Prevention of Future Deaths reports · 2017

Conall Gould

Regulation 28 report to prevent future deaths, reference 2017-0458, written 28 Sep 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report28 Sep 2017
Reference2017-0458
DeceasedConall Gould
CoronerEmma Brown
Coroner areaBirmingham and Solihull
CategoryMental Health 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: Northern Health and Social Care Trust

CORONER

| am Emma Brown Area Coroner for Birmingham and Solihull

CORONER’S LEGAL POWERS

1 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 23/05/2017 | commenced an investigation into the death of Conall Patrick Gould. The investigation
concluded at the end of an inquest on 26th September 2017. The conclusion of the inquest was that Mr.
Gould’s death was drug related.

CIRCUMSTANCES OF THE DEATH

Conall Patrick Gould died on the 13th February 2017 at the Queen Elizabeth Hospital in Birmingham
having been admitted earlier that day after being witnessed to behave erratically and then collapse.
Conall had a diagnosis of a delusional disorder, for which he had received inpatient treatment, anda
history of drug. When last reviewed prior to discharge from inpatient psychiatric care at Holywell
Hospital on the 30th January 2017 he had maintained a positive outlook and insisted that his most recent
overdose was recreational and without any intention to cause himself harm. Following his discharge his
behaviour did not give his family cause for concern that he would attempt suicide.

Following a post mortem the medical cause of death was determined to be:
1 (a) ECSTACY USE

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. -

4. At the time of discharge from Holywell Hospital on the 30" January 2017 Mr. Gould had been
referred to the community mental health team for a 7 day review and had been given an
appointment on the 2" February 2017. There is no evidence in the Trust’s records that the time,
date and location of this appointment was given to Conall or his parents.

2. The evidence of consuitant Psychiatrist, who saw Conall and his father on the 30"
January 2017 was that he anticipated that the discharge nurse would tell Conall and his mother
or father, as his carers, the date of his review at the point of discharge as this is the usual
practice.

3. Mr. Gould, Conall’s father, gave evidence that not only were he and his wife not told verbally of
the appointment nor were they given any written information about it: on a previous discharge
from an inpatient stay at another — | had been given a letter setting out the
appointment arrangements for his son following discharge. Conall was 21 at the time of his
discharge on the 30" January and his parents had taken a very active role in his care. If they had
been aware of the appointment they would have made every effort to secure Conall’s
attendance, as it was, believing there to be no plan for follow up, they did not prevent him from

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travelling to Birmingham for a period of rest with relatives (during which time he took the fatal
overdose of MDMA).

4. The evidence of i... conducted the RCA was that the Trust does not have
a protocol or policy stipulating the arrangements for notifying services users and their carers of
follow up arrangements on discharge and current practice does not require written
confirmation of follow up arrangements to be given to the service user or their carers.

5. The system currently creates a risk that services users and their carers will not be aware of
follow up appointments and therefore may not attend giving rise to a danger that opportunities
to review the service user’s condition and treatment will be lost.

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 by 23"
November 2017. 1, 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:

1am 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.

28/09/2017

Signature
Emma Brown Kréa Coroner Birmingham and Solihull

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 Respondent Not Named (PDF)
Northern Health
#7 and Social Care Trust

Ms Louise Hunt

HM Senior Coroner, Birmingham & Solihull Areas
The Coroner’s court

50 Newton Street

Birmingham B4 6NE

26 March 2018
Dear Ms Hunt

Mr Conall Patrick Gould Inquest held on 26 September 2017, Regulation 28 Report to
Prevent Further Deaths

Firstly, please accept my sincere apologies for the delay in this response to you. In relation
to the matters of concern raised by you during the Inquest held into Conall’s death, | can
now inform you of the actions the Trust has made to strengthen systems and processes of
care to support patients and their families on discharge from hospital.

The Trust has introduced into the Integrated Care Protocol (the in-patient clinical
documentation record of the multi-disciplinary treatment team) a requirement for all
patients, when being discharged from hospital, to receive written confirmation of their 7 day
follow-up appointment with relevant telephone contact numbers if they require assistance in
the immediate days following discharge. This protocol also directs that a relative/concerned
other, identified by the patient, will also be provided with this written information when
consent to do so has been given by the patient.

Under the heading ‘Discharge Process’ on p5 , section 3 has been amended in reference to
the information given to the patient on discharge and section 4 has been added in reference
to the carer and the information that should be shared with them, with the agreement of the

patient.

In addition, on page 78, the Discharge Care Plan has been amended significantly to ensure
both the patient and, if acceptable to the patient, the carer, are given a copy of the
Discharge Care plan, Support plan and list of medication.

The Trust believes this action adds a level of robustness to the existing discharge
processes and addresses the concerns raised and | have attached templates of the
documentation now provided to all patients.

| would wish to thank you for raising this matter and would also advise it is planned that this
protocol will be shared with Trusts across Northern Ireland at a workshop to be held on 6
June 2018.

Trust Headquarters, Bretten Hall, Antrim Area Hospital, Bush Road, Antrim BT41 2RL
Phone: 028 9442 4321 E mail: oscar.donnelly@northerntrust.hscni.net

Yours sincerely

Laer INS

Oscar Donnelly
Divisional Director of Mental Health, Learning Disability & Community Well-being

MCM/GEN/LET/ CP GOULD TO AREA CORONER FOR BIRMINGHAM AND SOLIHULL

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