Prevention of Future Deaths reports · 2022

Gareth Williams

Regulation 28 report to prevent future deaths, reference 2022-0270, written 31 Aug 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report31 Aug 2022
Reference2022-0270
DeceasedGareth Williams
CoronerCaroline Saunders
Coroner areaGwent
CategorySuicide (from 2015) · Wales prevention of future deaths reports (2019 onwards) · Mental Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

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

Regulations 28 and 29 of the Coroners (Investigations) Regulations 2013 

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1 

2 

3 

1.  The Chief Executive of Aneurin Bevan University Health Board (ABUHB) 

CORONER 

I am Caroline Saunders, Senior Coroner for the Area of Gwent 

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 

INVESTIGATION AND INQUEST 

On 2/9/2021 an investigation was opened into the death of Gareth WILLIAMS 

The investigation concluded at the end of the inquest on: 17/8/22 

The conclusion of the inquest was recorded as: 

Suicide 

The medical cause of death was: 

la) Suspension by ligature 

2 Tinnitus 

4 

CIRCUMSTANCES OF THE DEATH 

Gareth Williams was a  45-year-old man who had a  history of sensorineural 

hearing loss and intermittent tinnitus dating back to 2005. He was also treated 

for depression and insomnia. 

In early 2021 the situation deteriorated. Gareth's tinnitus worsened but 

despite being thoroughly examined by the ENT team there was no 

physiological problem that could be treated. 

 
 As a  result, Gareth's mental health went into decline. He suffered worsening 
depression and was referred to the mental health team after he started having 
suicidal thoughts and indeed acting these out. 

Written evidence from the Consultant Psychiatrist treating Gareth, stated 
Gareth was not clinically depressed, although evidence also indicated that he 
had low mood, was expressing hopelessness and experienced suicidal 
thoughts. Gareth was discharged from the mental health team because he had 
no recognisable mental illness. 

On 23/8/21, Gareth was discovered hanging 
in Abergavenny. Emergency services attended but Gareth could not be revived. 
His death being confirmed at 15:27 hours. 

5 

CORONER'S CONCERNS 

During the course of the inquest, 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: - 

Gareth Williams found himself  in a  no-win situation. His mental health could 

not be improved without a  resolution to his hearing problems and his tinnitus 

was untreatable. During the course of his treatment, Gareth was regularly 

transferred back to the "other" team, being told that either mental health or 

ENT was the most appropriate speciality. 

I found that Gareth was left without sufficient support, falling between 2 

teams, who did not directly communicate with each other. 

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. 

I should be grateful if the following information be provided to me: 

Whether Aneurin Bevan University Health Board intend to undertake a  review into 
the circumstances surrounding the death of Gareth Williams and confirm the steps 
which will be taken to ensure that there is better interdisciplinary working between 
physical and mental health specialities in the future. 

7 

YOUR RESPONSE 

You are under a  duty to respond to this report within 56 days of the date of this 
report, namely by 25/10/22. I, the Coroner, may extend this 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 necessary 

 
 
  
 8 

COPIES AND PUBLICATION 

I have sent a  copy of my report to the Chief Coroner and the following Interested 
Person (s) 

The family of Gareth Williams 

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 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 

DATE 31/08/22 

Signed 

Caroline Saunders 
Her Majesty's Senior Coroner for the Area of Gwent.

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 Aneurin Bevan University Health Board (PDF)
9th  March 2023 

Private & Confidential 
Caroline  Saunders 
Senior  Coroner  (Gwent) 

Dear  Ms Saunders 

Re: Regulation 28  Report received  by Aneurin Bevan  University 
Health Board  further to  the inquest touching on the death of Gareth 
Williams concluded on 17.08.2022 

I  am writing  to  provide  you  with  the Health Board’s  response  to  the 
Regulation  28  Report  to Prevent Future  Deaths,  following the  inquest  into 
the death  of  Mr  Gareth  Williams. 

