Prevention of Future Deaths reports · 2021

Saul Thomas

Regulation 28 report to prevent future deaths, reference 2021-0423, written 21 Dec 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report21 Dec 2021
Reference2021-0423
DeceasedSaul Thomas
CoronerDavid Reid
Coroner areaWorcestershire
CategoryState Custody related deaths · Mental Health related deaths
Organisation namedBirmingham and Solihull Mental Health 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.

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. The Governor, HMP Birmingham, Winson Green Road, Birmingham B18

4AS.

1 

CORONER 

I am David Donald William Reid, HM Senior Coroner for the coroner area of 
Worcestershire 

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. 

3 

INVESTIGATION and INQUEST 

On 9.5.19 an investigation was commenced into the death of Saul Richard THOMAS, 
a prisoner at HMP Hewell who died in his cell at the prison on 19.5.19 having 

. He was 42 years of age at the time of 

his death. 
This investigation concluded at the end of the inquest on 10.12.21. 

The medical cause of death was: 

The conclusion of the inquest was as follows:  

“Saul Thomas died as a result of 
not possible to determine what his intention was at the time he did this. 
See Questionnaire: 
1. Was Saul's mental health adequately assessed and managed by healthcare at
HMP Birmingham? NO

. It is 

2. If NO to Question 1:
(a) did a failure to assess and manage Saul's mental health at HMP Birmingham
probably cause or contribute to his death on 19 May 2019? NO
(b) If NO or CANNOT SAY to Question 2(a), did a failure to assess and manage
Saul's mental health at HMP Birmingham possibly cause or contribute to his death on
19 May 2019? YES

3. Do you consider that an ACCT suicide/self-harm mitigation plan should have been
opened at HMP Birmingham on or at any stage after 11 May 2019? YES

4. If YES to Question 3:
(a) did a failure to open an ACCT on or at any stage after 11 May 2019 at HMP
Birmingham probably cause or contribute to his death on 19 May 2019? YES
(b) if NO or CANNOT SAY to Question 4(a), did a failure to open an ACCT on or at
any stage after 11 May 2019 at HMP Birmingham possibly cause or contribute to his
death on 19 May 2019?

1 

 
 
 5. Was the outgoing handover about Saul from HMP Birmingham to HMP Hewell 
satisfactory? NO 

6. If NO to Question 5: 
(a) did that unsatisfactory handover probably cause or contribute to Saul's death on 
19 May 2019? NO 
(b) if NO or CANNOT SAY to Question 6(a), did that unsatisfactory handover possibly 
cause or contribute to Saul's death on 19 May 2019? YES 

7. Did HMP Hewell deal with the handover about Saul from HMP Birmingham in a 
satisfactory way? NO 

8. If NO to Question 7: 
(a) did the unsatisfactory way in which HMP Hewell dealt with the handover probably 
cause or contribute to Saul's death on 19 May 2019? YES 
(b) if NO or CANNOT SAY to Question 8(a), did the unsatisfactory way in which HMP 
Hewell dealt with the handover possibly cause or contribute to Saul's death on 19 
May 2019? 

9. Was the mental health referral made by healthcare at HMP Hewell 2019 adequate? 
NO 

10. If NO to Question 9: 
(a) did the inadequate mental health referral at HMP Hewell probably cause or 
contribute to Saul's death on 19 May 2019? YES 
(b) if NO or CANNOT SAY to Question 10(a), did the inadequate mental health 
referral at HMP Hewell possibly cause or contribute to Saul's death on 19 May 2019?  

11. Was information shared and considered adequately by healthcare staff at HMP 
Hewell? NO 

12. If NO to Question 11: 
(a) did inadequate sharing and consideration of information by healthcare at HMP 
Hewell probably cause or contribute to Saul's death on 19 May 2019? YES 
(b) if NO or CANNOT SAY to Question 12(a), did inadequate sharing and 
consideration of information by healthcare at HMP Hewell possibly cause or 
contribute to Saul's death on 19 May 2019? 

13. Was Saul's mental health adequately assessed and managed by healthcare at 
HMP Hewell? NO 

14. If NO to Question 13: 
(a) did the failure by healthcare to adequately assess and manage Saul's mental 
health at HMP Hewell probably cause or contribute to his death on 19 May 2019? 
YES 
(b) if NO or CANNOT SAY to Question 14(a), did the failure by healthcare to 
adequately assess and manage Saul's mental health at HMP Hewell possibly cause 
or contribute to his death on 19 May 2019? 

