Prevention of Future Deaths reports · 2023

Elliott Harratt

Regulation 28 report to prevent future deaths, reference 2023-0261, written 20 Jul 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Jul 2023
Reference2023-0261
DeceasedElliott Harratt
CoronerAlison Mutch
Coroner areaManchester South
CategoryChild Death (from 2015)
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:  Greater Manchester Integrated 
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 1st February 2023 I commenced an investigation into the death of 
Elliott James Harratt. The investigation concluded on the 26th  June 2023 
and the conclusion was one of Natural causes. The medical cause of 
death was 1a Extreme Prematurity 

4  CIRCUMSTANCES OF THE DEATH 

Elliott James Harratt's mother went into early labour with him. He was 
born at the family home and transferred to Tameside General Hospital. 
He was 20 plus 4 weeks gestation. He died at Tameside General Hospital 
on 29th  January 2023 from extreme prematurity 

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.  – 
In the course of the inquest into Elliott’s death evidence was heard of a 
matter that did not contribute to his death but was of concern for the 
future for other babies. 

The inquest heard evidence that the rhesus status of Elliott’s mum meant 
that after a sensitising event Anti D needed to be given to prevent Rhesus 
disease in a newborn baby. The evidence before the inquest was that the 
type of events that would constitute a sensitising event and what action 

1 

 
 
 
  
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 was then required were not made clear to Elliott’s mum. In addition, the 
type of events where a call to maternity triage for advice were not made 
clear to his mum. 

This was, the evidence suggested, because there was no readily 
accessible or consistent list given to expectant mothers at booking in 
appointments or at follow up signposting them. Such a document in the 
form of a handout laminate or as a list in the handheld notes would 
increase awareness of events where a call to maternity triage would be 
advisable for health of both the mother and baby enabling health 
professionals to intervene at the earliest possible stage. 

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 14th  September 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 Chief Coroner and to the following 
Interested Persons namely 1) 
Tameside General Hospital, who may find it useful or of interest. 

 on behalf of the Family; 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 

20.07.2023 

2

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 Greater Manchester Integrated Care (PDF)
E: mandy.philbin@nhs.net   

Date: 27th September 2023 

Ms A Mutch  
HM Senior Coroner 
Coroner’s Court  
1 Mount Tabor Street  
Stockport  
SK1 3AG 

Dear Ms Mutch, 

Re: Regulation 28 Report to Prevent Future Deaths  

Thank you for your Regulation 28 Report dated 20th July 2023 concerning the sad death of Elliott 
James Harratt on the 29th of January 2023. On behalf of NHS Greater Manchester Integrated Care 
(NHS GM), We would like to begin by offering our sincere condolences to Mr Harratt’s family for their 
loss. 

Thank you for highlighting your concerns during baby Harratt’s Inquest which concluded on the 26th of 
June 2023.  On behalf of NHS GMICB, we apologise that you have had to bring these matters of 
concern to our attention.  We recognise it is very important to ensure we make the necessary 
improvements to the quality and safety of future services.   

Following the inquest, you raised concerns in your Regulation 28 Report to NHS GM that there is a risk a 
future death will occur unless action is taken. The medical cause of death was Extreme Prematurity.   

I hope the response below demonstrates to you and baby Harratt’s family that NHS GM has taken the 
concerns you have raised seriously and will learn from this as a whole system.  

This letter addresses the issues that fall within the remit of NHSGM and how we can share the learning 
from this case. 

The inquest heard evidence that the rhesus status of Elliott’s mum meant that after a sensitising 
event Anti D needed to be given to prevent Rhesus disease in a newborn baby. The evidence 
before the inquest was that the type of events that would constitute a sensitising event and what 
action was then required were not made clear to Elliott’s mum. In addition, the type of events 
where a call to maternity triage for advice were not made clear to his mum. 

