Prevention of Future Deaths reports · 2021

Lee Thrumble

Regulation 28 report to prevent future deaths, reference 2021-0304, written 10 Sep 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report10 Sep 2021
Reference2021-0304
DeceasedLee Thrumble
CoronerScott Matthewson
Coroner areaMid Kent and Medway
CategoryState Custody related deaths · Suicide (from 2015) · Mental Health related deaths
Organisation namedOxleas NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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

Mid Kent and Medway Coroners 

Cantium House 
2nd Floor 
Maidstone 
Kent 
ME14 1XD 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

Lee Ryan THRUMBLE (died 18 April 2018) 

THIS REPORT IS BEING SENT TO:  

The Rt Hon Sajid Javid MP 
Secretary of State for Health and Social Security 
39 Victoria Street 
London SW1H 0EU 

1.  CORONER 

I am Scott Matthewson, Assistant Coroner for the coroner area of Mid Kent & 
Medway. 

2.  CORONER’S LEGAL POWERS 

I  make  this  report  under  the  Coroners  and  Justice  Act  2009,  paragraph  7, 
Schedule 5, and The Coroners (Investigations) Regulations 2013, regulations 
28 and 29. 

3. 

INVESTIGATION and INQUEST 

On  1  May  2018  the  Area  Coroner  for  Mid  Kent  &  Medway  commenced  an 
investigation into the death of Lee Ryan Thrumble who died, aged 26, on 18 
April 2018 at the Medway Maritime Hospital, Windmill Road, Gillingham, Kent 
ME7 5NY. 

 
 
 
 
 The  investigation  concluded  on  26  August  2021  at  the  end  of  an  inquest, 
conducted by me sitting with a jury. The jury concluded that Lee, who was a 
prisoner at HMP Rochester at the time, had died as a result of “Suicide to which 
failures to meet Lee's mental health needs contributed and to which failures to 
respond adequately to Lee's deteriorating behaviour in March and April 2018 
contributed.” The medical cause of death was: 

Ia. Hypoxic Brain Injury and Pneumonia 
Ib. Cardiac Arrest (resuscitated) 
Ic. Partial Suspension 
II.  

4.  CIRCUMSTANCES OF THE DEATH 

Lee was a serving prisoner at HMP Rochester when he suspended himself by 
the neck whilst in a cell in the Segregation Unit at HMP Rochester on 17 April 
2018. 

Lee  had  been  recalled  to  prison  on  the  2nd  January  2018.  Whilst  at  HMP 
Elmley  he  was  put  on  an  Assessment,  Care  in  Custody  and  Teamwork 
(“ACCT”) plan. He was referred to mental health services on 17 January 2018. 
His mood stabilised with treatment and support from the mental health team. 

However, the fact that Lee was under the care of the prison mental health team 
at HMP Elmley was not recorded on relevant systems and so, when Lee was 
transferred  to  HMP  Rochester,  he  was  not  provided  with  any  mental  health 
support. In addition, a previous referral for 1-1 psychology treatment was not 
communicated effectively to the receiving prison. 

On arrival at HMP Rochester Lee did not receive a health screening within 24 
hours of arrival. When the health screening was carried out, sufficient time was 
not allocated which led to health issues being recorded inaccurately. 

The jury found that: “There was also a lack of training at this prison which led 
to a failure to record and review information effectively. Lee did not receive a 
meaningful  clinical  interaction  after  the  initial  health  screening  and  prior  to 
being  found  partially  suspended  on  the 17/04/18.  This is a  failure within  the 
system. Lee's mental health needs were not met appropriately at this prison 
and  this  more  than  trivially  contributed  to  his  death  on  the  balance  of 
probabilities.  There  was  a  deterioration  in  Lee's  presentation  in  March/April 
2018  for  example  refusing  to  work,  distancing  himself  from  others  and 
appearing quieter. Adequate steps were not taken to support his deterioration 
and this contributed to Lee's death.”  

 
 
 
 
 
 
 
 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: 

Evidence was given by a Prison Service Governor and HMP Rochester, the 
Head  of  Healthcare  at  HMP  Rochester  and  (by  letter)  Prison-NOMIS 
Application Support And Change Manager that: 

(1) Critical  information  relating  to  prisoners  contained  on  his  Prison 

National Offender Management Information System (“NOMIS”). 

(2) Prison  Service  staff  and  clinical  staff  working  with  prisoners  are 
permitted to (and need) access NOMIS in order to keep prisoners safe. 

(3) Use of NOMIS is restricted to those who have been trained to use it (via 
a short online course known as the ‘Getting Started’ module). Once the 
online  training  has  been  completed  the  person  is  issued  with  a 
certificate.  That  certificate  is  then  provided  to  the  MOJ  Business 
Application  Support  Team  /  Justice  Digital  &  Technology.  That 
department then issues the person a NOMIS username and password. 
The turnaround time is usually two days. 

(4) Whilst all prison staff were trained in the use of this system and were 
able to access it, only some clinical staff are able to access NOMIS. 

(5) The  reason  that  all  Prison  Service  Staff  were  able  to  access  NOMIS 
was because training in the use of NOMIS is a compulsory part of their 
training. 

(6) The  reason  that  only  some  clinical  staff  could  access  NOMIS  was 
because  it  is  voluntary  (although  encouraged  and  supported  by  the 
MOJ). 

(7) If  NOMIS  training  was  a  compulsory  part  of  training  for  all  clinicians 

working with prisoners: 

a.  It  is likely  that most  (if  not  all) nurses  would be able  to  access 

NOMIS within a relatively short period of time. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 b.  Prisoners would, as a result, be safer. 

c.  The  Business  Application  Support  Team  /  Justice  Digital  & 
Technology  at  the  MOJ  would  welcome  and  support  such 
training (see  attached letter from 
  from 
that team dated 3 September 2021). 

I am concerned that: 

(a) Lee died partly because of a lack of training which prevented staff from 

accessing and reviewing information. 

(b) NOMIS contains important information that can be of use to clinical staff 

when looking after prisoners. 

(c) Not all nurses can access NOMIS because it is not a compulsory part 

of their training. 

(d) The NOMIS training is already available, can be completed online and 

access to NOMIS can be gained within two days. 

(e) If the current situation continues there is a risk that prisoners may die 

as a result. 

This situation should be reviewed and consideration given to whether NOMIS 
training  should  be  made  compulsory  for  clinicians  working  within  prisons  in 
England and Wales. 

6.   ACTION SHOULD BE TAKEN 

In my opinion, action should be taken to prevent future deaths and I believe 
that you and/or 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 4 November 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. 

8.  COPIES and PUBLICATION 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I have sent a copy of my report to the following: 

•  HHJ Thomas Teague QC, the Chief Coroner of England & Wales 
•  Mr Thrumble’s family 
•  HMP Elmley 
•  HMP Rochester 
•  Oxleas NHS Foundation Trust 
• 

Integrated Care 24 

I  am  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.  Signature: 

Scott Matthewson, Assistant Coroner, Mid Kent & Medway 
10 September 2021

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