15. Should an ACCT 
staff at HMP Hewell? YES 

 mitigation plan have been initiated by prison 

16. If YES to Question 16: 
(a) did the failure by prison staff at HMP Hewell to open an ACCT probably cause or 
contribute to Saul's death on 19 May 2019? YES 
(b) if NO or CANNOT SAY to Question 16(a), did the failure by prison staff at HMP 
Hewell to open an ACCT possibly cause or contribute to Saul's death on 19 May 
2019? 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 17. Was Saul Thomas' death contributed to by neglect? YES 

4 

CIRCUMSTANCES OF THE DEATH 

In answering the questions “when, where, how and in what circumstances did Mr. 
Douglas come by his death?”, the jury found as follows: 

“On 19/5/19 Saul Thomas died at HMP Hewell, 
cell.” 

 in his 

To clarify, Mr. Thomas was remanded into custody to HMP Birmingham, charged with 
a number of serious offences, on 15.4.19. This was his first experience of custody. He 
had a recent history of drug-induced paranoia, linked to his heavy use of cocaine, and 
whilst at HMP Birmingham was transferred to the mental health ward within the 
Inpatients Unit, so that his mental health could be formally assessed. During his time 
at HMP Birmingham, Mr. Thomas continued to express paranoid thoughts, particularly 
that other people were looking to harm him and that he would be killed. Following a 
court hearing on 16.5.19, he was transferred to HMP Hewell. Both prisons failed to 
ensure that HMP Hewell were made aware of the concerns over Mr. Thomas’ mental 
health and the fact that he was undergoing psychiatric assessment within the 
Inpatients Unit at HMP Birmingham before his transfer. Once at HMP Hewell, he was 
placed on an ordinary prison wing. It was recorded that he felt under threat, but didn’t 
know why. On the morning of 19.5.19 Mr. Thomas was found unresponsive in his cell 
at HMP Hewell, having 
. He was confirmed deceased 
some 30 minutes later. 

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.  –  

(1)  In the questionnaire which formed part of their conclusion, the jury found that 
an ACCT document should have been opened for Mr. Thomas at HMP 
Birmingham at some point after 11.5.19, and that a failure so to do probably 
caused or contributed to his death. I heard evidence from a senior member of 
staff at the prison that as many as a third of all staff at HMP Birmingham still 
 and to 
do not have up-to-date training relating both to 
the ACCT process. I was also concerned to hear from one prison officer that 
he had had no ACCT training since 2014. Until such training is provided to all 
staff working at the prison, there remains a risk of similar deaths occurring in 
the future; 

(2)  In the questionnaire which formed part of their conclusion, the jury found that 
the unsatisfactory handover about Mr. Thomas provided by HMP Birmingham 
to HMP Hewell possibly caused or contributed to his death. I heard evidence 
from a senior member of staff at HMP Birmingham that (a) prison staff there 
should have alerted their counterparts at HMP Hewell to the fact that Mr. 
Thomas had been undergoing psychiatric assessment within the Inpatients 
Unit there; and (b) that this was still a concern which needed to be looked 
into. I was concerned to hear that, whilst this failing has been recognized by 
HMP Birmingham, no action has been taken to ensure that it will not be 
repeated. Until action is taken to ensure that handovers between prisons 
include such important information, there remains a risk of similar deaths 
occurring in the future. 

3 

 
 
 
 
 
 
 
 
 
 
 
 
 
 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 by conducting an investigation into the deficiencies and 
failures outlined above, and ensuring that appropriate training is provided to all 
relevant staff. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 15.2.22. 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: 

Deighton Pierce Glynn solicitors, who represent Mr. Thomas’ family; 
Government Legal Department, who represent HM Prison Service; 
Browne Jacobson LLP, who represent Birmingham Community NHS Foundation Trust 
and Birmingham and Solihull Mental Health NHS Foundation Trust; 
Practice Plus Group 
Midlands Partnership NHS Foundation Trust; 
The Prison and Probation Ombudsman. 