As  requested,  the information  presented  below  is  intended  to  describe the 
action  taken  / being  taken  to  mitigate  the  risk  of  future  deaths. 

You  require  the  Health Board  to provide  you  with  the  following information: 

1.  Whether  the Health  Board  intends to  undertake  a  review  into  the 

circumstances  surrounding  the death  of  Mr  Williams,  and 

2.  Confirm  the  steps  which  will  be  taken  to  ensure  that  there  is  better 

interdisciplinary  working  between physical and  mental  health 
specialities  in the  future 

A  ‘concise  review’  was  undertaken  by  the  Mental Health  and  Learning 
Disabilities  Division  of  the  Health  Board  when  we  became  aware  of  Mr 
Williams’  death.  Since  that  time,  we  have had  the  opportunity  to review  the 
wider  input  of  other  specialties  and understand  what services  might have 
supplemented  the offers  of  treatment  and  intervention  available to  Mr 
Williams,  in  addition  to the  liaison  with  the  ENT  department  undertaken  by a 
community  mental  health  nurse  with and  for  Mr  Williams. 
Bwrdd Iechyd Prifysgol Aneurin Bevan 
Pencadlys, 
Ysbyty Sant  Cadog 
Ffordd Y  Lodj 
Caerllion 
Casnewydd 
De Cymru  NP18  3XQ 
Ffôn: 01633 436700 
E-bost:  abhb.enquiries@wales.nhs.uk 

Aneurin Bevan University Health Board 
Headquarters 
St Cadoc’s  Hospital 
Lodge Road 
Caerleon 
Newport 
South  Wales  NP18  3XQ 
Tel  No: 01633 436700 
Email:  abhb.enquiries@wales.nhs.uk 

Bwrdd Iechyd Prifysgol Aneurin Bevan  yw enw gweithredol Bwrdd Iechyd Lleol Prifysgol Aneurin  Bevan 

Aneurin  Bevan University  Health  Board is the operational name of Aneurin  Bevan University Local Health  Board 

 
 
 
 
  
 
 
 
 
   
 
 
 
 
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 The  Health Board  acknowledges  that  its  organisational  structure  has 
historically, not  naturally  lent  itself  well  to  easy  and timely  communication 
between  its  multiple  specialties  and disciplines  across  the Divisions. 

I  am pleased  to share  that  Welsh  Government has  confirmed  that  a Health 
Board  service  - ‘Adferiad’  - originally  developed  for  people  experiencing  the 
effects of  ‘Long Covid’  will  be  receiving  substantive,  recurrent funding  from 
April 2023  which  will also  allow  it  to broaden  its  inclusion  criteria to  people 
with other  medical  and long-term  conditions  for  whom  there  are  no existing 
care  pathways. This  service  will  be  delivered by  a  team  of  medical, nursing 
and Allied  Health  Professionals –  including Health and  Clinical  Psychologists, 
thus  offering a  multi-disciplinary  perspective  from  the point  of  referral and 
for  consultation  to other  disciplines  & specialties. Part  of  the  expansion  of 
the service  will  be  to  map existing  services  to ensure  the  person  is on  the 
‘right’  pathway, with  a ‘bespoke’  approach  to each  person’s  needs. 

It  is  anticipated  that  people with co-morbidities  and needs  such  as  Mr 
Williams  could  be  referred  to Adferiad.  The  new  team  will provide  expertise 
upfront in  terms  of  assessment  and  planning  care. The  team  would develop 
an  individualised  recovery  and  rehabilitation  plan  with  individuals. 

I  trust  that  this information  assures  you  of  the Health Board’s  plans  to 
improve interdisciplinary  working between  physical  and mental  health 
specialties  in  the  future.  If any  further  information  or  assurance  is required, 
please  do not  hesitate to  contact  me. 

Yours  sincerely 

Prif Weithredwr/Chief Executive 

2

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