Prevention of Future Deaths reports · 2019

Arthur Jepson

Regulation 28 report to prevent future deaths, reference 2019-0300, 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
Reference2019-0300
DeceasedArthur Jepson
CoronerDavid Urpeth
Coroner areaSouth Yorkshire (West)
CategoryEmergency services related deaths (2019 onwards)
Organisation namedYorkshire Ambulance Service NHS Trust
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 

THIS REPORT IS BEING SENT TO: 

1.  Chief Executive, Yorkshire Ambulance Service, Trust Headquarters,    
Brindley Way, Wakefield 41 Business Park, Wakefield, WF2 0XQ 

1 

CORONER 

I am David Urpeth, assistant coroner, for the coroner area of South Yorkshire West 

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 3.10.18, an investigation into the death of Arthur William Jepson was commenced. 
The investigation concluded at the end of the inquest on 16.9.19. The conclusion of the 
inquest was Natural Causes 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Jepson suffered stomach pain and called 999. The evidence was that the initial call 
was made at 15.32. That call was initially triaged as Category 5 but when the paramedic 
telephoned an hour later the matter was re classified at category 3. The ambulance 
arrived at 19.31.  

.  
CORONER’S CONCERNS 

5 

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.  –  

During the inquest, evidence showed:- 

1. 
2. 

that the pressure on resources was high that day.  
that a review at the two hour point should have taken place to ascertain if the 
matter needed re categorisation.  

3.  Such a review didn’t happen. 
4.  Whilst the evidence at inquest was that this is unlikely to have changed the 

outcome in this case, it was a concern to me that it could be in another case. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you have the 
power to take such action.  

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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 the Chief Coroner to all Interested Persons :- 

The family of Mr Jepson, the deceased.  
CQC 

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 

16.9.19                                   SIGNED BY:  DAVID URPETH, ASSISTANT CORONER 

2

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 Yorkshire Ambulance Service (PDF)
INHS

Yorkshire

Ambulance Service

20 November 2019 NHS Wurt
PRIVATE & CONFIDENTIAL Chief Executive’s Directorate
Mr. D. Urpeth Ambulance Headquarters
Assistant HM Coroner for South Yorkshire (Western) Springhill
Brindley Way
Wakefield 41 Business Park
Wakefield
WF2 0XQ

Sent by e-mail only

Tel: 0333 130 0550

Dear Sir,

Re. Prevention of Future Deaths report —- Mr. Arthur Jepson

| write further to your letter enclosing your prevention of future deaths report
following the inquest of Mr. Arthur Jepson, which the Trust received on 25
September 2019.

Firstly, may | extend my apologies on behalf of Yorkshire Ambulance Service
NHS Trust to the family of the late Mr. Jepson. Following Mr. Jepson’s inquest
on 3 October 2019 at the Medico-Legal Centre, Sheffield you outlined your
concerns regarding the apparent lack of a review of Mr. Jepson’s call following
a two hour period to ascertain whether the incident needed re-categorisation.
Although as described in your letter, you felt that given the evidence heard at
the inquest, it would have been unlikely to have changed the outcome for the
late Mr. Jepson, you were concerned that this may have an impact upon other
patients’ care.

As outlined in the Trust's letter to you dated 4 October 2019 from the Legal
Services Department, it is regrettable that information regarding the Trust’s
call-back standard operating procedure was not alluded to in written and oral
evidence and to provide assurance that there was, and continues to be, a
procedure in place to ensure that incidents are reviewed once the expected
response timescales had been exceeded. As was heard within the oral and
written evidence at the inquest, the Trust was experiencing high demand at
the time of Mr. Jepson’s call, especially within the area of South Yorkshire and
unfortunately a call-back was not made to Mr. Jepson once two hours had
elapsed for which | apologise.

Your letter has prompted the Trust to refresh its approach to dealing with such
matters and to build upon work already ongoing within the Emergency
Operations Centres (“EOCs’) with improving its processes and procedures.
As outlined within the letter from the Trust on 4 October 2019, there is work
currently ongoing to create a centralised Senior Clinical Advisor standard
operating procedure (“SOP”) and the current call-backs and comfort calls SOP
has been identified as forming an integral part of this revised central SOP.

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The new centralised Senior Clinical Advisor standard operating procedure
was ratified at an internal governance meeting on 19 November 2019 and it is
anticipated that the new procedure will be in place by early December 2019.

It is intended that at times of high demand, or for patient care, it may be
appropriate for senior clinical advisors (“SCAs’”) to undertake call backs and
comfort calls. To provide a structured approach to this process a filter exists
within the computer aided dispatch (“CAD”) system and this filter allows for
incidents which have exceeded their expected timeframe to be viewed
separately from other incidents awaiting dispatch by the allocated clinician. In
addition to this, any incident likely to breach the mean time will be visible.

The SCA should speak with the patient wherever possible and should
introduce themselves and ask if anything has changed since the initial call
was made. If no change has occurred, the SCA will explore the options of
alternative transport however if this is unavailable or not a possible option,
then the SCA will reassure the patient that an ambulance response will be
with them as soon as possible and advise them to call back via 999 if the
patient’s condition deteriorates. If there has been a change in the patient's
conditions then a Manchester Triage System (“MTS”) triage must be
completed by the clinician and re-categorised as appropriate, using a
dedicated upgrade / downgrade code.

It is expected that Category 1 incidents with excessive response times will be
assessed and given support by the dedicated Category 1 Clinician separate to
the process outlined above.

In order to gain assurances that the processes are effective, reporting
mechanisms shall be put in place to ensure that the revised call-back
procedures are being undertaken and ensuring that any excessive incidents
receive regular contact to establish whether the Trust’s response is still
appropriate and safe.

| trust this letter is to your satisfaction and once again, my sincerest
condolences to the family of Mr. Jepson.
Yours faithfully,

of

Rod Barnes
Chief Executive Officer
Yorkshire Ambulance Service NHS Trust

MINDFUL 3
EMPLOYER *

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