Prevention of Future Deaths reports · 2020

Simon Delahunty

Regulation 28 report to prevent future deaths, reference 2020-0077, written 24 Mar 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report24 Mar 2020
Reference2020-0077
DeceasedSimon Delahunty
CoronerAndrew Walker
Coroner areaLondon (North)
CategorySuicide (from 2015) · Alcohol, drug and medication related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

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

Her Majesty’s Coroner for the 
Northern District of Greater London 
(Harrow, Brent, Barnet, Haringey and Enfield) 

North London Coroners Court, 
29 Wood Street, 
Barnet EN5 4BE 

Telephone 0208 447 7680 
0208 447 7689 
Fax 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

  Ministerial Correspondence and Public Enquiries Unit 
  Department of Health and Social Care  
  39 Victoria Street  
  London 
  SW1H 0EU 

1 

CORONER 

I am Andrew Walker, senior coroner, for the coroner area of Northern District of Greater 
London 

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 the 21st day of October 2019 I opened an investigation touching the death of Simon 
Anthony Delahunty aged 46 years old. I opened an inquest on the 29th October 2019. 
The inquest concluded on the 30th January 2020. The conclusion of the inquest was 
“Suicide contributed to by the circumstances within his life". The medical cause of death 
was 1a Hypoxic Brain Injury, 1(b) Hypoxic Cardiac Arrest and 1(c) Overdose of 
Oramorph ,Midazolam, Paracetamol beer and Vodka.. 
CIRCUMSTANCES OF THE DEATH 
On the Second of October 2019 Simon Anthony Delahunty took an overdose of 
medication prescribed for another patient who had recently died at the address. The 
medications were part of end of life care that had been left at the the address . It is 
likely that Mr Delahunty's actions were impulsive as he had made arrangements to stay 
for some time at this address. 

4 

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. – 

There are no arrangements or guidance concerning the collection or disposal of unused 
end of life prescription medication. 

 Her Majesty’s Coroner for the 
Northern District of Greater London 
(Harrow, Brent, Barnet, Haringey and Enfield) 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you 
[AND/OR your organization] 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 the 19th May 2020 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;- 

The Family. 

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 

24-3-2020

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 Dept of Health and Social Care (PDF)
a

From the Lord Bethelf
Department Parliamentary Under Secretary of State for innovation
of Health & 39 Victoria Street
Lond
Social Care Storer
Our Ref 020 7210 4850
Mr Andrew Walker
HM Senior Coroner, North London
HM Coroners Court
29 Wood Street
Barnet EN5 4BE
15 December 2020
Dear Andrew,

Thank you for your letter of 24 March 2020 about the death of Simon Anthony Delahunty.

| am replying as Minister with responsibility for medicines and as your letter only came to
the Department's attention on 7 October 2020, | am grateful for the additional time in which
to make this response.

Firstly, | would like to say how sorry | was to read the circumstances of Mr Delahunty's
death and | offer my sincere condolences to Mr Delahunty’s family and loved ones.

We agree that it is important to have methods to dispose of medicines waste safely, that
protect the public from harm.

Disposal of unwanted medicines is an essential service of the NHS Community Pharmacy
Contractual Framework’, to be provided by all community pharmacies in England. This
requires them to accept unwanted medicines from private households, residential care
homes and children's homes. These returned medicines are then stored securely and
safely by pharmacies until they are collected for safe disposal.

NHS England and NHS Improvement, as commissioners of NHS Pharmaceutical Services,
have arrangements in place for a waste contractor to collect the unwanted medicines from
pharmacies at regular intervals for safe disposal. This ensures that the public have an easy
method of returning unwanted medicines to pharmacies for safe disposal, helping to reduce
harm to themselves and environmental damage caused by inappropriate disposal methods.

Patients or their families and carers, should be advised by community nursing staff, GPs or
pharmacists to return any unwanted or unrequired medicines to their local community
pharmacy for safe disposal. This recommendation is made in National Guideline 46
Controlled Drugs: safe use and management?, published by the National Institute for
Health and Care Excellence (NICE) in 2016.

" https /Awww.gov.uk/government/publications/community-pharmacy-contractual-framework-2019-to-2024
? https:/Awvww.nice.org.uk/quidance/ng4é [1.5.11]

Following a patient's death, any unused medicines should also be returned to a community
pharmacy for safe disposal. Possession of a controlled drug by someone other than the
person for whom it was dispensed is illegal. This does not prevent the transport of
controlled drugs to patients, or the returning of drugs to pharmacies for safe disposal.

NICE National Guideline 46: Controlled drugs: Safe use and management, contains
additional guidance on following locally agreed processes for reviewing anticipatory
prescribing of controlled drugs. These local processes include assessing the risk to others
in the patient's household or with access to their home if controlled drugs are to be supplied
and prescribed in anticipation of need at the end of life. The risk and likelihood of accidental
or deliberate overdose, misuse and diversion are all matters that should be considered.

Additionally, in circumstances where a local risk assessment has identified that the
continued presence of the controlled drugs poses a significant and immediate risk, either
of deliberate or accidental harm, then local arrangements may be made to remove the
controlled drugs from the home for destruction.

1 hope this information is helpful. It may also interest you to note that work is underway to
reduce waste medicines in the first place, which may help mitigate situations highlighted
by the unfortunate circumstances surrounding Mr Delahunty's death.

Medicines optimisation is a key workstream within NHS England's Medicines Value
Programme? that aims to ensure that the right patients get the right choice of medicine, at
the right time. Through focusing on patients and their experiences, the goal is to help
patients to improve their outcomes; take their medicines as intended; avoid taking
unnecessary medicines; reduce wastage of medicines; and improve medicines safety.

In addition, the Secretary of State for Health and Social Care, Matt Hancock, has asked Dr
HE, the Chief Pharmaceutical Officer for England, to carry out a review of over-
prescribing in the NHS. This work is looking at reducing inappropriate prescribing, with a
particular focus on the role of digital technologies; research; culture change and social
prescribing; repeat prescribing; and transfer of care. The report of the review will provide
recommendations to reduce overprescribing to improve patient safety and reduce
medicines wastage.

| hope this response is helpful. | am grateful to you for bringing these concerms to my
attention.

LORD BETHELL

3 https:/Avww.england.nhs.uk/medicines-2/value-programme/

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