Prevention of Future Deaths reports · 2017

Anne Morris

Regulation 28 report to prevent future deaths, reference 2017-0383, 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
Reference2017-0383
DeceasedAnne Morris
CoronerChristopher Williams
Coroner areaLondon Inner (South)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses published2

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)

NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

1. Chief Executive - Oxleas NHS Foundation Trust.
2. The Director —- The Priory Hospital Ticehurst House.
3. Secretary of State for Health, Department of Health.
4. The Care Quality Commission.
5. The Chief Coroner.

1 | CORONER

lam Christopher Williams an assistant coroner, for the coroner area of inner London
South (Southwark Coroners Court).

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.
htto:/Awww. legislation.gov.uk/uksi/2013/1629/requlation/28/made and

hito.//www legislation gov.uk/uksi/201 3/1629/regulation/29/made

3 | INVESTIGATION and INQUEST

An investigation into the death of Anne Morris commenced on the 28/6/2017. The
investigation concluded at the end of the inquest on 2"! November 2017. The
conclusion of the inquest was that the medical cause of death was 1(a) hanging. The
short form conclusion was “Suicide”.

4 | CIRCUMSTANCES OF THE DEATH

1) On the 26/6/2017 Anne hanged herself whilst she was alone inside the house of
a friend in Merryfield Road, Eltham. She had secured the house from the inside
and her _ | had to gain access by a ladder to an upstairs
room. She left a handwritten message expressing that her life had been “ruined”

™ financial debts caused by a former partner and apologising to her friend,

2) The inquest heard evidence that on the 8" May 2017 Anne had become very
distressed by a solicitors’ letter claiming substantial legal fees, dating back to
2010, which had been unpaid by her ex-cohabiting and business partner.

3) On the 9/6/2017 after taking an overdose of paracetamol tablets she was
visited by the Lewisham Home Treatment (psychiatric) Team (Oxleas HTT) on
the 10/6/17 and was voluntarily admitted to hospital by the Oxleas NHS
Foundation Trust (Oxteas). Oxleas covered the Eitham area. Anne’s usual
address was in Surbiton prior to her temporary stay in Eltham.

4) Due to a shortage of psychiatric beds she was placed by Oxleas in the Priory
Hospital Ticehurst House in Sussex, which is a private hospital, and was
discharged to her friends address in Eltham on the 23/6/17.

5) During the inquest | read the evidence of a consultant
Psychiatrist at the Priory Hospital, who recorded that prior to Anne’s discharge
from hospital she consented to staff speaking to her Protea
and Peter Forrester who provided her accommodation in Eltham.

6) RE candidly noted in his report that there was no record of any staff
contacting Anne's friend or her brother prior to discharge.

7) On the 25/6/17 Anne was seen by the Oxleas HTT at the Eltham address. The
Oxleas HTT did not have the benefit of a discharge plan from the Priory
Hospital.

8) Ina Root Cause Analysis report provided by Oxleas NHS Trust it was recorded
that as “AM approached her discharge from Ticehurst Priory, there is no
evidence of forward discharge planning with the community team to whom care
was being transferred or the address where AM would be staying and therefore
which team would be responsible for her follow up”.

9) During the inquest both] anc Incicated to me their
concerns that they were not contacted by the mental health services prior to
Anne’s discharge from hospital to discuss her care in the community.

10) At ‘iil | indicated to the representative for Oxteas, EE
and that | was considering making a regulation 28 report but
before doing so | would be assisted by written representation from Oxleas
concerning what had been done by Oxleas since the death to address the
problems concerning discharge from hospital in the RCA report. | gave Oxleas
14 and days to respond and then a further 14 days a and

to provide written observations on the Oxleas response,

11) The response from Oxleas, 13/11/17 (received 23/11/17), identified the
following recommendations and progress:

i) GP records must be requested by the Greenwich Home Treatment
Team when an unknown out of area patient is referred to the service.

ii) Clinical documentation must be updated and in a timely manner.

