Prevention of Future Deaths reports · 2019

Tony Dunne

Regulation 28 report to prevent future deaths, reference 2019-0265, written 20 Aug 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Aug 2019
Reference2019-0265
DeceasedTony Dunne
CoronerMary Hassell
Coroner areaInner North London
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Suicide (from 2015) · Mental Health related deaths
Organisation namedEast London NHS Foundation Trust
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: Prevention of Future Deaths report

Tony Mark DUNNE (died 21.02.19)

THIS REPORT IS BEING SENT TO:

1. Dr Paul Gilluly
Chief Medical Officer
East London NHS Foundation Trust
Trust Headquarters
9 Alie Street
London E1 8DE

CORONER

lam: Coroner ME Hassell
Senior Coroner
Inner North London
St Pancras Coroner's Court
Camley Street
London N1C 4PP

CORONER’S LEGAL POWERS

| make this report under the Coroners and Justice Act 2009,
paragraph 7, Schedule 5, and

The Coroners (Investigations) Regulations 2013,
regulations 28 and 29.

INVESTIGATION and INQUEST

On 25 February 2019, one of my assistant coroners, Edwin Buckett,
commenced an investigation into the death of Tony Mark Dunne. The
investigation concluded at the end of the inquest yesterday. | made a
determination of suicide. The medical cause of death was:

1a multiple traumatic injuries.

CIRCUMSTANCES OF THE DEATH

Tony Dunne had alcohol dependence disorder and also extreme anxiety
& mild depression. He jumped from a 7" floor window late on the evening
of 20 February 2019.

He had been seen by a mental heaith nurse at Homerton University
Hospital emergency department earlier that evening, having been found
by police beside an 8" floor window intending to jump, but had refused
informal admission and was deemed not detainable under a section of
the Mental Health Act.

He rang the Crisis Line a little over an hour after discharge. He was not
asked if he was feeling suicidal and he rang off after 5 minutes.
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.

Mr Dunne rang the Crisis Line a little over an hour after he had been
discharged from the emergency department.

He had been seen at the emergency department because he had been
found by police standing by an 8" floor window intending to jump.

The Crisis Line call taker read his medical notes and so knew this history,
but nevertheless did not ask him if he was now feeling suicidal.

If she had asked him and he had said yes, she could have asked him to

come in to the hospital again or she could have called an ambulance for
him.

ACTION SHOULD BE TAKEN

In my opinion, action should be taken to prevent future deaths and |
believe that 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 21 October 2019. |, 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 following.

HHJ Mark Lucraft QC, the Chief Coroner of England & Wales
Care Quality Commission for England
Ee Parents of Tony Dunne
HE other of Tony Dunne

| 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 Senior Coroner, at the time of your response,
about the release or the publication of your response by the Chief
Coroner.

DATE SIGNED BY SENIOR CORONER

20.08.19 ‘ MEHL olf

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 London NHS Trust (PDF)
East London
NHS Foundation Trust

Pleas

Associate Director of Legai Affairs.
Trust Headquarters.

9 Alie:Street

London

_ EV 8DE
Telephone: 0207 655.4064

21 -Qctaber 2019

Coroner ME Hasseil

Senior Coroner

Innér North London ;
St Parieras Coroner's Court
Camley Street

London

NiC 4PP

Dear Madam
Inquesttouching upon. the.death of Tony Dunne

This isa formal resporise to:-your Regulation 28 Report dated :20 August 2019 in
which you set out your concems relating to the care Mr Dunne received from:East
Londén NHS Foundation Trust (the Trust).

Your concerns. related to Mr Dunne’s assessment ‘carried out by the.registered
mental health nurse (RMN) when Mr Dunne-called the City and Hackney Crisis.and
Resolution Home Treatment Team's. (City. and Hackney HTT). crisis line ori 20
February 2019 at 22:51. In:particular, you note that.it was only over an hour since Mr
Dunne was discharged from A&E, yet the RMN did net ask Mr Dunne if he- felt
sulcidal.

Jam Aware that, you heard evidence during the course of the Inquest that the RMN
believed that she had asked Mr Dunne if he. was-Suicidal during her’assessment as it
was her usual practice. However, she:could not specifically recall if she-had. Further,
she had not made a full reeordiiig it: Mr Dunne’s. medical notes of her assessment:
We understand that without a ‘full note you cannot be reassured that 4 full risk
assessment’ was undértaken and that Mr Dunne: was asked if he was suicidal.

Given the concern you raised was not identified in the Trust's SI.report we reviewed
this matte? in more detail. We further identifie jad that the RMN:went off sick shortly
after her phone call with Mr Dunné-and that this likely impacted ypon the quality of
her medical note.

Chair: Marie Gabriel. Chief Executive: Dr Navina Evans

The importance of good quality; full, complete and appropriate risk assessments is:a
key skill for all our clinical staff-atithe Trust. In-order to’reinforce. this, the City and:
Hackney HTT will be providingadditional training duiing. its away days scheduled.for
4 and 5 December:2019. This will include: ,
1) Reviewing ‘the core-competencies and ‘standard of risk assessment.required
by clinicians operating the crisis lina in line with the Trust's Competency
Framework for Mental Health Crisis Lines; and

2) Reinforcing the standard of medical record taking expected by the crisis line
clinicians. in accordance with the Trust's Mental Health Crisis Line Standard
Operating. Procedure:

Godd quality handover of patient care is also.expécted of our-clinicat staff'at the Trust:
including in cases. of sudden illhess. The Gity: and Hackney HTT will alsa be providing:
training iti relation:to’this topic, in:accordance with the Trust's. Managing Sickness
Absence Policy onits away days on.4-and 5, December 2019.

Additionally, the Trust appreciates that in cases of sudderr illness, circumstatices
‘May arise beyond staff members: contro! impacting.the quality of their handover. In
order fo:ehsure continuity of care forall of its patients, the City and Hackney HTT will
be rolling-out a new protocol:on. checking outstanding work following sickness. Going
forward, if-a clinician tanning the crisis line is-suddenly ill, at the first opportunity,
that staff: members" immediate line mariager will review their case load forthat shift
-and ensure that all appropriate. actions have been taken arid that this is reflected in:
the-medical notes.

| hope that the information above reassures you that the Trust has taken your
concerns seriously and that the action taken has adequately addréssed those
concerns.

If you do require any further information please. do not hesitate to.contaci me.

Youis sincerely

Dr Paul Gillutey
Chief Medical Officer

Chair. Marte Gabriel a Chief Executive: Dr Navina Evans

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