Prevention of Future Deaths reports · 2023

Richard Griffiths

Regulation 28 report to prevent future deaths, reference 2023-0333, written 14 Sep 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Sep 2023
Reference2023-0333
DeceasedRichard Griffiths
CoronerKate Robertson
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.

Kate Robertson 
Assistant Coroner for North Wales (East and Central) 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:   
Betsi Cadwaladr University Health Board (BCUHB) 

1 

CORONER 

I am Kate Robertson, Assistant 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 30 March 2023 an investigation was commenced into the death of Richard Geraint 
Griffiths (DOB 12/1/70) who died on 26 March 2023. The investigation concluded at the 
end of the inquest on 14 September 2023.  The conclusion of the inquest was suicide. 

4 

CIRCUMSTANCES OF THE DEATH 

The circumstances of the death are as follows :- 

Richard Griffiths moved home to the Conwy area from South Gwynedd in October 2022 to live 
with his mother. He was under the care of the South Gwynedd Community Mental Health 
Team.  For reasons unknown the transfer of care did not occur. Sadly, on 26 March 2023 he 
was found suspended 
was cut down and the emergency services were also called. He was pronounced deceased at 
the location.  

. Once he was found he 

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  – 

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

 
 
 
 
 
 
  
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 a.  The Investigation undertaken by the Health Board was deficient in that it did not 
contain pertinent points relating to how the transfer of care did not occur. I 
have previously issued a number of Prevention of Future Death Reports relating 
to quality and timeliness of investigation.  

b.  The Health Board’s Transfer of Care document at the time the transfer occurred 
did not include any detail or process as to how the transfer should occur. The 
amended policy has still not been finalised and there remains a concern that 
deaths will continue to occur if the process is not finalised and shared widely 
within the Health Board to staff. 

c.  Patient notes for mental health are still not electronic; they are paper based. I 
have issued several Prevention of Future Death Reports specifically relating to 
this. There has been considerable delay in actioning this and yet there is still not 
anticipated timescale for this to occur. As such, deaths will continue to occur or 
may occur into the future with the risk that notes are paper based only. The risk 
relates to only one department or individual having access to them at once 
when there is wider support for the patient. 

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 9 November 2023. I, Kate Robertson, 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, to the Chief Coroner and 
to 

, Health Minister.  

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 14 September 2023 

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

  
 
 
 
 
 
 
 
 
 
 
  
 
 
 Signature   
Assistant 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: 3 November 2023 

Kate Robertson 
Assistant Coroner 
North Wales (East and Central) 
Coroner's Office 
County Hall 
Wynnstay Road 
Ruthin LL15 1YN 

Dear Ms Robertson, 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 
Richard Geraint Griffiths 

I am writing in response to the Regulation 28 Report to Prevent Future Deaths dated the 
14th  September  2023,  issued  by  yourself  to  Betsi  Cadwaladr  University  Health  Board 
following the inquest of Mr Griffiths. 

I would like to begin with offering my deepest condolences to the family and friends of Mr 
Griffiths. 

In the notice, you highlighted your concerns that the Health Boards investigation into the 
care and treatment provided to Mr Griffiths was not of the expected standard. 

In response to the notice, I asked our Mental Health and Learning Disabilities Division 
(MH&LD)  to  consider  your  concerns  and  provide  details  of  their  plans  to  ensure  the 
provision of robust investigation reports and action plans for improvement. 

, the Director of MH&LD Division, reported to you on the 14th  September 
2023 that an addendum investigation would be undertaken to  expand on the pertinent 
points relating to how the transfer of care of Mr Griffiths did not happen. 

The  investigation  is  underway,  and  the  investigating  officer  (IO)  has  undertaken 
interviews  with  staff  directly and  indirectly involved  in  Mr Griffiths’  care  and  treatment. 
The IO has considered the transfer process that was in place at the time Mr Griffiths was 
receiving  care,  the  improvements  that  have  been  made  since,  and  the  review  of  the 
Transfer and Discharge of Care Protocol. The addendum report is currently progressing 
through the Health Board’s approval process and I will be happy to share this with you 
on its completion in the coming weeks. 

On  the  15th  September  2023,  the  Quality  Governance  team  contacted  the  Heads  of 
Operations and Heads of Nursing throughout MH&LD to share the concerns you raised 
about the quality of the investigation report. The Quality Governance team requested that 
in future, IOs meet with the staff involved in the delivery of care and treatment to explore 
in  detail  the  decision-making  and  actions  taken  when  delivering  care  and  that  the 

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 

 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
 
 
 
 
 outcome of reports are shared with the staff involved. The Quality Governance team now 
also check for this aspect during the quality assurance of reports. This will ensure more 
detailed investigations that get to heart of the contributory factors and the root causes of 
incidents. 

The  Transfer  and  Discharge  of  Care  Protocol  has  been  revised  to  include  explicit 
guidance relating to transfers of care between community teams. This includes the steps 
to be taken by the care coordinator, supporting administrative staff and the single point 
of  access  service  (SPOA).  Progression  of  this  protocol  through  the  Health  Board 
ratification process is being led by the MH&LD Deputy Director of Nursing and progress 
is overseen by the MH&LD Policy and Procedure Group. The revised protocol is due at 
MH&LD  Policy  and  Procedure  Group  in  December  2023  after  which  it  will  progress 
through the Health Boards revised ratification process. I anticipate that the protocol will 
be ratified by the end of January 2024. 

Within the notice, you also raised your continued concerns about the implementation of 
digital patient records for MH&LD. In previous correspondence with you, the Health Board 
has reported significant delays with the development and implementation of a suitable 
system at a national level. I understand that you have raised your concerns about the 
delays with the Health Minister directly. We now know that following a decision made by 
WG the national system will not be progressing in the way that was previously expected. 
This has significantly altered MH&LD divisional plans for digital transformation as these 
were dependent upon the use of the WCCIS Care Director Version 5 product, with a pilot 
having been due to start in September 2023, and the expectation that a wider adoption 
across all applicable MH&LD services would follow. Regional meetings are now taking 
place across Wales to discuss the options that have been presented to them by WG as 
alternative to WCCIS Care Direct Version 5.  BCUHB has met with Local Authorities to 
discuss  implications  across  health  and  social  care  services  in  order  to  come  to  an 
agreement on the preferred option for North Wales. 

In addition I am pleased to report that a Strategic Outline Case for an Electronic Patient 
Record system(s) is being developed on a Health Board wide level to address the issue 
of  fragmented  care  records;  the  deadline  for  the  strategic  outline  case  is  the  end  of 
January 2024. MH&LD are taking a key role in shaping the outline case to ensure that 
the Division’s needs are considered as part of the Health Board wide proposal. 

Whilst MH&LD are keen to support and progress the processes outlined above, we are 
mindful of the scale of the task for agreeing a national solution and are therefore working 
with BCUHBs Chief Information Officer to consider options which may bring MH&LD a 
more timely solution.  This remains a major priority for the Division and is supported by 
the Health Board. 

I hope this letter sets out for you the actions we have taken to ensure the concerns you 
raised 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 Griffiths for 
their loss. 

Yours sincerely 

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

cc 

, Deputy Director of Quality

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