Prevention of Future Deaths reports · 2020

Joan Sanderson

Regulation 28 report to prevent future deaths, reference 2020-0198, written 5 Oct 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report5 Oct 2020
Reference2020-0198
DeceasedJoan Sanderson
CoronerAlison Mutch
Coroner areaGreater Manchester South
CategoryHospital Death (Clinical Procedures and medical management) 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.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

i 

THIS REPORT IS BEING SENT TO: 1) Greater Manchester Health & 
Social Care Partnership; 2) the Healthcare Safety Investigation Branch 

1  CORONER 

I am Alison Mutch, Senior Coroner, for the Coroner Area of Greater 
Manchester South 

2  CORONE~SLEGALPOWERS 

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 15th June 2020 I commenced an investigation into the death of Joan 
Sanderson. The investigation concluded on the 4th September 2020 
and the conclusion was one of Narrative: Died from complications of 
a surgical procedure following an accidental fall. 

The medical cause of death was 1a) Cardiopulmonary arrest; 1b) 
MRSA positive left hip metalwork infection; II) Dementia, Diabetes 
mellitus 

4  CIRCUMSTANCES OF THE DEATH 

Joan Margaret Sanderson had an accidental fall. She was admitted to 
Tameside General Hospital where a displaced intertrochanteric fracture 
of the left hip was diagnosed. She was operated on. She developed an 
infection which was identified as MRSA. She deteriorated and died on 
15th June 2020 at Tameside General Hospital. 

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. -

 The inquest heard evidence from the Trust that following her death they 
had carried out a RCA to understand what learning could be taken from 
Mrs Sanderson's death. A key piece of learning was identified, as 
patients being admitted for orthopaedic surgery, from a care home or 
those that have had a previous positive MRSA result should have a 
routine swab sent for MRSA on admission to hospital. 

In this case a swab was not collected as that was not standard at that 
time. Surgery would not be held up awaiting the outcome but it would 
have allowed earlier identification of MRSA which could impact the 
outcome in another case where emergency surgery is required and 
there is an infection post operatively. Patients admitted for elective 
surgery have a  MRSA swab collected 12 weeks prior and receive 
decolonisation treatment for a positive MRSA result prior to surgery. 

The inquest was told this change had been rolled out in the trust and 
was seen as wider learning that could prevent future deaths within the 
NHS. 

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. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the 
date of this report, namely by 30th November 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 namely Mr 
deceased, and Tameside General Hospital, who may find it useful or of 
interest. 

son of the 

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. 

2 

 9 

Alison Mutch 
HM Senior Coroner 
05.10.2020 

3

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 Gm Health and Social Care Partnership and Healthcare Safety Investigation Branchwillbe (PDF)
AUTHORITY in Greater Manchester

Greater Manchester Health and Social Care Partnership
Ath Floor

3 Piccadilly Place

London Road

Manchester M1 3BN

Date: 19 November 2020

Ms A Mutch OBE
HM Senior Coroner
Coroner's. Court

1 Mount Tabor Street
Stockport

SK1 3AG

Dear Ms Mutch

Re: Regulation 28 Report to Prevent Future Deaths —- Joan Margaret Sanderson
15.06.2020

Thank you for your Regulation 28 Report dated 5 October 2020 concerning the
death of Joan Margaret Sanderson on 15 June 2020. Firstly, | would like to express
my deep condolences to Joan Margaret Sanderson's family.

The inquest concluded that Joan Margaret Sanderson's death was a result of 1a)
cardiopulmonary arrest; 1b) MRSA positive left hip metalwork infection; 2) Dementia,
Diabetes mellitus.

Following the inquest you raised concerns in your Regulation 28 Report to NHS
England regarding that there was no requirement for MRSA swabbing of patients
being admitted for orthopaedic surgery, from a care home or those that have had a
previous positive MRSA result. Whilst surgery would not have been delayed awaiting
the outcome of results, it could impact the outcome in another case where
emergency surgery is required and there is an infection post-operatively.

| have noted that your Regulation 28 letter has also been sent to HSIB and | will
leave it to the named respondent to address the concerns which you have
expressed. My letter therefore addresses the issues that fall within the remit of
GMHSCP.

Greater Manchester Health and Social Care Partnership is made up of all the NHS arganssations and councils in the city region.
We're overseeing devolutian and taking charge of the £6bn health and social care budget.

www.gmhsc.org.uk

Summary of actions taken or being taken by the organisation involved.
The Trust confirmed that;

1. The MRSA Policy was updated in February 2019 to align with national
screening guidance around MRSA screening of patients from other hospitals,
nursing/residential homes, or those that have had a previous positive
screen/clinical sample result on admission is undertaken.

Actions taken or being taken to prevent reoccurrence across Greater
Manchester.

1. Learning to be presented/shared with the Greater Manchester Quality Board.
This meeting is attended by commissioners, including commissioners of
specialist services, regulators, Healthwatch and NICE.

2. Learning to be shared with the Greater Manchester commissioners of
services to consider the findings of the investigation within the context of the
services they commission

3. Learning to be shared with the Greater Manchester Infection Prevention and
Control Collaborative for members to take into their provider organisations to
ensure that national screening guidance is being followed. Findings to be also
shared with the Northwest NHS England/improvement infection prevention for
consideration of sharing across the Northwest

The Greater Manchester Health and Social Care Partnership (GMHSCP) is
committed to improving outcomes for the population of Greater Manchester. In
conclusion key learning points and recommendations will be monitored to ensure
they are embedded within practice.

| hope this response provides the relevant assurances you require. Thank you for
bringing these important patient safety issues to my attention and please do not
hesitate to contact me should you need any further information.

Yours sincerely

Chair of GM Medical Executive, GMHSCP

Greater Manchester Health and Social Care Partnership is made up of all the NHS organisations and councils in the city region.
We're overseeing devolution and taking charge of the £6bn health and social care budget.

www.gmhsc.org.uk

HSIB

27 November 2020

HSib, aa
Alison Mutch OBE Cody Technology Park
HM Senior Coroner Farnborough
Coroner's Court Hampshire
1 Mount Tabor Street gui401x
Stockport
SK1 3AG
Dear Ms Mutch,

RE: Regulation 28: Report To Prevent Future Deaths. The death of Joan Margaret
Sanderson on 15 June 2020

Thank you for contacting HSIB regarding a prevention of future deaths report regarding Joan
Margaret Sanderson dated 5 October 2020.

Following careful consideration, we will not be taking forward an investigation into your concerns.
We are only able to undertake a limited number of national investigations each year, and therefore
try to focus on those with the most potential for new learning across the NHS. The National Criteria
for selection is described on our website: httos://www.hsib.org.uk/public-patients/how-we-decide-
to-investiqate/

We do not underestimate the seriousness of your concerns and may consider this issue again in
the future as further information becomes available. The information that you have shared with
us is important, even if we do not start an investigation as a result. Everything we receive is added
to our database, whether we start an investigation or not. As it grows, our database builds a
picture of risk in healthcare and allows us to identify recurring problems and patterns. Should we
wish to contact you in the future regarding this information, it would help if we store the personal
details you have given us, if this is acceptable to you. If you prefer that we do not keep your
details, please let us know and we will ensure that they are removed from our database in
accordance with our privacy notice (httos://Awww.hsib.org.uk/privacy/).

Once again, thank you for contacting us and we are sorry that we are not able to take this forward.

Yours sincerely,

Chief Investigator

SS !,!7 CNOUIRIES aHSIS.ORG.UK | WWW.HSIS.ORG.UIK ae)

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