Prevention of Future Deaths reports · 2023

Andrew Shambrook

Regulation 28 report to prevent future deaths, reference 2023-0177, written 31 May 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report31 May 2023
Reference2023-0177
DeceasedAndrew Shambrook
CoronerJohn Gittins
Coroner areaNorth Wales (East and Central)
CategorySuicide (from 2015) · Wales prevention of future deaths reports (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.

John Adrian Gittins 
Senior Coroner for North Wales (East and Central) 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:  BCUHB, Ysbyty Gwynedd, Penrhosgarnedd, Bangor, 
Gwynedd LL57 2PW.      
CORONER 

1 

I am John Adrian Gittins, Senior Coroner for North Wales (East and Central)                     

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 the 28th of March 2022 I commenced an investigation into the death of Andrew John 
Shambrook (DOB 17.2.77 DOD 27.3.22). The investigation concluded at the end of the inquest 
on the 28th of April 2023.  The cause of death was recorded as being due to 1(a) Hanging and 
the conclusion of the inquest was that of suicide. 

The evidence indicated that Mr Shambrook was under the care of the mental health services and 
that there had been a referral to the Home Treatment Team, however he did not meet their 
criteria for treatment.  

4 

CIRCUMSTANCES OF THE DEATH 

The circumstances of the death are that Mr Shambrook took his own life by hanging 

on the 27th of March 2022. 

5 

CORONER’S CONCERNS 

During the course of the inquest the evidence revealed the following matter 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 MATTER OF CONCERN is as follows.  – 

The health board (by their own admission through counsel) acknowledge that there is no 
documented or robust policy in relation to decision making/meeting criteria and thereafter future 
treatment and care pathways when a patient is referred to the Home Treatment Team  

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. 

Coroner's Office, County Hall, Wynnstay Road, Ruthin, LL15 1YN 

 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, namely by 
26th of July 2023 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 Family of the Deceased and to the Chief Coroner. 

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 

Dated 31st May 2023 

Signature 
Senior Coroner for North Wales (East and Central) 

Coroner's Office, County Hall, Wynnstay Road, Ruthin, LL15 1YN

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 Betsi Cadwaladr University Health Board (PDF)
Bloc 5, Llys Carlton, Parc BusnesLlanelwy, 
Llanelwy, LL17 0JG 

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

Block 5, Carlton Court, St Asaph Business 
Park, St Asaph, LL17 0JG 

Dyddiad / Date: 26 July 2023  

John Gittins  
HM Senior Coroner 
North Wales (East and Central) 
Coroner's Office 
County Hall 
Wynnstay Road 
Ruthin LL15 1YN 

Dear Mr Gittins,  

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 
Andrew John Shambrook 

I write in response to the Regulation 28 Report to Prevent Future Deaths dated 31 May 
2023,  issued  by  yourself  to  Betsi  Cadwaladr  University  Health  Board,  following  the 
inquest touching the death of Andrew Shambrook.  

I would like to begin by offering my deepest condolences to the family and friends of Mr 
Shambrook for their loss.  

In the Notice, you highlighted your concerns that the health board has no documented or 
robust policy in relation to decision making criteria and thereafter, future treatment and 
care pathways when a patient is referred to the Home Treatment Team (HTT). 

In response to the Notice, I requested our Mental Health and Learning Disability Division 
(MHLD) to carefully consider your concerns and provide details of their plans to make our 
services as safe as possible, taking into account the learning from the inquest.  

Firstly, I can confirm that there is an approved Home Treatment Team Operational Policy 
(MHLD 0035) that has been in use since April 2018. However, this operational policy has 
exceeded its review date and we are progressing this through the review and ratification 
process as a priority.  

The  policy  will  be  reviewed  by  a  working  group  of  key  stakeholders,  to  include  home 
treatment  team  managers  and  key  clinicians,  led  by  a  senior manager.  As  part  of  the 
process of reviewing the Home Treatment Team Operational Policy, the reviewers will be 
provided  with  your  comments  and  instructed  to  ensure  that  these  are  fully  taken  into 
account. 

Once the review is complete, the revised policy will be subject to a period of consultation 
and  will  then  proceed  through  the  ratification  process.  Progress  on  the  review  and 
ratification process will be monitored by the divisional policy and procedure development 
subgroup and any potential delays will be escalated to the divisional senior leadership 

Cyfeiriad Gohebiaeth ar gyfer y Cadeirydd a'r Prif Weithredwr / Correspondence address for Chairman and Chief Executive: 
Swyddfa'r Gweithredwyr / Executives’ Office 
Ysbyty Gwynedd, Penrhosgarnedd 
Bangor, Gwynedd LL57 2PW 

Gwefan: www.pbc.cymru.nhs.uk / Web: www.bcu.wales.nhs.uk 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
  
 
 team. Assurance will be provided on a monthly basis to the corporate regulatory group.  
I expect this process to be complete by 31 January 2024 and I will be happy to share with 
you a copy of the refreshed policy at that time.  

As an interim measure, MHLD have provided an addendum to the policy to ensure the 
concerns noted at the inquest are addressed. The addendum to the Policy will be shared 
across MHLD to ensure that there is consistency across all areas and I have enclosed a 
copy of this for your reference. 

I hope this letter sets out for you the actions we have taken to ensure the concerns raised 
by yourself and Mr Shambrook’s family are being addressed.  

We  would  be  happy  to  meet  with  you  further  and  discuss  our  plans  in  more  detail,  or 
provide further information and assurance should that be helpful.  

Once again, I offer my deepest condolences to the family and friends of Mr Shambrook 
for their loss.  

Yours sincerely 

Cyfarwyddwr Meddygol Gweithredol / Dirprwy Prif Weithredwr Dros Dro 
Executive Medical Director / Acting Deputy Chief Executive  

cc  

, Executive Director of Public Health 

, Deputy Director of Quality

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