Prevention of Future Deaths reports · 2021

Steve Cooke

Regulation 28 report to prevent future deaths, reference 2021-0266, written 8 Aug 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report8 Aug 2021
Reference2021-0266
DeceasedSteve Cooke
CoronerSonia Hayes
Coroner areaMid Kent and Medway
CategoryEmergency services related deaths (2019 onwards)
Organisation namedSouth East Coast Ambulance Service NHS Foundation 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: 

1.  Chief Executive Officer South East Coast Ambulance Service NHS Foundation 

Trust 

1 

CORONER 

I am Sonia Hayes assistant coroner, for the coroner area of Mid Kent & Medway 

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.  

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 

I make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009 and 
On 22 June 2021 an investigation was commenced into the death of STEVE MARTIN 
Regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.  
BRIAN  COOKE.  The  investigation  concluded  at  the  end  of  the  inquest  on  23  July 
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 
2021.  The  conclusion  of  the  inquest  was  COVID-19  Pneumonia  due  to  COVID-19 
http://www.legislation.gov.uk/uksi/2013/1629/part/7/made 
Infection - Natural Causes. 

4 

CIRCUMSTANCES OF THE DEATH 

Steven Cooke was found deceased at home on 26th December 2020 by police doing a 
welfare check due to family concerns of COVID19 Pneumonitis due to COVID -19 infection 
with a positive test on 23rd December 2020. Steven called an ambulance with  extreme 
shortness of breath and apparent hypoxia on 25th December 2020 and an ambulance was 
dispatched as a category 2 within 26 minutes. There were communication difficulties, and 
the ambulance crew was dispatched to the wrong address and Steven was not located. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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 could occur unless action is taken. In the 
circumstances it is my statutory duty to report to you. 

  Evidence was heard at the Inquest that there were communication difficulties that resulted in  
  the ambulance being dispatched to the wrong address and Mr Cooke not being located: 

  Mr Cooke made an emergency call taken by NHS 111 with symptoms of COVID-19 and was 
  extremely breathless with apparent hypoxia, the call handler was struggling to understand  
  him in a busy working environment. The call was transferred for clinical assessment and  
  an ambulance was dispatched. Paramedic ambulance crew arrived in under five minutes to  
  an address provided by the emergency operations control (EOC) and could not locate the  
  patient, Mr Cooke.  
  The crew checked the address with EOC and managed to gain access from a key holder to  
  the address that was unoccupied and a thorough search and enquiries with neighbours  
  established the address was unoccupied.   

The MATTERS OF CONCERN are as follows.  – 

(1)  Ambulance crew updated EOC Mr Cooke could not be located. EOC made checks with 
a telephone number on the system to attempt to establish the location of Mr Cooke. 
This telephone number was Mr Cooke’s ex-partner on 25th December 2020.The EOC 
established that Mr Cooke was not with his ex-partner.  

The call handler when speaking to Mr Cooke’s ex-partner: 

(i) 

(ii) 
(iii) 
(iv) 

(v) 

EOC terminated the call within 62 seconds – this very brief given the serious 
nature of the query to locate a missing sick patient 
did not give a complete explanation of the reason for the call  
did not ask for Mr Cooke’s current address 
instead suggested part of the address that the crew had been dispatched to 
knowing Mr Cooke could not be located there and did not listen to or give 
sufficient time for Mr Cooke’s ex-partner to respond 
did not update Mr Cooke’s ex-partner that Mr Cooke had not be located 

(2)  Mr Cooke was very unwell and in need of medical attention: 

(i) 
(ii) 

(iii) 

the matter was not escalated further when Mr Cooke could still not be located 
the original call was not listened to again to attempt to establish the correct 
 Hammond 
address being given by Mr Cooke. Mr Cooke gave the address as 
Hill and it was the call handler who suggested a different part of the address as 
there was difficulty establishing the postcode and this was approximately five 
metres from where Mr Cooke lived.  
It was possible to hear Mr Cooke stating with difficulty the word ‘opposite’ when 
this part of the address was suggested.  

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 5th October 2021. 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. 

2 

 
 
   
   
   
 
 
 
 
 
 
 
 
 8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested 
Persons 
interest. 

 (ex-partner). I have also sent it to CQC who may find it useful or of 

I am 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. 

I may also send a copy of your response to any other person who I 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. 

9 

 Signature: 

 Sonia Hayes Assistant Coroner Mid Kent and Medway 
 8th August 2021 

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 South East Coast Ambulance Service (PDF)
Ms S Hayes 
HM Assistant Coroner for Mid Kent and Medway 

23 September 2021 

Dear Madam 

Steve Cooke deceased 

I write in response to the Regulation 28 Prevention of Future Deaths report issued on 8th August 
2021 following the inquest into the sad death of Mr Cooke. 

I was very sorry to learn of the death of Mr Cooke and I would like to convey my heartfelt 
condolences to his family and friends. 

I have asked the Senior Management Team in charge of our 999 and 111 services to investigate 
your concerns. They have looked at two issues: 

1.  Our process for establishing the address to which to send an ambulance 

It has been identified that whilst there was in place clear instruction to 999 call handlers that 
the caller must give the address rather than the handler suggesting it, this instruction had not 
been replicated in the 111 system.  This is being remedied. 

For 999 calls, the “EOC (Emergency Operations Centre) Call Handling Procedure states in 
paragraph 2.1: 

2.1.1. 999 call answer and incident entry should be followed as per NHSP training. 

2.1.2. Any address taken by an EMA that does not match to the EISEC return received from 
BT must be confirmed to ensure that it is correct. This must be confirmed by the caller 
giving the address and not the EMA reading it back to them. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 This is now being replicated in the 111 service by way of an Operational Bulletin, a copy of 
which is attached.  The Bulletin will be in force as soon as it has gone through internal 
governance, which should take one to two weeks. 

2.  Our process upon a patient not being found by crew on scene 

A further Operational Bulletin has been written to update and improve our process when 
crew on scene are not able to locate the patient.  I attach a copy.  It will be noted that the 
process involves the escalation of the incident to a team leader who will listen again to the 
original call to verify the address, search our records for any previous calls from the same 
telephone number and identify any sources of further information such as next of kin or a 
careline.  If the team leader can locate a family member or careline to call, they must give a 
full explanation and allow the recipient of the call time to understand what is being said and 
provide a meaningful response.  Checks will also be made of local hospitals and Police. 

This bulletin is also making its way through internal governance and is expected to be in force 
within one to two weeks. 

I trust that this provides assurance that the concerns identified in this inquest have been 
addressed and that if similar circumstances were to occur in the future, our chances of finding 
the patient are much improved.  If I can be of further assistance or can provide any further 
information, please do not hesitate to contact me. 

Yours sincerely 

Chief Executive Officer 
South East Coast Ambulance Service NHS Foundation Trust 

Attachments: 

1.  Operational Bulletin – 111 Ambulance dispatch calls and confirming address process 
2.  Operational Bulletin – Patient Location Verification Process

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