Prevention of Future Deaths reports · 2020

Sarah Ferneyhough

Regulation 28 report to prevent future deaths, reference 2020-0187, written 29 Sep 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report29 Sep 2020
Reference2020-0187
DeceasedSarah Ferneyhough
CoronerCaroline Beasley-Murray
Coroner areaEssex
CategoryAlcohol, drug and medication related deaths · Emergency Services related deaths
Organisation namedEast of England 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.

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: 

Emergency Call Prioritisation Advisory Group (ECPAG) 
Association of Ambulance Chief Executives 
AACE’s National Directors of Operations Group  
National Association of Ambulance Medical Directors                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   

1 

CORONER 

I am Caroline Beasley-Murray, senior coroner, for the coroner area of Essex 

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. 
[HYPERLINKS] 

3 

INVESTIGATION and INQUEST 

On 22 may 2019 I commenced an investigation into the death of Sarah Ferneyhough a 
30 year old young woman who died on 22 May 2019 at 
Halstead. The investigation concluded at the end of the inquest on 10 February 2020.  

 Abels Road 

The conclusion of the inquest was expressed as a Narrative viz:- The deceased died at 
her home address in the early hours of 22 May 2019. She had taken an overdose of 
venlafaxine, amisulpride and hydroxyzine as well as cocaine, cannabis and alcohol. At 
23.53am on 21 May 2019 she called the ambulance service but on attendance of fire 
and ambulance crews at 3.04am on 22 May she could not be resuscitated. There was a 
delay in the attendance and failings in the procedures in place for the categorisation of 
calls. It is not certain whether, if paramedics had arrived sooner, she would have 
survived. The evidence does not indicate on the balance of probabilities that the 
deceased intended to take her own life. 
CIRCUMSTANCES OF THE DEATH 

See above 

The medical cause of death was 1a) alcohol and multiple drug toxicity 
CORONER’S CONCERNS 

4 

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.  –  

1.  The deceased’s call was described as an “abandoned call” and thereafter 

automatically categorised as a category 3  A review of this practice is required. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 2.  A review is required as to whether it is appropriate for all reported medical 

3. 

conditions to be categorised no higher than category 3 
In the situation leading up to Ms Ferneyhough’s death, the duty EOC who had 
authority to upgrade the categorisation of the call did not listen to the recording 
of the “abandoned” call and was not provided with full details of any medical 
information given. Measures could be put in place to ensure that the duty EOC 
or other person who has authority to upgrade the categorisation of calls is asked 
to listen to the recording of the “abandoned” call or provided with  full details of 
any medical information given. 

1. 

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 16th December 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 –  

East of England Ambulance Trust – Hempsons solicitors 
Solicitors for 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 

  Mrs Caroline Beasley-Murray senior coroner Essex 

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 East of England Ambulance Service (PDF)
NHS

East of England

Ambulance Service

NHS Trust
Ms Caroline Beasley-Murray East of England Ambulance Service NHS Trust
Senior Coroner for Essex Whiting Way
Melbourn
Essex.CoronersService@essex.gov.uk Cambridgeshire
SG8 6NA

14" December 2020

Dear Ms Beasley-Murray

Thank you for your communication regarding the Regulation 28 (Report to Prevent Future Deaths) in
respect of the death of Sarah Ferneyhough. | would like to offer my condolences to Sarah’s family and
those affected by this tragic event.

| can confirm we have distributed the report to the four organisations named in the report as per your
request. AACE have confirmed they have reviewed the Trust’s response and we are awaiting
feedback from the other groups.

| have responded to the points raised in the Regulation 28 report separately below:

1. The deceased’s call was described as an “abandoned call” and thereafter automatically
categorised as a Category 3. A review of this practice is required.

The Trust has reviewed its process for abandoned calls and specifically those calls relating to
potential Mental Health concerns. The Trust has already introduced a new EOC Standard Operating
Procedure (ESOP) specifically for Mental Health calls and has now made a further revision to the
document. Within this ESOP, guidance is given that if the call is abandoned and therefore has
incomplete triage (i.e. we haven't been able to seek responses to all the triage questions), and the
information provided suggests the patient is actively at risk due to action they have already taken,
or currently taking to harm themselves or end their life, then consideration should be given to
responding as a Category 2 call.

There is also another ESOP currently in development to address the concerns identified at inquest
in relation to abandoned calls and this is currently going through the Trust's governance and
approval process. This will be completed and released in December 2020. Within this ESOP it is
planned that certain calls will be categorised as a Category 2 and examples may include:

e Chest Pain

e Breathing Difficulty

e - Loss of consciousness

e Severe haemorrhage (bleeding)

e Stroke
e¢ Pregnancy/Labour
¢ Overdose

Chief Executive: =
Chair:

 <_—— #WeAreEEASTAC

* Calls with a mental health element such as suicidal intent, thoughts or threats, serious self-
harm or mental health crisis

2. A review is required as to whether it is appropriate for all reported medical conditions to be
categorised no higher than Category 3
The Trust is awaiting a response on national coding but in the meantime has introduced the
measures as described above to enable higher risk calls to be escalated and coded as a Category
2 where appropriate.

3. In the situation leading up to Ms Ferneyhough’s death, the duty EOC who had authority to
upgrade the categorisation of the call did not listen to the recording of the “abandoned” call
and was not provided with full details of any medical information given. Measures could be
put in place to ensure that the duty EOC or other person who has authority to upgrade the
categorisation of calls is asked to listen to the recording of the “abandoned” call or provided
with full details of any medical information given.

The ESOP on Abandoned Calls, in development, will now also include a series of checks that must
be undertaken by the control room Duty Manager. This includes a requirement to listen to the call
recording to ensure details given are accurate and the response is appropriate. This will also
facilitate clinical escalation and review where required.

| hope this letter demonstrates the steps the Trust is taking in relation to our management of
abandoned calls and calls where there are concerns about a patient's mental health. Please do not
hesitate to contact me should you require a further update.

Acting Chief Executive Officer

Chair:
www.eastamb.nhs.uk #WeAreEEAST

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