Prevention of Future Deaths reports · 2023

Joan Corcoran

Regulation 28 report to prevent future deaths, reference 2023-0197, written 20 Jun 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Jun 2023
Reference2023-0197
DeceasedJoan Corcoran
CoronerAlison Mutch
Coroner areaManchester South
CategoryEmergency services related deaths (2019 onwards)
Organisation namedStockport 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 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:  The 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 19th  December 2022 I commenced an investigation into the death of 
Joan Mary Corcoran. The investigation concluded on the 15th  May 2023 
and the conclusion was one of Narrative:  Died from complications of 
heart failure whilst being transported to hospital for treatment 
contributed to by the complications of an accidental fall. The medical 
cause of death was 1a) Myocardial Infarction 1b) Heart Failure 1c) 
Hypertension II) Neck of femur fracture (operated on) 

4  CIRCUMSTANCES OF THE DEATH 

Joan Mary Corcoran had an accidental fall. She was operated on for a 
fracture to the neck of femur. Post-operatively she developed pneumonia. 
Subsequently the wound became infected, and a wound wash and 
debridement took place. She became increasingly frail. She was 
discharged home with support from the discharge to assess team. She 
felt unwell on 13th  December 2022 and called for an ambulance with 
chest pains. Her initial call was dealt with as a category 5 call, and she 
contacted her GP. Her GP visited her and was concerned about her 
presentation. A further call to the ambulance service resulted in her being 
classified as a category 2 call. The blood tests taken indicated she was in 
severe heart failure and at a risk of a myocardial infarction. The 
ambulance arrived significantly outside the target Department of Health 
response times. The ambulance crew identified she needed urgent 
cardiac treatment and she was for transfer to hospital. Enroute to hospital 
she deteriorated further and died in the ambulance from complications of 
heart failure. 

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.  – 

The inquest heard evidence that under the Department of Health’s 
Ambulance Response time criteria, a category 2 call should have an 
average response time of 18 minutes and be within 40 minutes in 9 out of 
10 cases. 

The evidence before the inquest was that in her case the response time 
on the category 2 call was 1 hour and 5 minutes - significantly outside the 
target time. A response within the target time would have meant that she 
would not have deteriorated and died in the ambulance. She would have 
been in a hospital with access to treatment available in such a setting. 

The evidence before the inquest was that her case was not a one off and 
delays of this nature had been occurring throughout the day. The mean 
time for Category 2 response times that day was 1 hour and 22 minutes 
and the 90th  percentile was just over 3 hours. 

At 17.58 that day there were 142 emergencies waiting in Greater 
Manchester alone and 430 across the North West. The average response 
time at that point for Category 2 patients was 2 hours and 33 minutes. 
The inquest heard that the cause of these significant delays in patients 
receiving care in a timely manner was multifactorial and included the 
demand for ambulances across Greater Manchester and the North West 
and the long ambulance delays at A and E departments due to the 
demand on A and E services. 

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 15th  August 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. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 8  COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following 
Interested Persons namely 1) 
Solicitors on behalf of Stockport NHS Foundation Trust; 3) Weightmans 
LLP on behalf of North West Ambulance Service, who may find it useful 
or of interest. 

; 2) 

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 
HM Senior Coroner 

20.06.2023 

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)
From Minister Whately MP 
Minister of State for Care 

39 Victoria Street 
London 
SW1H 0EU 

Ms Alison Patricia Mutch OBE 
HM Senior Coroner for the Coroner Area of Greater Manchester South 
Coroner's Court  
1 Mottram Street  
Mount Tabor  
Stockport  
SK1 3AG  

Dear Ms Mutch, 

2 May 2024 

Thank you for your letter of 20 June 2023 to the Secretary of State for Health and Social Care 
about  the  death  of  Joan  Mary  Corcoran.  I  am  replying  as  I  am  replying  as  Minister  with 
responsibility for urgent and emergency services. Please accept my sincere apologies for the 
delay in responding to this matter. I would like to assure you that the department is mindful of 
the  statutory  responsibilities  in  relation  to  prevention  of  future  deaths  reports  and  we  are 
prioritising responses as a matter of urgency. 

