Prevention of Future Deaths reports · 2021

Steven Stout

Regulation 28 report to prevent future deaths, reference 2021-0059, written 3 Mar 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report3 Mar 2021
Reference2021-0059
DeceasedSteven Stout
CoronerGraeme Irvine
Coroner areaEast London
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Mental Health related deaths · Suicide (from 2015)
Organisation namedNorth East London NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses published2

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.

MISS N PERSAUD
SENIOR CORONER

EAST LONDON

Walthamstow Coroner's Court, Queens Road Walthamstow, E17 8QP
Telephone 020 8496 5000 Email coroners@walthamforest.gov.uk

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

Ref 7

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
OEU Sent via email to}

And,

CEO, North East London NHS Foundation Trust.
Trust Head Office, CEME Centre- West Wing, Marsh Way, Rainham, Essex,
RM13 8GQ
Sent via email to:

1 | CORONER

| am Graeme Irvine, acting senior coroner, for the coroner area of East London

2 | CORONER’S LEGAL POWERS

| 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.
http://www legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7

http://www legislation.gov.uk/uksi/2013/1629/part/7/made

3 | INVESTIGATION and INQUEST

On 26" November 2019 | commenced an investigation into the death of Steven Paul
David Gary Stout age 40. The investigation concluded at the end of the inquest on2nd
March 2021. The conclusion of the inquest a narrative conclusion:

“Mr Steven Stout was detained by police on the morning of 14 October 2019 under

section 136 of the Mental Health Act 1983. Mr Stout was intoxicated by alcohol and
had cut both of his wrists.

Following medical treatment for his injuries Mr Stout was assessed at the section
136 suite at hospital. Following a Mental Health Act assessment, Mr Stout was made
subject to an order under section 2 of the Mental Health Act 1983. After a three-day
delay Mr Stout was admitted to a mental health ward on 17 October 2019.

On the ward Mr Stout is assessed by a consultant, it was determined that he ought
to be discharged from the section two order with support in the community from the
home treatment team.

Mr Stout was discharged from the ward on 18 October 2019 without a referral to the
home treatment team, accordingly he was not supported in the community by them.

On 4 November 2019 Mr Stout was found unresponsive, suspended by his neck
from a ligature. Despite the prompt attendance of emergency services, he could not
be resuscitated and his life was pronounced extinct at 07:43 hours. Mr Stout had
deliberately taken his own life.

Although it is possible that home treatment team support in the community could
have avoided this outcome, it cannot be said, on the balance of probability, that
home treatment team intervention would have probably provided an opportunity to
Save or preserve Mr Stout's life.”

The medical cause of death was: 1a Suspension

CIRCUMSTANCES OF THE DEATH

See above narrative

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 could 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 failure of Turner Ward, Goodmayes hospital to accurately record and file
important medical records including; decisions on discharge, risk assessments,
and a crisis, relapse and contingency plan.

2. The failure of Turner Ward Goodmayes hospital to ensure the effective referral
of a patient from the ward to the home treatment team within the community.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you
[AND/OR your organisation] 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 28" April 2021 |, 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 Chief Coroner and to the following Interested
Persons the family of Mr Stout, the CQC. | have also sent it —_— Director of
Public Health who may find it useful or of interest.

| am also under a duty to send a copy of your response to the Chief Coroner and all
interested persons who in my opinion should receive it.

| may also send a copy of your response to any other person who | believe may find it
useful or of interest.

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.

3" March 2021 /f\ ‘SIGNED BY CORONER!
(NOS:

Responses

2 responses 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 Department of Health and Social Care (PDF)
From Nadine Dorries MP 
Minister of State for Patient Safety, 
Suicide Prevention and Mental Health 

39 Victoria Street 
London 
SW1H 0EU 

020 7210 4850 

27 May 2021 

Your Ref: G1/ sc/ 111761 
Our Ref: PFD-1311422 

Mr Graeme Irvine 
HM Acting Senior Coroner, East London 
Walthamstow Coroners Court 
Queens Road 
London E17 8QP 

Dear Mr Irvine 

Thank you for your letter of 3 March 2021 about the death of Steven Stout.  I am replying 
as Minister with responsibility for mental health services and I am grateful for the additional 
time in which to do so.  

To begin, I would like to say how very saddened I was to read the circumstances of Mr 
Stout’s death and I would like to offer my most heartfelt sympathies to his family and loved 
ones.  It is so desperately sad to lose a loved one and to do so in circumstances where 
there is concern about the care they received must be particularly devastating.   

We must do all we can to take learnings from Mr Stout’s death and, in light of your 
concerns, I expect the North East London NHS Foundation Trust to look carefully at the 
care provided to Mr Stout and to take the actions needed to improve the care of mentally-ill 
patients and prevent future deaths.  