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 

Signed 

             ------------------------------------------------------------------------------------------------- 

D. D. W. Reid                                                                                21st December 2021   

H.M. Senior Coroner for Worcestershire                                         

4

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 Hmpps (PDF)
Director General Prisons 
HM Prison and Probation Service 
8th Floor Ministry of Justice 
102 Petty France 
London SW1H 9AJ 

 14 February 2022 

Mr David Reid 
HM Senior Coroner 
Worcestershire Coroner’s Court 
The Civic 
Martins Way 
Stourport-on-Severn 
Worcestershire 
DY13 8UN 

Dear Mr Reid, 

Thank you for the two Regulation 28 reports of 21 December 2021 following the inquest into 
the death of Saul Thomas at HMP Hewell on 19 May 2019, addressed to the Governors of 
HMP Birmingham and HMP Hewell respectively. I am responding on behalf of HMPPS as 
the Director General of Prisons. 

I know that you will share a copy of this response with the family of Mr Thomas and I would 
like to express my condolences for their loss. Every death in custody is a tragedy and the 
safety of those in our care is my absolute priority. 

Following  evidence  heard  at  the  inquest  you  have  raised  two  matters  of  concern:  staff 
training in the Assessment, Care in Custody and Teamwork (ACCT) process (the system by 
which  prisoners  at  risk  of  suicide  and  self-harm),  and  the  need  for  effective  handover 
procedures when prisoners transfer prisons.  

HMP  Birmingham  have  increased  the  capacity  of  their  ACCT  version  6  training,  and  now 
have  a  plan  in  place  to  train  80%  of  their  staff  in  suicide  and  self-harm  (SASH)  over  the 
coming six months. The training plan prioritises staff working in areas of the prison that are 
considered  high  risk,  including  the  Care  and  Separation  Unit  (CSU),  Healthcare  Unit, 
Reception and the Reverse Cohorting Unit (RCU). To achieve this the Governing Governor 
has asked the Prison Group Director for additional training to be made available to reduce 
the  number  of  staff  requiring  training.  In  addition,  HMP  Birmingham  will  ensure  all  future 
new staff will receive SASH training as part of their induction. 

HMP Hewell have advised that in December 2021 alone they delivered training to a further 
205 staff in the latest version of the ACCT. Despite having been impacted by COVID-19 and 
its restrictions, they are continuing to work through the backlog of staff ACCT training and 
over  the  coming  months  expect  to  have  trained  a  much  larger  percentage  of  staff.  The 
prison  has  209  staff  fully  trained  in  SASH,  and  a  further  66  currently  working  through  the 
required  training  modules.  By  the  end  of  March  2022  HMP  Hewell  will  have  a  further  two 
members  of  staff  trained  as  SASH  trainers,  and  therefore  will  be  able  to  provide  more 
training opportunities at HMP Hewell in order to speed up the delivery. 

 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 With regard to transfer procedures, a new process is now in place at HMP Birmingham for 
when  prisoners  who  are  being  supported  by  healthcare,  including  mental  health  services, 
are  being  transferred  to  another  establishment.  As  soon  as  it  is  known  a  prisoner  is 
transferring, the healthcare team are required to make contact with the receiving prison. If 
this  is  not  possible  then  the  matter  is  escalated  to  the  healthcare  manager  and  duty 
Governor who are then required to ensure a handover takes place before they leave their 
shift.  In  addition  to  this,  on  the  day  of  the  transfer  reception  staff  are  required  to  call  the 
receiving  reception manager  to  notify them  of  a new  arrival  transferring  from  a  healthcare 
unit.  These  actions  will  be  recorded  on  the  prisoner’s  National  Offender  Management 
Information  System  (NOMIS)  record  and  the  new  digital  Prisoner  Escort  Record  will  also 
record any and all prisoner healthcare requirements. 

Thank  you  again  for  bringing  your  concerns  to  my  attention.    I  trust  that  this  response 
provides assurance that action is being taken to address the matters that you have raised, 
and I would once again like to reiterate my sincere condolences to the family of Mr Thomas.  

Yours sincerely 

Director General of Prisons

Related reports

Other reports by David Reid

See all →

More reports categorised “State Custody related deaths”

See all →

Track Birmingham and Solihull Mental Health NHS Foundation Trust

See every Prevention of Future Deaths report matching Birmingham and Solihull Mental Health NHS Foundation Trust, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.