Firstly, I would like to say how saddened I was to read of the circumstances of Ms Corcoran’s 
death,  and  I  offer  my  sincere  condolences  to  her  family.  The  circumstances  your  report 
describes are concerning and I am grateful to you for bringing these matters to my attention.  

The report raises concerns over long ambulance response times by North West Ambulance 
Service  NHS  Trust  (NWAS).  In  preparing  this  response,  Departmental  officials  have  made 
enquiries with NHS England and the North West Ambulance Service Trust (NWAS) who have 
reassured me that regional performance is improving. 

As the Minister responsible for urgent and emergency care services, I recognise the significant 
pressure  the  urgent  and  emergency  care  system  is  facing.  That  is  why  we  published  our 
‘Delivery  plan  for  recovering  urgent  and  emergency  care  services’  which  aims  to  deliver 
sustained  improvements  in  waiting  times.  Our  ambitions  for  this  year  are  to  improve  A&E 
waiting times to 78% of patients to be admitted, transferred, or discharged from A&E within 
four hours by March 2025, and to reduce Category 2 ambulance response times to 30 minutes 
across 
is  available  at  https://www.england.nhs.uk/wp-
content/uploads/2023/01/B2034-delivery-plan-for-recovering-urgent-and-emergency-care-
services.pdf 

fiscal  year.  The  plan 

this 

Your  report  highlights  that  NWAS  were  under  high  demand  at  the  time  of  the  incident.  A 
primary aim of our delivery plan is to boost ambulance capacity. Ambulance services received 
£200 million of additional funding in 2023/24 to expand capacity and improve response times, 
and we are maintaining this additional capacity in 2024/25. This is alongside the delivery of 
new ambulances and specialist mental health vehicles. With more ambulances on the road, 
patients will receive the treatment they need more swiftly.  

1 

 
 
 
 
 
  
  
 
 
 
 
 
 
 
 
 
 I recognise that ambulance trusts work within a health and care system and issues such as 
delayed patient handovers to hospitals can impact on capacity and response times. That is 
why a  key  part  of the  delivery  plan  is  about  improving  patient  flow  and bed capacity  within 
hospitals.  We  achieved  our  2023/24  ambition  of  delivering  5,000  more  staffed,  permanent 
hospital beds this year compared to 2022-23 plans, backed by £1 billion of dedicated funding, 
and we will maintain this capacity uplift in 2024/25. Further, we also achieved our target of 
scaling up virtual ward bed capacity to over 10,000 ahead of winter 2023/24, and there are 
now over 11,000 beds available nationally. We also have provided £1.6 billion of funding over 
two years to support the NHS and local authorities to ensure timely and effective discharge 
from hospital. These measures are helping improve patient flow through hospitals, reducing 
delays in patient handovers so ambulances can swiftly get back on the roads.    

At a national level, we have seen significant improvements in performance this year compared 
to last year. In 2023-24, average Category 2 ambulance response times (including for serious 
conditions such as heart attacks and strokes) were over 13 minutes faster compared to 2022-
23, a reduction of over 27%. NWAS average Category 2 response times were over 13 minutes 
faster, a 32% reduction. 

Information on ambulance handover times has been published since October 2023. In March 
2024, average patient handover times in the NWAS region were 32 minutes 51 seconds, and 
this is the second month in a row that handover time has improved.  

However,  I  recognise  there  is  still  more  to  do  to  reduce  response  times  further,  and  the 
Government will continue to work with NHS England to achieve this. 

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

Yours,  

HELEN WHATELY

Related reports

Other reports by Alison Mutch

See all →

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

See all →

Track Stockport NHS Foundation Trust

See every Prevention of Future Deaths report matching Stockport 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.