Prevention of Future Deaths reports · 2018

Daniel Young

Regulation 28 report to prevent future deaths, reference 2018-0240, written 26 Jul 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Jul 2018
Reference2018-0240
DeceasedDaniel Young
CoronerShirley Radcliffe
Coroner areaLondon Inner (West)
CategoryOther 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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO

Rt Hon Matt Hancock MP

Secretary of State for Health
Department of Health and Social Care
39 Victoria Street

London

SW1H OEU

1 | CORONER

lam Shirley Radcliffe, Assistant Coroner for the coroner area of Inner West London

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.

3 | INVESTIGATION

On 5th February 2016 | opened an inquest into the death of Daniel Young, then
aged 30 years.

The inquest concluded on 28" and 29" June 2018. The conclusion of the
inquest was a narrative conclusion, the medical cause of death was shock and
haemorrhage due to stab wound to the abdomen.

4 | CIRCUMSTANCES OF THE DEATH

1. Daniel Young was a fit and healthy university lecturer. On 19" January 2016,
he was randomly attacked on his way to work. He sustained a fatal stab
wound to the abdomen.

2. His attacker (ML) had been a patient of local mental health services. He had
suffered from periods of psychosis. He was known to be aggressive when
psychotic.

3. At the time of the attack, ML was living in the community with no secondary
mental health follow up. He had been discharged to his GP and told to remain
on his antipsychotic medication for at least 6 months and only reduce them
slowly, if at all. He was told that stopping the medication may lead to a
relapse of his psychosis.

4. ML stopped his antipsychotics soon after discharge from the CMHT.

5. Atthe criminal trial ML was found guilty of manslaughter by reason of
diminished responsibility.

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.

The MATTERS OF CONCERN are as follows. —

1. When ML was discharged to the care of his GP by the Community Mental
Health team, he was warned not to stop his medication because of the
risk of relapse.

2. GP surgeries do not routinely monitor that psychiatric patients are
collecting their antipsychotics. Evidence revealed that it is not uncommon
for such patients stop their medication and relapse. Relapse puts them at
a risk of harm to themselves and, sometimes, they pose a risk to others.

3. Following the death of Mr Young, the GP responsible for the care of ML
has implemented a system within the practice to monitor the collection of
antipsychotic medication of their patients. This is funded by the practice.

4. lattach a copy of the Protocol for Monitoring Collection of Antipsychotic
Prescriptions.

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 24 September 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons :

Parents of Daniel Young
(address known to the court)

| 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.

26" July 2018

Dr Shirley Radcliffe,

HM Assistant Coroner for Inner West London,
Westminster Coroner’s Court,

65, Horseferry Road,

London.

SW1P 2ED

i
|
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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 Department of Health Social Care (PDF)
a From Jackie Doyle-Price MP

D e p artm ent Parliamentary Under Secretary of State for Mental Health and Inequalities
Department of Health and Social Care

of Health & 39 Victoria Street
i London
Social Care SW1H OEU

Our reference: PFD 1143538

Dr Shirley Radcliffe

HM Assistant Coroner, Inner West London
Westminster Coroner’s Court

65 Horseferry Road

London

SWIP 2ED

\2 September 2018

deov Ve ”

Thank you for your letter of 26 July to the Secretary of State for Health and Social
Care about the death of Mr Daniel Young. I am responding as Minister with
portfolio responsibility for Mental Health.

I have noted carefully the concerns in your report. My officials have made enquiries
with NHS England on these matters.

You will be interested to know that NHS England is currently developing a
framework for community mental health services which will articulate models of
improved joint working between primary and secondary mental health services in
community settings.

This will support teams to work together to plan a patients’ care holistically and
ensure that any transitions between settings and different teams can be facilitated
with the relevant professionals having ready access to all relevant information. This
is particularly important for people transitioning between service settings, for whom
medication reviews need to be followed up.

In addition, I am advised that the framework will set out quality benchmarks and
recommendations for local systems, reflecting current evidence and existing guidance

published by the National Institute for Health and Care Excellence (NICE), to support
commissioners and providers across the health and care system to model and
implement the framework. It will include key considerations regarding medication
adherence and medicines optimisation.

To support improved care coordination in the community, the framework will set out
the key competencies and skills that staff from different professional backgrounds
will need in order to support people they care for, and to link with other professionals
and services to ensure all of a person’s needs are met. The framework will recognise
needs that require special attention, such as support from a community or specialist
mental health pharmacist to discuss medication choices and compliance.

The community framework will also include examples of best practice information,
including evidence-based community discharge processes. These will specifically
reference the importance of considering a person’s discharge destination and ongoing
care needs and communicating with relevant teams to ensure that the necessary
support is put in place in a timely manner to enable smooth transition.

In the interim, NHS England has confirmed that it will undertake the following
actions by the end of the year to address the issues noted in your report:

e NHS England will write to GP practices to make them aware of this issue and
to consider what mechanism they do or could employ to monitor the collection
of antipsychotic medication prescriptions;

e NHS England will explore with NHS Digital what opportunities there are for
primary care clinical systems to alert GPs around prescription collection issues
for named patients and named drugs; and

e NHS England will work with NHS Improvement on a communication to
providers around making discharge letters explicit on medication risks that
need to be monitored in primary care.

I hope this response is helpful. Thank you for bringing your concerns to our
attention.

E DOYLE-PRICE

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