Prevention of Future Deaths reports · 2019

Nimo Younis

Regulation 28 report to prevent future deaths, reference 2019-0394, written 20 Nov 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Nov 2019
Reference2019-0394
DeceasedNimo Younis
CoronerMary Hassell
Coroner areaInner North London
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Mental Health related deaths
Organisation namedCamden and Islington NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

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

Nimo YOUNIS (died 25.01.19)

THIS REPORT IS BEING SENT TO:

1. Ms Angela McNab
Chief Executive
Camden & Islington NHS Foundation Trust (C&I)
4" Floor, East Wing
St Pancras Hospital
4 St Pancras Way
London NW1 OPE

. Commissioner Cressida Dick
Metropolitan Police Service (MPS)
6 Floor, New Scotland Yard
Victoria Embankment
London SW1A 2JL

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 4 February 2019, one of my assistant coroners, William Dolman,
commenced an investigation into the death of Nimo Younis aged 37
years. The investigation concluded at the end of the inquest on 18
November 2019. The jury made a narrative determination at inquest, a
copy of which | attach.

CIRCUMSTANCES OF THE DEATH

Nimo Younis was detained in the psychiatric intensive care unit of St
Pancras Hospital under section 3 of the Mental Health Act. She was
granted unescorted leave from Ruby Ward at 6pm on 24 January 2019,
with an agreement to return at 8pm. She did not.

The following day between 6.35pm and 8.48pm (when she was found at
the home of a friend by police), she hanged herself.

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.

When Nimo Younis did not return to the ward as agreed at 8pm on 24
January, her absence was quickly noted. From 9.32pm that evening, a
series of telephone conversations took place between Camden &
Islington NHS Trust (C&l) Ruby Ward staff and the Metropolitan Police

Service (MPS), but there was police classification of a high risk missing
person and consequent action only at approximately 5pm the following
day. Thus she was not found before she hanged herself.

1. C&l ward staff did not have a proper understanding of what action
the MPS would take in what circumstances, following the report of
a patient absent without leave.

. C&l ward staff did not have a proper understanding of what action
the MPS required others to take in order to prompt the police to
progress the matter further.

. C&l ward staff did not have a practical plan as to how to take that
action with the resources at their disposal.

. C&l ward staff did not have a proper understanding of what key
information they needed to provide the MPS in order to trigger a
police missing person enquiry, or to escalate an existing enquiry.

. C&l ward staff did not promptly or fully utilise the significant
potential of their patient’s friends, who were ultimately the route
by which Nimo Younis was found, and who would certainly have
acted sooner if they had appreciated the lack of action being taken
- whatever the reason for that lack of action.

6. The MPS decision makers, particularly the night time duty
inspector, did not have all the information that the MPS held when
they were making decisions. Evidence was given that this was a
resourcing issue on that particular night and of course it is difficult
to legislate for that, but creative thinking may be utilised to
address such an issue.

. Whether or not there is agreement between the MPS and any trust
about who should be doing what, there must be a clarity about
what information the MPS needs in order to make the best
decisions and what action the MPS will then take.

If the situation preceding Nimo Younis's death is to be avoided in
the future, the MPS needs to set out its position simply and clearly,
and the trust needs to ensure that all relevant staff truly
understand the position and are equipped to act accordingly.

This needs to include a recognition that different organisations
may have different definitions of the same terms.
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 20 January 2020. |, 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.

e HHJ Mark Lucraft QC, Chief Coroner of England & Wales
° EE ‘tienc of Nimo Younis and interested person

| 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

20.11.19 Wetter

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