Prevention of Future Deaths reports · 2019

Douglas Minns

Regulation 28 report to prevent future deaths, reference 2019-0052, written 14 Feb 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Feb 2019
Reference2019-0052
DeceasedDouglas Minns
CoronerTom Osborne
Coroner areaMilton Keynes
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:
Mr Richard Alsop, Chief Operating Officer, Milton Keynes CCG

1 CORONER

I am Tom OSBORNE, Senior Coroner for the area of Milton Keynes

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 23/08/2018 I commenced an investigation into the death of Douglas Albert Walter MINNS aged
93. The investigation concluded at the end of the inquest on 17th December 2018. The conclusion of
the inquest was that the deceased died from an accident, namely the fall at home.

4 CIRCUMSTANCES OF THE DEATH
The deceased suffered a fall at home,
2018 at 8.30pm in the evening and he made an emergency call to the ambulance service. He was
attended to by the ambulance service at 00.25 on 22nd August 2018 and he was eventually conveyed
to Milton Keynes University Hospital arriving at 02.08. A CT scan revealed a large subarachnoid and
subdural bleed caused by the fall. He died at the hospital at 15.50 on 22nd August 2018. The delay in
the ambulance attending was due to high operational demand.

, on 21st August

5 CORONER’S CONCERNS

The MATTERS OF CONCERNS are as follows: During the course of the evidence it was explained to
me that the provision of a falls service was withdrawn some years ago, the service would provide for
someone to attend the home of the person who had fallen, get them on their feet, assess their
wellbeing, serve a cup of tea and get them back into bed if required. If they required more urgent
treatment, they would report to the ambulance service. The withdrawal of the service puts patient’s
lives at risk and, in view of the strains on the ambulance service, consideration should be given to re-
introducing it.
someone responds.

It is unacceptable for a 93 year old man to be left lying on the floor for four hours before

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 4th April 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

 South Central Ambulance Service
The Family of Mr Minns

I have also sent it to the Chief Executive of Milton Keynes Hospital who may find it useful or of
interest.

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.

9

Tom OSBORNE
Senior Coroner for
Milton Keynes
Dated: 14 February 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 Milton Keynes CCG (PDF)
NHS

Milton Keynes

28 March 2019 Clinical Commissioning Group

NHS Milton Keynes Clinical Commissioning Group

Coroner's Officer Sherwood Place
HM Coroner's Office 155 lala
Civic Offices % ee
1 Saxon Gate East

pilion|Reynes Telephone: 01908 278685
MK9 3EJ Email:

Web: www.mlitonkeynesccg.nhs.uk

Dear Ms Toms

Re: Regulation 28 Report to Prevent Deaths: Falls service

Thank you for your letter received 18" February, concerning the fall and subsequent death of
Mr M.

Milton Keynes did have a falls service as you describe, some years ago. That service was
superseded by a number of community based services that have been put in place to offer a
targeted approach to individual situations. These include:

A Home 1* Rapids service provided by our community provider, CNWL comprising of
experienced nurse practitioners and prescribers, who respond to a call from a GP,
ambulance services or other allied health professional.

The service triages all cails within 15 minutes and has a 2 hour attendance requirement,
unless advised otherwise by another health care professional who has seen the patient.

In the majority of cases, attendance by Home 1* Rapids will result in the patient being
assessed and made comfortable at home, avoiding a hospital attendance. Should transfer
to hospital be necessary, the team calls for assistance or an ambulance according to the
severity of the condition.

This service operates 24/7, has approximately 1500 new referrals per year and is provided
in people's homes including Care Homes.

The Staying Steady service provided by CNWL therapists as part of their Home 1*
function. It is intended for people usually over 65 who have, or are at risk of falling.

The service works with individuals to improving balance, core strength, mobility etc. It is
not an acute service, but takes referrals form GPs, hospital staff or self/relatives. The
service assesses an individual's fall risk factors and works with them to make changes in
their home environment where necessary, including providing adaptive equipment. They
also investigate the circumstances surrounding a fall and develop a preventative action
plan to increase confidence with walking and daily activities; as well as developing
individual exercise programmes that they be undertaken at home to develop strength and
balance.

This service, operating in office hours, receives approximately 1600 referrals a year.

e The MK Council's Falls Service provided by B-Well works with Staying Steady to provide
assessment, treatment and advice to older people who have fallen, are at risk of falling, or
are fearful of falling, in a supportive environment. People can be assessed in their own
homes and where exercise classes are required these are available free of charge to help
reduce the risk of falling and improve mobility and balance.

| hope the above description of commissioned services provides suitable assurance that
although the original falls services was discontinued, it has been replaced by a 24/7 Home ih
Rapids service to deal with acute episodes of falling in the community; supported by two in
office hours services which focus on prevention and non-urgent needs. The Home 1* Rapids
service reflects the objectives of the original falls service in that they attend the home, carry
out an assessment, make the individual comfortable and call an ambulance if required.

Please do not contact me should you require additional information

Yours sincerely

Chief Operating Officer

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