Prevention of Future Deaths reports · 2019

Olive Johnson

Regulation 28 report to prevent future deaths, reference 2019-0031, written 24 Jan 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report24 Jan 2019
Reference2019-0031
DeceasedOlive Johnson
CoronerPaul Cooper
Coroner areaLincolnshire
CategoryEmergency services related deaths (2019 onwards)
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

Regulation 28: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This from is to be used after an inquest.
REGULATION 28 REPORT TO PREVENT DEATHS

THIS REPORT IS BEING SENT TO:

1 EMAS……………………………………
2 ……………………
3 ……………………………………

1 CORONER

I am Paul S Cooper Assistant Coroner for the area of Lincolnshire

2 CORONER’S LEGAL POWERS

I 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 and INQUEST

On 18/05/2018 I commenced an investigation into the death of Olive JOHNSON aged 97. The
investigation concluded at the end of the inquest on 23 January 2019. The conclusion of the inquest
was:

I a Acute Myocardial Infarction

I b Left Anterior Descending Coronary Artery Thrombus

I c -

II -
4 CIRCUMSTANCES OF THE DEATH
The deceased died within 24 hours of being admitted to Pilgrim Hospital , Fishtoft ,Lincolnshire on
11th May 2018

5 CORONER’S CONCERNS

The MATTERS OF CONCERNS are as follows:
a) Why were no first responder's called out in relation to the deceased?
b) How many occasions have EMAS exceeded their response times since 01/01/2108 to date?
c) Is it fair that if a patient is regraded whilst awaiting an initial response the total time from the initial
call to the regrading is cancelled out?
d) Do EMAS believe they have enough conveying resources to meet their response targets?

6 ACTION SHOULD BE TAKEN
In my opinion action should be taken to prevent future deaths and I believe you (and/or your
organisation) have the power to take such action.

7 YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 21 March 2019.

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.

8 COPIES and PUBLICATION

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

Nephew -
……………………………………………………………………………………………………………………

I 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.

Dated: 24th January 2019

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 East Midlands Ambulance Service NHS Trust (PDF)
Mr P S Cooper

Assistant Coroner
Lincolnshire County Council
Coroner’s Service

Unit 1, Endeavour Park
Boston, Lincs

PE217TQ

Dear Mr Cooper

INHS|

East Midlands

Ambulance Service
NHS Trust

Trust Headquarters

1 Horizon Place

Mellors Way

Nottingham Business Park
Nottingham

NG8 6PY

PALS telephone: 0333 012 4216
Head office telephone: 0115 884 5000
Fax: 0115 884 5001

Website: www.emas.nhs.uk

21 March 2019

Re: Report to Prevent Future Deaths: Olive Johnson

Thank you for your Regulation 28 Report to Prevent Future Deaths, dated 23 January 2019,
bringing to my attention HM Coroner's concerns arising from the Inquest into the death of Ms

Olive Johnson.

| would like to assure you that the Trust takes all matters relating to patient safety extremely
seriously. In particular, matters arising from Coroners’ Inquests from which lessons can be learnt,
including Prevention of Future Death Reports, are discussed by the Incident Review Group and

Lessons Learned Group.

Matters of Concern:

a) Why were no First Responders called out in relation to the deceased?

On the day in question, there were three voluntary Community First Responders logged on
duty. The role of a Community First Responder is to provide pre-ambulance arrival assistance
to patients within their community.

One responder was committed on another call; one responder was responding to cardiac and
respiratory arrests only and the third responder was located over 20 miles away.

The Community First Responder role is not designed for the responder to travel excessive

distances out of their community. As the third responder was over 30 minutes away at normal
road speed, this would be considered too far away to travel to attend Ms Johnson.

b) How many occasions have EMAS exceeded their response times since 01 January
2018 to date?

During the period 1 January 2018 to 31 January 2019, we have exceeded our response
times as follows:

Respond | Develop | Collaborate

East Midlands

Ambulance Service
NHS Trust

c) Is it fair that if a patient is regraded whilst awaiting an initial response, the total
time from the initial call to the regrading is cancelled out?

It has been decided from a national perspective that when a call is re-categorised to a
higher priority, the time frame for the resource to be conveyed commences from the time of
the re-grading.

d) Does EMAS believe they have enough conveying resources to meet their
response targets?

A jointly commissioned, independent “demand and capacity review’ identified a gap
between the resources presently available, and what was needed to deliver national
performance standards for ambulance services.

In 2018, new contract terms were agreed by the Trust with Hardwick Clinical
Commissioning Group (CCG), providing extra investment during 2018-2019 and 2019-
2020. Hardwick CCG which manages the EMAS contract on behalf of 22 CCGs across the
region, signed off the terms for up to £9m extra funding for clinical staff, ambulances and
other resources being provided in the first year. This could potentially rise to approximately
£19m next year, dependent on performance targets being met and other financial
agreements made as part of the contract terms.

The funding will directly address the gap identified in the demand and capacity review, and
is expected to result in a stepped improvement in the Trust’s ambulance response times
and consistency of response across all areas of the East Midlands region. The additional
money will be invested in the right level of resources to enable the Trust to respond more
quickly and consistently to 999 calls and urgent GP requests and to achieve national
standards at a county level, which came into force for all ambulance trusts in autumn 2017.

| hope that the measures set out in this letter provide you with the appropriate level of assurance in
relation to our commitment to continuous improvement of services.

Please do not hesitate to contact me should you require any additional information, or any
clarification, in connection with the above.

Yours sincerely

Richard Henderson
Chief Executive

Respond | Develop | Collaborate

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