Prevention of Future Deaths reports · 2018

Michael Wheeler

Regulation 28 report to prevent future deaths, reference 2018-0414, written 4 Oct 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Oct 2018
Reference2018-0414
DeceasedMichael Wheeler
CoronerEmma Brown
Coroner areaBirmingham and Solihull
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBirmingham and Solihull Mental Health NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

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: NHS England and Birmingham and Solihull Clinical Commissioning
Group

CORONER

lam Emma Brown Area Coroner for Birmingham and Solihull!

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.

INVESTIGATION and INQUEST

On 2" August 2018 | commenced an investigation into the death of Michael Paul Wheeler and an inquest
is listed to take place on the 7" December 2018.

CIRCUMSTANCES OF THE DEATH

Mr. Wheeler died as a result of jumping from a fourth floor window at the home of his brother with
whom he was staying on the 26" july 2018. Mr. Wheeler had attended the Queen Elizabeth Hospital
Birmingham on the 24" July 2018 because he was demonstrating extreme paranoia. He was concerned
for his own safety and that of family members to the extent that he was trying to stop family members
from leaving the house and had called the police to report that people were coming to attack him when
there was no basis for this belief. Mr. Wheeler was seen by a psychiatric nurse from the Birmingham and
Solihull RAID team whilst in hospital to who family reported an increase in bizarre behaviour in the last 8
to 9 weeks, including Mr. Wheeler isolating himself and becoming increasingly paranoid. Mr. Wheeler
told RAID he would keep himself safe but it was identified by the nurse that he had limited
understanding of his circumstances due to his paranoia. The RAID clinician concluded he could be
discharged that day but needed to be seen urgently and referred him to the Home Treatment Team
(‘HTT’) for a review the following day. Mr. Wheeler was visited the following day, the 25" july 2018, by a
community psychiatric nurse from the HTT and it was identified that he required a medical review. This
was booked for 10am on the 27" July 2018.

Following a post mortem the medical cause of death was determined to be:
| 1a) Multiple Injuries

CORONER’S CONCERNS

During the course of the investigation to date the evidence has 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. Mr. Wheeler’s family have provided evidence that he was extremely paranoid by the 24" of July
2018 and this was causing him to act irrationally and at times aggressively, they were very
fearful for his safety and reported this to the mental health nurses he saw on the 24" and 25".
Despite these concerns Mr. Wheeler was not reviewed by a Psychiatrist and therefore his
condition went undiagnosed with no treatment plan. Furthermore it is noted that there was no
plan to review Mr. Wheeler at all on the 26" July 2018.

2. The Coroner is aware, although not from evidence obtained in respect of Mr. Wheeler’s case as
the inquest is yet to take place, that inpatient beds within the BSMHFT are currently operating
at 109% capacity and are often not available. Consequently, patients who would otherwise
have been offered in-patient treatment, are having to be managed by the HTTs. Partly asa
consequence of this but partly due to other pressures the demand on the HTTs is often too
great to enable them to visit all patients requiring a visit in any one day. One particular problem
in the Birmingham and Solihull area is that the occurrence of psychosis is more than 3 times
higher than the national average. It is understood that the Trust is exploring options to expand
its HTT service but funding is required.

3. The fact that at the current time HTT cannot always provide urgent medical review by a
psychiatrist creates a risk to life.

4. Although evidence at inquest has yet to be heard there is a concern that this case, along with

several other cases being investigated by the Birmingham and Solihull Coroners’ jurisdiction may
arise from underfunding of mental health services.

5. The strain on the systems of mental health services provided by both Forward Thinking
Birmingham and Birmingham and Solihull Mental Health NHS Foundation Trust has become
apparent to the Birmingham and Solihull Coroners in recent months. Consequently this report to
prevent future death is being made in conjunction with reports to prevent future deaths arising
from 6 other investigations into deaths between May and August 2018 that demonstrate a risk
that future deaths will occur as a result of under-funding.

6. Inaddition to this report letters are enclosed from the Medical Directors of both Trusts setting
out their concerns.

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 29"
November 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

I have sent a copy of my report to the Chief Coroner and to the following Interested Persons: the next of
kin Off and the Birmingham and Solihull Mental Health Trust. | have also sent it to Birmingham
Women’s and Children’s NHS Foundation Trust and the Care Quality Commission who may find it useful
or of interest.

lam 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.

04/10/2018

Signature each 2.8

Louise Hunt, Senior Coroner Birmingham and Solihull

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