It is important that NHS organisations keep accurate medical records from admission and 
discharge and ensure that they are accessible to those involved in an individual’s care as 
is appropriate. 

More generally, I would like to assure you that we continue to take action nationally to 
support people with severe mental illnesses and to prevent suicide and self-harm. 

The NHS Long Term Plan and NHS Mental Health Implementation Plan 2019/20 – 
2023/24, commits to new and integrated models of care between crisis, acute, primary and 
community services.  These new and integrated models aim to ensure that people with 
severe mental illnesses can access the right level of support, advice and guidance 
wherever they present in the system.  This includes providing care and support for people 
with co-existing substance use needs.   

On 27 March 2021, we published our COVID-19 mental health and wellbeing recovery 
action plan, backed by £500million to support people’s mental health in 2021/22.   

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 £58million of this will be used to accelerate the roll-out of the community mental health 
framework to treat adults and older adults with serious mental illness, including.  This 
includes bringing forward the expansion of integrated primary and secondary care for 
adults and older adults with serious mental illness; embedding mental health practitioner 
roles in Primary Care Networks across the country to better meet the needs of people 
living with severe mental illnesses in primary care; and, expanding peer support and non-
clinical workforce to boost the capacity of community mental health services. 

The recovery action plan also includes £6million funding to boost support for specific 
suicide prevention work.  £1million will bolster NHS England and NHS Improvement’s work 
on suicide prevention and £5million is being made available to support voluntary sector 
organisations that prevent suicide in the community.  This extra funding is in addition to the 
£57million investment for suicide prevention through the NHS Long Term Plan between 
2019/20 and 202324, which will see investment in all areas of the country to support local 
suicide prevention plans and establish suicide bereavement support services. 

I hope this response is helpful.  Thank you for bringing these concerns to my attention.  

NADINE DORRIES 

MINISTER OF STATE FOR PATIENT SAFETY, SUICIDE PREVENTION  
AND MENTAL HEALTH
Response from North East London NHS Foundation Trust (PDF)
PRIVATE  & CONFIDENTIAL  

Mr Graeme Irvine 
Area Coroner 
Waltham Forest Coroners Court 
Queens Road 
Walthamstow 
London 
E17 8QP 

Sent by email to:  
Graeme.Irvine@walthamforest.gov.uk 
and  

@walthamforest.gov.uk 

Your ref:             G 1 / sc/111761 
Our ref:               894 

Dear Mr Irvine,  

Chief Executive Trust 
Head Office 
West Wing 
CEM E Centre 
Rainham 
Essex 
RM 13 8GQ 

7 April 2021

Re: Inquest touching upon the death of Steven Paul Gary Stout 

I refer to your letter dated 3 March 2021 and the enclosed Regulation 28 report issued in respect 
of your concerns regarding record keeping and the referral to Home Treatment Team (HTT), from 
Turner Ward at Goodmayes Hospital.   

The  Trust  has  taken  into  consideration  concerns  highlighted  in  the  Regulation  28  report  and 
agreed to take a number of actions to address your concerns. This includes: 

  Provision  of  record  keeping  training  to  staff  on  Turner  Ward  to  ensure  that  staff  are 

reminded about the Trust’s expectations in respect of the record keeping.  

  Development  and  implementation  of  a  discharge  checklist  to  ensure  that  the  discharge 
procedure safeguards patients’ clinical needs more robustly and supports healthcare staff.  

  Audits to monitor implementation of the discharge checklist. 
  Update  of  the  HTT  Service  Operational  procedure  to  ensure  that  the  patients  are  not 
discharged without HTT or ACAT assessment, in the cases where there is a suggestion 
that the patients may benefit from HTT service input. 

  Update  to  Trust’s  Clinical  Handover  of  Care  and  Discharge  Policy  to  ensure  that  the 
discharges take place more safely and effectively, and the referrals have been effectively 
completed to address the clinical needs of the patient as required.    

Please find enclosed Trust’s action plan for further detail.  

I wish to assure you that learning from incidents is a priority for the Trust and I am very grateful for 
your contribution to the improvement of our services, by way of raising your concerns to me.  

Chair:  
Chief  Executive:  

www.nelft.nhs.u
k 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I hope that the enclosed action plan provides reassurance to you that the Trust has taken this sad 
incident  very  seriously  and  that  it  reflects  our  commitment  to  improve  care  quality  and  patient 
safety.  
If you have any further queries, please contact my office on 

Yours sincerely, 

Chief Executive Officer 

Encs: 

  Trust’s Action Plan 
  Regulation 28 report

Chair:  
Chief  Executive:  

www.nelft.nhs.u
k 

 
 
 
 
 
 
 
 
 
 
 
 Chair:  
Chief  Executive:  

www.nelft.nhs.u
k

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