017  following  the  inquest  into  the  death  of  Mr  Mark  Anthony  Doyle  at  HMP 
Pentonville. Care UK would like to express its condolences to Mr Doyle’s family and friends. 

Care  UK  is  the  main  provider  of  healthcare  services  at  HMP  Pentonville.  I  have  addressed  the 
issues you have directed to Care UK only which you have highlighted as paragraphs 5.2 and 5.3.  

The matters of concerns are highlighted in bold with the response set out below each concern. 

, Head of Healthcare, described how 
Matter of Concern 1: Although, 
healthcare staff have received recent encouragement to make entries on a prisoner’s ACCT 
in  relation  to  matters  that  could  bear  on  risk,  I  am  concerned  that  this  does  not  go  far 
enough to change past practice and ensure that relevant information is shared, in light of 
the prison staff’s lack of access to System One records and the infrequent occasions that 
Care UK staff made entries on Mr Doyle’s ACCT daily record. 

Response: Following the inquest I have reflected and reviewed healthcare processes and there 
have  been  discussions  within  the  healthcare  team.  Going  forward  we  will  ensure  that  the  Local 
Operating  Procedures  (LOPs)  are  embedded,  with  senior  management  undertaking  audits,  to 
ensure that where any relevant risks and triggers are identified, we will share information with the 
prison in the following ways:– 

  Update on C nomis – entry to be made by allocated healthcare staff 
  Update the ACCT document and highlight any trigger points 
  Share  with 

Safer  Custody 

team 

their 

the 

via 

functional  mailbox 

SafercustodyPentonville@hmps.gsi.gov.uk. 

By sharing triggers with the Safer Custody team, healthcare can ensure that the senior managers 
on the landings and units are updated on what information has come through to their team. 

Care UK Health & Rehabilitation Services Limited - Registered in England No 10498997 
Registered Office: Connaught House, 850 The Crescent, Colchester Business Park, Colchester, Essex CO4 9QB 

  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Matter  of  Concern  2:  Decisions  that  prisoners  are  fit  to  be  transferred  from  F  Wing  are 
made and conveyed to prison staff by the charge nurse on duty that morning annotating by 
hand a list of the prisoners on the Wing. There appears to be no clear criteria for assessing 
when a prisoner is fit for transfer; the information that should be considered in making this 
determination  is  left  to  the  discretion  of  the  decision  maker;  and  there  is  no  process  for 
recording  the  decision,  the  reasons  for  it  or  the  identity  of  the  decision  maker  in  the 
prisoner’s records or otherwise. 

Response: We agree that the system described above requires improvement. We have therefore, 
with immediate effect, implemented a Patient Wing Movement Assessment. This is similar system 
to what we have in the in-patients unit as follows. 

All prisoners who are deemed necessary to be admitted to the Substance Misuse Unit will remain 
on the unit for a period of stabilisation and until it is deemed safe for them to be moved off this unit 
and to be placed on normal location. By default, prisoners should not be discharged from the in-
patients unit for two weeks as a minimum. If someone needs to be moved from the unit then the 
senior  manager  and  clinical  lead (either  a  GP  or  Care  UK  employed  Nurse  Medical  Prescriber) 
must review the patient’s notes and make a decision on whether or not they are fit to move. This 
decision and the reasons for it will be recorded  in the new Assessment template  in the patient’s 
SystmOne medical notes.  

“Ward rounds” and “review meetings” will be undertaken three times a week. All patients should 
be discussed in the review meeting and agreement reached and whether they are suitable or not 
to be moved from the unit and transferred to either E wing (an overspill wing for stable Substance 
Misuse  Service  clients)  or  to  ordinary  location.  This  ward  round  should  always  be  attended  by 
senior clinicians including either a GP or unit clinical lead. 

The discussion and outcome of the meeting will be recorded in the patient’s SystmOne notes and 
the decision shared with the wing officer so that they are aware of who can and cannot be moved 
from the unit. 

We are committed to providing a high quality healthcare service at HMP Pentonville and are doing 
everything  we  can  to  ensure  those  detained there  are  as  safe  as  possible  and  receive  the  best 
quality  care. We  are  committed to ensuring that  the  lessons learnt following  this  inquest  are  not 
just implemented at HMP Pentonville but across Care UK’s services. 

We  trust  that  the  above  responses  provide  the  information  that  you  require  but  please  do  not 
hesitate to contact us if Care UK can be of any further assistance.  

Yours  

Regional Service Manager  
London & IOW prisons  

On behalf of Care UK 

Care UK Health & Rehabilitation Services Limited - Registered in England No 10498997 
Registered Office: Connaught House, 850 The Crescent, Colchester Business Park, Colchester, Essex CO4 9QB

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