Prevention of Future Deaths reports · 2018

Kenneth Horne

Regulation 28 report to prevent future deaths, reference 2018-0131, written 3 May 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report3 May 2018
Reference2018-0131
DeceasedKenneth Horne
CoronerMargaret Jones
Coroner areaStoke-on-Trent & North Staffordshire
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:
P| Healthcare Governance Manager Patient Safety, Royal Stoke University Hospital
HR Corporate Governance Manager, Staffordshire & Stoke-on-Trent Partnership NHS

CORONER
| am Margaret J Jones HM Assistant Coroner for Stoke-on-Trent & North Staffordshire

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.
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7

http://www. legislation. gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

On 23 March 2018 | commenced an investigation into the death of Kenneth William Horne. The
investigation concluded at the end of the inquest on 2nd May 2018. The conclusion of the inquest was
that the deceased had a history of lung cancer in 2015 which had been operated on. In December 2016
he was admitted to the Royal Stoke University Hospital, Stoke on Trent with a chest infection. He was
investigated for cancer of the colon but was unfit for further tests due to his comorbidities and general
frailty. He transferred to ward 80 where infections settled. He suffered two falls on the ward whilst
mobilising from the toilet without requesting assistance. One of the falls was on the morning of the 27th
January 2017 which was also his planned discharge to Leek Moorlands Hospital where he was admitted
at 7.50pm. Details of his previous falls were not included on the discharge letter and there was no verbal
nurse to nurse handover. His falls documentation and risk assessments were sent with him to Leek
Hospital but the transfer of care form had not been updated. At 2.00am on the 28th January 2017 he was
found on the floor at the side of his bed. Observations indicated a deteriorating condition and he was
readmitted to the Royal Stoke University Hospital. A CT scan found a very large haematoma of the left
thoracic wall and possible infection. His nutritional intake remained poor. He was not suitable for
intervention and was treated as palliative. He transferred to Bradwell Hall Nursing Home, Newcastle-
under-Lyme on the 22nd February 2017 where he died on the 24th February 2017. The cause of death
was.

1a Sepsis.

1b Bronchopneumonia.

1c Chest wall injury.

ll Old age.

CIRCUMSTANCES OF THE DEATH

The conclusion of the inquest was Accidental Death.

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 deceased had 2 falls whilst at the Royal Stoke University Hospital, one on the morning of his
transfer to Leek Moorlands Hospital. The falls were not included in the discharge letter.

(2) There was no nurse to nurse discharge call between the hospitals.

(3) The Transfer of Care form was not up to date. If these matters had been properly dealt with Leek
Moorlands Hospital might not have accepted the transfer. He had a fall with serious injury approximately
6 hours after admission to Leek Moorlands Hospital.

Asa side issue and a matter of concern, communication with the relatives appeared to be poor.

No Datix form was completed for the second fall in the Royal Stoke University Hospital until December.
ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe the Royal Stoke University
Hospital and Leek Moorlands Hospital 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 Friday
29" June 2018, |, 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:

FY son of the deceased.

!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.

03/05/2018

Signature: MA os

Margaret J Jones HM Assistant Coroner Stoke-on-Trent & North Staffordshire

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 University Hospitals of North Midlands NHS Trust (PDF)
Your Ref:  10393 

Our Ref:    INQ/084/17 
Date:         18th June 2018 

STRICTLY PRIVATE & CONFIDENTIAL 
Mrs M Jones 
Assistant Coroner 
547 Hartshill Road 
Stoke on Trent 
ST4 6HF 

Dear Mrs Jones 

Kenneth William HORNE 

Executive Suite 
Trust Headquarters 
Springfield 
City General Site 
Newcastle Road 
Stoke on Trent 
ST4 6QG 

Tel:  01782 676612 

Email: 

Further  to  your  letter  dated  3  May  2018,  I  am  pleased  to  provide  a  response  to  your  report  under 
paragraph  7  of  Schedule  5  of  the  Coroners  and  Justice  Act  2009  and  Regulations  28  and  29  of  the 
Coroners (Investigations) Regulations 2013, addressing your concerns surrounding the death of Kenneth 
William Horne. 