This was, the evidence suggested, because there was no readily accessible or consistent list 
given to expectant mothers at booking in appointments or at follow up signposting them. Such a 
document in the form of a handout laminate or as a list in the handheld notes would increase 
awareness of events where a call to maternity triage would be advisable for health of both the 
mother and baby enabling health professionals to intervene at the earliest possible stage 

Every patient is offered an ultrasound scan at around 10 to 14 weeks of pregnancy. This is called the 
dating scan. It's used to see how far along the patient is in their pregnancy and check the baby's 
development. The scan may also be part of a screening test for Down's syndrome. 

4th Floor, Piccadilly Place, Manchester  M1 3BN   
Tel: 0161 6257791  www.gmintegratedcare.org.uk 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
  
 There is a second (anomaly) scan at 18-21 weeks where they check for structural abnormalities in the 
baby. Further scans can be offered depending on health and pregnancy. 

At these appointments the clinicians discuss any potential risks such as the mother having D blood type 
(previously known as “Rhesus D”, “RhD” or “Rhesus”), and it is also an opportunity to answer any 
questions and provide both verbal and written information in relation to what to do if there are any 
concerns about the baby or the mother.  

If a mother has D blood type, this is discussed at the 18-21 week scan to ensure that the mother is 
aware of their status.  They are also given written information on this. The written information is 
produced by NHS Blood and Transplant: 

•  Blood Groups and Red Cell Antibodies in Pregnancy – NHS Blood and Transplant leaflet 

https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/18055/inf166-blood-groups-and-
red-cell-antibodies-in-pregnancy.pdf  

•  Protecting women and babies with anti-D Immmunoglobulin – NHS Blood and Transplant leaflet 

https://www.bfwh.nhs.uk/wp-content/uploads/2015/08/inf1300.pdf  

Each of our Trusts in Greater Manchester that provide maternity services are set up slightly differently in 
relation to how they deliver services, however the advice they provide to mothers on when to contact 
services is consistent across the system and comes in many forms, written, verbal and online.   

We will use this event as an opportunity to highlight the importance of ensuring that mothers who do 
have D blood type, have the appropriate guidance, written information and understand when to contact 
services.  

Actions taken or being taken to share learning across Greater Manchester: 

1.  Learning to be presented/shared with the Greater Manchester System Quality Group on the 16th 
of November 2023. This meeting is attended by a broad range of system leaders including 
clinical and care leaders, commissioners of specialist services, locality representatives from each 
of the 10 GM boroughs, the CQC, Healthwatch who represent the public voice and NICE. 
Through sharing in this forum, we expect members to review and ensure learning is incorporated 
into their commissioned services. 

2.  As part of our approach to embedding the learning we share the learning from this and similar 
cases at Greater Manchester and borough level. This is cascaded to professionals through 
relevant governance and learning forums to ensure that learning is incorporated into their 
services. In this case it will be discussed at the Local Maternity and Neonatal Network Safety 
Assurance Panel on the 5th of October 2023.  

In conclusion, key learning points and recommendations will be monitored to ensure they are embedded 
within practice. NHS GM is committed to improving outcomes for the population of Greater Manchester.  

We hope this response demonstrates to you and baby Harrat’s family that NHS GM has taken the 
concerns you have raised seriously and is committed to working together as a system including our 
service users, carers and families to improve the care provided.  

Thank you for bringing these important patient safety issues to our attention and please do not hesitate 
to contact us should you need any further information. 

4th Floor, Piccadilly Place, Manchester  M1 3BN   
Tel: 0161 6257791  www.gmintegratedcare.org.uk 

 
  
 
 
 
  
  
   
 
 
 
 
 
 Yours sincerely 

Mandy Philbin 
Chief Nursing Officer 
GM Integrated Care 

Sandra Stewart  
Place Based Lead Tameside  
GM Integrated Care 

4th Floor, Piccadilly Place, Manchester  M1 3BN   
Tel: 0161 6257791  www.gmintegratedcare.org.uk 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 4th Floor, Piccadilly Place, Manchester  M1 3BN   
Tel: 0161 6257791  www.gmintegratedcare.org.uk

Related reports

Other reports by Alison Mutch

See all →

More reports categorised “Child Death (from 2015)”

See all →

Track Child Death (from 2015)

See every Prevention of Future Deaths report matching Child Death (from 2015), 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.