12) In responses | received jon they both expressed

concerns that neither of them had been contacted by the Priory hospital staff
prior to Anne's discharge and that Anne’s indication that she was willing for staff
to contact them both had not been communicated to the community HTT. In the
case Of MM he expressed the opinion that if the mental health services
had contacted him he would have been more aware of the risk Anne presented
to herself and he might have been able to help avert the tragedy.

CORONER’S CONCERNS

From the evidence before me at the inquest and written representations | have received
after the inquest there are 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) 1am concerned that the staff at the Priory Hospital did not make contact with
friends and relatives after Anne had consented to them being contacted.

(2) The Priory Hospital did not formulate a written plan, before discharge from
hospital, identifying the HTT who would be responsible for onward care in the
community and, in particular making the relevant HTT aware that Anne was
agreeable to health care professionals speaking to Peter Forester and Bernard
Bakes regarding support with her mental health issues.

|

(3) The Priory Hospital did not identify a responsible HTT for the discharge address
in Eltham and there was no liaison with an HTT prior to discharge.

(4) The Oxleas HTT do not appear to have proactively contacted the Priory Hospital

for a written discharge plan prior to, or at the time, of the home visit on the

25/6/17. Had the HTT made contact with the Priory Hospital it would still have

been possible to formulate a plan (including the availability of collateral

assistance from Messr:

(5) The Oxleas HTT do not appear to have been aware of Anne’s willingness for
mental health professionais to contact regarding
community support with her suicide risk. Had Oxleas HTT proactively made
contact with the Priory Hospital they could have been made aware of this
arrangement.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe your
organisations have the power to take the following action: -

1. The Priory Hospital should indicate what steps have been taken since the
death to ensure that where a patient has given consent to staff contact named
friends and relatives in the community that efforts should be made to consult
those individuals when preparing a discharge plan.

2. The Priory Hospital should indicate what steps have been taken since the
death to ensure a system of promptly issuing care plans prior to discharge into
the community inciuding contact details of friends and next of kin where the
patient consents to contact with named individuals.

3. The Priory Hospital should indicate what steps have been taken since the
death to ensure that the responsible HTT for the area in which the patient will be
living is contacted directly and that such contact is confirmed by a response
from the relevant HTT.

4. Oxleas HTT shouid indicate what steps have been taken since the death to
ensure a system of liaising with the discharging hospital in situations where they
have not been provided with a discharge plan in order to obtain the same or to
urgently formulate one with the discharging hospital.

YOUR RESPONSE

You are both under a duty to respond to this report within 56 days of the date of this
report, namely by 12" February 2018. |, the coroner, may extend the period.

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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons who may find it useful or of interest:

e Secretary of State for Health, Department of Health.
« The Care Quality Commission.

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

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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.

18" December 2017 ( —a Christopher Williams — Assistant Coroner

Responses

2 responses 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 Oxleas NHS Trust (PDF)
Oxleas NHS |

IMProOVing IVES NHS Foundation Trust

15 February 2018

Pinewood House

Pinewood Place

Dartford

Kent

Clerk to Senior Coroner DA? 7WG
Coroner for Inner South District Greater London

Southwark Coroner's Court

Private and Confidential

Vel: 01322 625778 I
Fax: 61322 625727 :

1 Tennis Street Website: www.oxleas.nhs.uk |
Southwark |
SE11YD

Dear Mr Thompson

Re: preventing Future Deaths report touching the death of MORRIS, Anne (date of death 26/06/2017)
[Case Ref: 01820/2017]

Thank you for your letter of 22 December 2018, enclosing the preventing future deaths report touching
the death of Anne Morris, requesting a response by 12 February 2018.

The Assistant Coroner, Christopher Williams, identified that action should be taken by our Home
Treatment Team, namely that, Oxleas Home Treatment Team should indicate what steps have been taken
since the death to ensure a system of liaising with the discharging hospital in situations where they have
not been provided with a discharge plan in order to obtain the same or to urgently formulate one with the
discharging hospital.