Recorded Circumstances of the Death 
On 23 March 2018 HM Assistant Coroner commenced an investigation into the death of Kenneth William 
Horne.  The  investigation  concluded  at  the  end  of  the  inquest  on  2  May  2018.  The  conclusion  of  the 
inquest  was  that  the  deceased  had  a  history  of  lung  cancer  in  2015  which  had  been  operated  on.  In 
December  2016  he  was  admitted  to  the  Royal  Stoke  University  Hospital,  Stoke  on  Trent  with  a  chest 
infection.  He  was  investigated  for  cancer  of  the  colon  but  was  unfit  for  further  tests  due  to  his 
comorbidities and general  frailty.  He was transferred to  ward  80  where  infections settled.  He suffered 2 
falls on the ward whilst mobilising from the toilet without nursing assistance. One of the falls was on the 
morning of 27 January 2017 which was also his planned discharge to Leek Moorlands Hospital where he 
was admitted at 7.50pm. Details of his previous falls were not included on the discharge letter and there 
was no verbal nurse to nurse handover. His falls documentation and risk assessments were sent with him 
to Leek Hospital but the transfer of care form had not been updated. At 2.00am on 28 January 2017 he 
was found on the floor at the side of his bed. Observations indicated a deteriorating condition and he was 
re-admitted to the Royal Stoke Hospital. A CT scan found a very large haematoma of the left thoracic wall 
and possible infection. His nutritional intake remained poor. He was not suitable for intervention and was 
treated  as  palliative.  He  was  transferred  to  Bradwell  Hall  Nursing  Home,  Newcastle  under  Lyme  on  22 
February 2017 where he died on the 24 February 2017.  

The cause of death was 1a: sepsis, 1b bronchopneumonia, 1c: chest wall injury, 2: old age. 

 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 Concerns 
During the course of the  inquest you felt that evidence revealed matters giving rise for concern. In your 
opinion, matters for concern are as follows: 

1.  The deceased has 2 falls whilst at the Royal Stoke University Hospital, one on the morning of his 

transfer to Leek Moorlands Hospital. The falls were not included in the discharge letter. 

2.  There was no nurse to nurse discharge calls between the hospitals. 

3.  The Transfer of Care form was not up to date. If these matters had been properly dealt with Leek 
Moorlands  Hospital  might  not  have  accepted  the  transfer.  He  had  a  fall  with  serious  injury 
approximately 6 hours after admission to Leek Moorlands Hospital.  

4.  As a side issue and a matter of concern, communication with the relatives appeared to be poor. 
No  datix  form  was  competed  for  the  second  fall  in  the  Royal  Stoke  University  Hospital  until 
December. 

You  reported  this  matter  under  Paragraph  7,  Schedule  5  of  the  Coroners  and  Justice  Act  2009  and 
Regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.  

Action Taken 
For ease of reference, your concerns will be addressed in turn. 

1.  All  Clinical  Leads  to  instruct  Junior  Doctors  and  Nurse  Practitioners  that  when  summarising 
discharge  letters,  any  significant  event  such  as patient falls  while in hospital  is  reflected  on  their 
discharge summary. 

2.  Ward  staff  to  ensure  that  alongside  the  paper  version  of  handover  between  UHNM  and  other 

hospitals, a verbal handover happens as part of a trusted assessment.  

3.  The  Transfer  of  Care  Form  has  now  been  revamped  and  a  more  comprehensive  and  holistic 
Patient  Profile  documentation  is  in  place.  This  is  a  more  detailed  handover  and  requires  other 
members of the multi-disciplinary team to contribute in its completion.  

4.  This  incident  was  already  shared  widely  across  the  General  Medicine  Department  and  Medical 
division.  A  Memo  has  been  circulated  divisionally  to  reiterate  the  importance  of  accurate  and 
timely datix reporting.  

In  additional  to  this,  the  Corporate  Governance  Team  are  in  the  process  of  co-ordinating  an  audit  of 
discharge  summaries  with  our  external  auditors.  It  is  hoped  that  this  will  take  place  within  the  2018/19 
financial year and any findings will be addressed by the Corporate Governance Team.  

I sincerely hope that this report provides you with assurance that the Trust has taken the matters arising 
from  the  inquest  touching  upon  the  death  of  Mr  Horne  seriously.  The  Trust  strives  to  provide  a  high 
standard of care to all patients and I am grateful to you for raising these matters on this occasion. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Should you wish to discuss any aspect of this report further, please do not hesitate to contact me directly. 

Yours sincerely 

PAULA CLARK 
CHIEF EXECUTIVE

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