Prevention of Future Deaths reports · 2022

Keith Hopwood

Regulation 28 report to prevent future deaths, reference 2022-0175, written 15 Jun 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report15 Jun 2022
Reference2022-0175
DeceasedKeith Hopwood
CoronerAlison Mutch
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:  Secretary of State for Health and Social Care 

1 

CORONER 

I am Alison Mutch, Senior Coroner, for the Coroner Area of Greater 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 30th September 2021 I commenced an investigation into the death of Keith 
Hopwood. The investigation concluded on the 17th May 2022 and the 
conclusion was one of:  Narrative: Died from a myocardial infarction whilst 
awaiting the arrival of an ambulance. The medical cause of death was 1a) 
Myocardial Infarction; 1b) Stenotic Coronary Artery Atheroma; and II) 
Hypertension, Diabetes Mellitus 

4 

CIRCUMSTANCES OF THE DEATH 

On 29th September 2021 at 11:28 Keith Hopwood called an ambulance as he 
had fainted and felt very unwell. His call was assessed at a category 3. An 
ambulance was dispatched to his home address at 11:38. It was rerouted to a 
more urgent call at 11:43. At 12:50 Keith Hopwood was spoken to by a clinician. 
He reported chest pains and feeling very unwell. The call was suddenly 
disconnected. Mr Hopwood should have been upgraded to a category 2 but was 
not. A private ambulance under contract to NWAS was dispatched at 13:17 and 
arrived at 13:34 at his home address 
. Keith Hopwood was 
unresponsive and could not be resuscitated. Post mortem examination found 
he had died from a myocardial infarction due to stenotic coronary artery 
atheroma. 

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 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.  The inquest heard that the delays in relation to the ambulance service 
were due to significant resource issues for all ambulance services not 
just North West Ambulance Service. The inquest was told that the 
shortages were due to staffing levels and demand. Steps had been taken 
to try to increase resources but the ambulance service was still 
struggling to meet the demand. In this case it was clear that had the 
initial ambulance not have been rerouted due to demand and pressure 
on services that he would have been alive when he was seen and have 
been transported to hospital; 

2.  The inquest heard that in the initial call to the ambulance service he was 
told to call back if he got worse in any way. His response was to say that 
he couldn’t feel any worse than he had in the last 10 minutes. The 
algorithm driving the conversation did not direct that this response 
should require exploration of symptoms and why he had made this 
comment. As a consequence an opportunity to explore his presentation 
further was lost; 

3.  The ambulance that arrived was a private ambulance and not equipped 
to deal with a cardiac patient. If the second call had been correctly 
categorised it would not have been dispatched as private ambulances 
are deployed with less qualified staff to calls categorised as 3 and 4 due 
to a lack of NHS Ambulance resources. As a consequence a further 
ambulance had to be deployed to the scene when Mr Hopwood was 
found to be unresponsive; 

4.  The second call from Mr Hopwood disconnected. Because he was alone 
a disconnection does not automatically result in an escalation of a call. 
Had he been with someone who said he had become unresponsive that 
would have generated a different approach. 

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. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this 
report, namely by 10th August 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 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 is proposed. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following 
Interested Persons namely 1) 
 on behalf of the family; 2) 
North West Ambulance Service, who may find it useful or of interest. 

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  Alison Mutch OBE 
HM Senior Coroner 

15.06.22 

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)
Alison Mutch 
HM Senior Coroner, Greater Manchester South 
HM Coroner's Court 
1 Mount Tabor Street 
Stockport 
SK13AG 

•Department

of Health & 
Social Care

December 2022 

Dear Ms Mutch, 

C 

Thank you for your letter of 15 June 2022, to the Secretary of State for Health and Social Care, 
about the death of Mr Keith Hopwood.  I am replying as Minister with responsibility for Health 
and Secondary Care and thank you for the additional time allowed. 

. 

I would like to begin  by offering my deepest condolences to the family arid  loved ones of Mr 
Hopwood.  It is of course vital that we take learnings where they are identified to improve NHS 
care 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 and 
the Care Quality Commission (CQC). 

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.  There 
are a range of measures in place to improve performance. 

The NHS has set out a plan to substantially increase capacity and resilience this winter.  NHS 
bed  capacity will  be  increased  by the  equivalent of at least 7,000 general and  acute beds, 
including a mix of new physical beds and expanding the use of innovative virtual wards to treat 
patients safely at home. 

Building on the NHS plan,  Our Plan for Patients set out further urgent action, including £500 
million for an Adult Social Care Discharge Fund, helping people get out of hospitals quickly, 
freeing  up beds and reducing long waits in A&E.  This is alongside work led by the National 
Discharge  Taskforce  to  reduce  delayed  discharge  across  acute,  mental  health,  and 
community care settings, working with social care partners to implement best practice 

In  addition,  NHS  England  has  allocated  £150  million  of  additional  system  funding  for 
ambulance service pressures this year and £20 million to upgrade the ambulance fleet.  NHS 
England is also providing targeted support to some of the hospitals facing the greatest delays 
in the handover of ambulance patients into the care of hospitals, helping them to identify short 
and longer-term interventions to  improve delays and get ambulances swiftly back out on the 
road.  This is alongside a new national Winter Improvement Collaborative programme to help 
other trusts identify the root causes of handover delays and implement best practice. 

Furthermore,  ambulance  trusts  receive  continuous central monitoring  and  support from  the 
National Ambulance Coordination Centre, and all local systems are establishing 24/7 System 
Control Centres to better manage demand at a system level. 

(J 

4 

 
 The NHS will also expand.falls response services right across the country, whjch will see local 
teams  sent  to  help  people  who  have  fallen  in  their  home  or  in  care  homes,  rather  than 
unnecessary trips to hospital. 

We have made significant investments in the ambulance workforce, and the number of NHS 
ambulance  staff and  support staff has increased  by over 40%  since  August 2010.  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.  St John Ambulance has also been contracted  to  deliver auxiliary 
ambulance  services,  providing  national  surge  capacity  of up  to  5,000  hours per  month  to 
support  the  ambulance  response  during  periods  of  increased  pressure,  allowing  NHS 
ambulance crews to focus on responding to emergency calls. 

In addition, national 999 call handler numbers have been boosted to around 2,350, over 300 
more  than  September 2021,  with  plans  to  increase  further  to  2,500  by  December  2022, 
supported  by a £1.3 million  national  recruitment campaign.  This  is alongside a £50 million 
national investment across NHS 111  in England for 2022/23, supporting additional NHS  111 
capacity to ensure people get the care they need when they need it, avoiding  unnecessary 
demand on ambulances.  This builds on additional investment from last year. 

Finally, in 2020/21, £450 million was invested to upgrade A&E facilities in over 120 separate 
trusts, to boost capacity and  reduce overcrowding helping to clear ambulance queues more 
quickly. 

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

Yours sincerely, 

C 

WILL QUINCE MP 

MINISTER OF STATE FOR HEALTH 

0 

5

Related reports

Other reports by Alison Mutch

See all →

More reports categorised “Emergency services related deaths (2019 onwards)”

See all →

Track Emergency services related deaths (2019 onwards)

See every Prevention of Future Deaths report matching Emergency services related deaths (2019 onwards), 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.