Prevention of Future Deaths reports · 2019

Ffion Jones

Regulation 28 report to prevent future deaths, reference 2019-0298, written 16 Sep 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report16 Sep 2019
Reference2019-0298
DeceasedFfion Jones
CoronerDavid Regan
Coroner areaSouth Wales Central
CategoryEmergency services related deaths (2019 onwards) · Wales prevention of future deaths reports (2019 onwards)
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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

ANNEX A 

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS (1) 

NOTE: This form is to be used after an inquest. 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

The Chief Executive of the Welsh Ambulance Service 

1  CORONER 

I am David Regan, Assistant Coroner, for the coroner area of South Wales 
Central 

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 

A Coronial investigation was commenced into the death of Ffion Louise Jones 

concluding at the end of the inquest which I conducted on 12th and 13th 

September 2019. The conclusion was a narrative conclusion and the medical 

cause of death was 1a. hypoxic ischaemic brain injury; 1(b) out of hospital 

cardiac arrest; 1(c) addisonian crisis 

4  CIRCUMSTANCES OF THE DEATH 

These were recorded as :- 

Ffion Jones died as a result of a crisis of Addison’s disease following a collapse 

at  the  surgery  of  her  General  Practitioner.    Despite  requests  for  urgent 

attendance, there was no ambulance attendance for almost 1 hour following her 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 General Practitioner’s emergency call.  The call was not escalated to the clinical 

support desk as it should have been.  Escalation would have been likely to have 

led to ambulance attendance prior to Ffion arresting, in which case Ffion would 

have been resuscitated and quickly transferred to hospital.  It is likely that she 

would have survived. 

The narrative conclusion which I returned was: 

Ffion Jones died as a result of an Addisonian Crisis  She suffered a seriously 

damaging arrest at her General Practitioner’s surgery while waiting almost one 

hour for ambulance service assistance that had been requested urgently, but had 

been delayed by a failure to escalate her case to the clinical support desk. 

The Inquest focused upon:- 

a.  The fact that Ffion presented to her GP shortly after 14.00 on 7.12.16 
in  a severely unwell state such that her GP quickly decided that she 
needed urgent transfer by ambulance to hospital 

b.  The GP initially sought to effect this using a number which the 
ambulance service had informed her could allow health care 
professionals to obtain an emergency response 

c.  The GP then telephoned 999 as directed and sought to stress the 

urgency of the requirement for ambulance attendance.   

d.  The call was subject to standard questioning and the response assessed 

by the MPDS prioritisation tool and graded amber 2 

e.  Her call was not referred to the clinical support desk as it should have 

been 

f.  Had this occurred the response would have been upgraded from amber 

2 to amber 1 

g.  The clinical support desk operates a referral system which includes 
supporting members of the public and operates a queuing system 

h.  There remains no dedicated means for an external health care 

professional to have urgent access to a discussion with a clinical 
member of staff to ensure that their assessment of their patient’s 
clinical need is fully, properly and quickly conveyed to the ambulance 
service, to ensure the proper assessment of the urgency of the response. 

2

 
 
 
 
 
 
 
 
 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 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) The Improvement plan provided at the Inquest did not include any 

consideration of the specific shortcomings in service provision leading 
to Ffion’s death and the witness speaking to it was unable to address 
these issues 

(2) There remains no dedicated means for an external health care 

professional to have urgent access to a discussion with a clinical 
member of ambulance service staff to ensure that their assessment of 
their patient’s clinical need is fully, properly and quickly conveyed to 
the ambulance service, and thus that there is a properly informed 
assessment of the urgency of the response. 

(3) There is a real risk of the recurrence of the circumstances leading to 

Ffion’s death 

6  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe 
you and 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 11th November 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 family who may find it useful or of interest, 
Heath inspectorate Wales, Welsh Government, Medical Director of Cardiff 
and Vale University Health Board.  

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.

3

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 9 

16th September 2019                                                SIGNED: 

                                                                                     D Regan
Assistant Coroner

4

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