The steps that we have taken are:

e In the event that the information, including a detailed discharge plan is not received within 24
hours for patients transferred from an inpatient unit, the Home Treatment Team now contact the
referring organisation to request that this is sent immediately and if not available they have a
discussion about their recommendation for further treatment.

Director, because it only described the information which should be provided to other units not
what services should do in order to obtain information when a patient is referred / transferred.
This will ensure standardisation in all Oxleas services in addition to the Home Treatment Team and
this will then be disseminated through our clinical effectiveness governance process, This action is

© Our ‘Transfer of Care within Oxleas and externally' protocol has been reviewed by the Medical |

complete. |

MINDFUL
Og EMPLOYER
Response from Priory Group (PDF)
PRIORY

GROUP OF COMPANIES

Director of Risk and Safety
Priory Group
Fifth floor
80 Hammersmith Road
London, W14 8UD
Tel. 020 7605 0923

Email:

Friday 2 February 2018

Case Ref: 01820/2017

Mr John Thompson

Assistant Coroner, London Inner South
Southwark Coroners Court

1 Tennis Street

London, SE1 1YD

Private and confidential

Dear Mr Thompson
Re. Anne Morris (deceased)

I write to you in response to the Regulation 28 Report to Prevent Future Deaths dated Friday
22 December 2017 that you issued in response to the Inquest Touching the Death of Ms
Anne Morris.

I note that you have addressed your report to i and A, please
note that IEMs no longer connected with Priory Hospital Ticehurst. I write to you on
behalf o

Firstly I would like to advise you that we were disappointed that this particular Inquest went
ahead without our full involvement. Had we been invited to give evidence we would have
reassured you in terms of the improvement actions taken in response to Ms Morris’ death.
Despite our reservations we accept your report and set out the matters of concern and our
responses below.

The staff at the Priory Hospital did not make contact with friends and relatives
after Ms Morris had consented to them being contacted.

Please note that we have reviewed and re-launched Priory Healthcare Policy HO2: Admission,
Transfer and Discharge and made reference to the involvement of family, friends and carers
in the discharge planning process (paragraph 5.1e). A rolling programme of training
webinars which detail policy and practice is planned for 2018 and discharge planning will
feature as part of these webinars. Please be assured that the point that you have made in
respect of communicating with family and friends prior to discharge will be highlighted as
part of these webinars.

The Priory Hospital did not formulate a written plan, before discharge from
hospital, identifying the Home Treatment Team (HTT) who would be responsible
for onward care in the community and, in particular making the relevant HTT
aware that Ms Morris was agreeable to healthcare professionals speaking to
Peter Forester and Bernard Blakes regarding support with her mental issues.

As above this matter has been addressed as part of the policy review. Form H11A Discharge
Checklist which is associated with the policy has been amended to include a section to
record the contact details of friends and family (including the next of kin). The policy itself
stipulates very clearly that care plans should be circulated prior to the patient’s discharge
from hospital. This point of good practice will be highlighted as part of the webinar training
programme.

The Priory Hospital did not identify a responsible HTT for the discharge address in
Eitham and there was no liaison with an HTT prior to discharge.

This matter has been addressed as part of the policy review. The newly reviewed policy
reinforces the requirement to identify which service will provide care and support to the
patient at the point of discharge from hospital (paragraphs 5.1b, 6.7 and Form H11A) and to
ensure that the service confirm in writing their acceptance of their responsibility to deliver
follow-up care and support. Once again this requirement will be highlighted as part of the
webinar training programme.

We note that the fourth and fifth matters of concern relate to Oxleas Mental Health NHS
Trust rather than to Priory Group.

I do hope that these actions will provide you with the reassurance that you require. If I can
be of further assistance then please do not hesitate to contact me.

Yours sincerely,

‘

Director of Risk and safety

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