Prevention of Future Deaths reports · 2022

John Murphy

Regulation 28 report to prevent future deaths, reference 2022-0126, written 22 Apr 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report22 Apr 2022
Reference2022-0126
DeceasedJohn Murphy
CoronerLauren Costello
Coroner areaManchester South
CategoryEmergency services related deaths (2019 onwards)
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 

THIS REPORT IS BEING SENT TO: 

1. Secretary of State for Health and Social Care

1 

CORONER 

I am Lauren Costello, Assistant Coroner, for the Coroner Area of Manchester South 

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 12th July 2021 I commenced an investigation into the death of JOHN SCOTT 
MURPHY then aged 46 years. The investigation concluded at the end of the 
inquest on 21st April 2022. The conclusion of the inquest was natural causes. 

  The medical cause of death being 

  1a    Covid-19 Pneumonitis 

   II     Hypertensive Heart disease. 

1 

 4 

CIRCUMSTANCES OF THE DEATH 

John Murphy tested positive for Covid-19 infection in the week before he died.  His family 
reported that he seemed to be improving although he was extremely fatigued.  He lived 
alone and was alone in his home when he started to deteriorate in the early hours of 
Sunday 11th July 2021.  At 03:20 he called the North West Ambulance Service and he 
reported that he was breathing too fast.  The Service were dealing with extremely high 
demand at that time and had escalated its Patient Safety Plan response to Level 4, Tier 5.  
Mr Murphy was categorised as a category 2 patient needing emergency care.  An 
ambulance arrived at his property at 05:21 and by that time he had passed away.  A post-
mortem examination confirmed that he had undiagnosed hypertensive heart disease which 
can be a risk factor for a poorer outcome with COVID 19. 

A number of measures have been undertaken by the North West Ambulance to address 
emergency response times including: 

•  Utilising the Voluntary Aid Service and private ambulance support, 
•  Ongoing recruitment, although it is acknowledged that this takes time, 
•  The introduction of a Clinical assessment of category 3 cases rather than 

automatic ambulance allocation, 

•  Movement to NHS pathway tool from MPDS which changes the way Category 3 

and 4 calls are managed again to reduce ambulance allocation. 

Live waiting times in Greater Manchester during the Inquest hearing were on average at 
34 minutes against a target of 18 minutes and in 9 out of 10 calls the response time was 1 
hour 29 minutes against a target of 40 minutes. 

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. 

The MATTERS OF CONCERN are as follows. – 

(1)  Despite a number of measures being undertaken by the North West Ambulance 

Service, the delay in paramedics attending Category 2 calls has not been resolved 
to within target ranges because there are residual staff and emergency vehicle 
shortages.  

(2)  The resources available in the North West Ambulance Service cannot be fully 

utilised because of the delays in ambulances clearing Accident and Emergency 
departments caused by the pressure on these departments across the NHS. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you and 
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 23rd June 2022. 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: 

North West Ambulance Service 

I 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. 

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 

DATE     

                 SIGNED BY CORONER   

22nd April 2022                 

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 Department of Health and Social Care (PDF)
Ms Lauren Costello 
HM Assistant Coroner for Manchester South 
Coroner's Court 
1 Mount Tabor Street 
Stockport 

•Department 

of Health & 
Social Care 

2.}(,(I. November 2022 

Dear Ms Costello, 

Thank you for your letter of 28 April 2022 to the then Secretary of State Sajid Javid, about the 
death  of  John  Scott  Murphy.  I  am  replying  as  Minister with  responsibility  for  Health  and 
Secondary Care and thank you for the additional time allowed. 

Firstly,  I would  like to  say how saddened  I was to read of the circumstances of Mr Murphy's 
death, and  I offer my sincere condolences to his family and loved ones.  The circumstances 
your report describes are very concerning and I am grateful to you for bringing these matters 
to my attention. 

· 

In preparing this response,  Departmental officials have made enquiries with NHS England, as 
well as the relevant regulator, the Care Quality Commission (CQC). 

There  is  work  ongoing  to  address  the  concerns  outlined  in  your  report.  The  North  West 
Ambulance  Service  (NWAS)  lead  commissioners,  representatives  from  the  local  health 
system and  NHS England have developed a 6-point winter improvement plan concentrating 
on key actions to assist in improving performance levels for 999 and Urgent and  Emergency 
Care.  Ambulance handover times  are also a  major part of the Greater Manchester Urgent 
and Emergency Care Improvement Plan for 2022/23. 

The government is committed to supporting the ambulance service to manage the pressures 
it  is  facing,  ensuring  that  people  receive  the treatment that they  need  when  they  need  it. 
Ambulance trusts receive continuous central monitoring and support from  the NHS England 
funded  National Ambulance Coordination Centre,  and there is a range of support in place to 
In  addition,  NHS  England  has allocated  £150  million  of additional 
improve  performance. 
system  funding  for ambulance  service  pressures  in  2022/23,  supporting  improvements  to 
response  times  through  additional  call  handler  recruitment,  retention  and  other  funding 
pressures. 

You  may wish  to  know that we  have  also  made  significant  investments  in  the  ambulance 
workforce.  The  number of NHS ambulance and  support staff has  increased  by 40%  since 
February 2010, and Health Education England has a mandated target to train 3,000 paramedic 
graduates  nationally per annum from 2021-2024, further increasing the domestic paramedic 
workforce to meet future demands on the service.  The number of national 999 call handlers 
has also been boosted to over 2,300 at the start of May 2022, about 400 more than September 
2021, with  potential for services to increase capacity further during 2022/23.  Additionally,  a 
£1.3 million national campaign for the 999 call handlers was initiated in March to support trusts. 
This is alongside a £50 million national investment across NHS 111  in England for 2022/23 to 
support additional NHS 111  capacity to ensure people get the care they need when they need 
it and avoid unnecessary demand on ambulances.  This builds on additional investment from 
last year. 

 
 Finally,  ambulance  services  across the  country  have  been  working  closely with  their local 
systems  to  reduce  avoidable  conveyance  and  support  patients  to  get the  care  they  need 
outside of hospital.  Conveyance rates to Emergency Department are the lowest ever outside 
periods of national lockdown.  To drive further progress and support regional and local system 
arrangements,  we have  established  a  national  discharge  taskforce  with  membership  from 
local government, the NHS and national government.  Local health and social care partners 
are already standing up the use of additional action to support discharge and improve patient 
flow. 

We  will  continue  exploring  options  that  minimise  delays  to  hospital  discharge,  including 
identifying  capacity  to  accommodate  people  who  no longer need  acute hospital  care  while 
continuing to need other forms of support. 

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

Yours sincerely, 

WILL QUINCE MP 
MINISTER OF STATE FOR HEALTH

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