Prevention of Future Deaths reports · 2023

Claire Homer

Regulation 28 report to prevent future deaths, reference 2023-0448, written 10 Nov 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report10 Nov 2023
Reference2023-0448
DeceasedClaire Homer
CoronerHarry Lambert
Coroner areaInner North London
CategoryOther related deaths
Organisation namedCamden and Islington 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:  Prevention of Future Deaths report 

Claire Elizabeth HOMER (died 05.05.23) 

THIS REPORT IS  BEING SENT TO: 

The Medical  Director,  CEO and  Legal  Department of: 
Camden and  Islington  NHS Foundation Trust 
St Pancras  Hospital 
4 St Pancras Way 
London 
NW1  OPE 

1  CORONER 

I am:  Harry Lambert 

Assistant Coroner 
Inner North London 
Poplar Coroner's Court 
127 Poplar High Street 
London  E14 0AE 

2  CORONER'S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009, 
paragraph 7,  Schedule 5,  and 
The Coroners (Investigations)  Regulations 2013, 
regulations 28 and  29. 

3 

INVESTIGATION and INQUEST 

On 23 My 2023 an investigation was commenced into the death of Claire 
Homer aged  46  years.  The  investigation  concluded  at  the  end  of the 
inquest held on  2nd  and  11 th  November 2023. 

The Inquest found  that Claire  Elizabeth  Homer suffered from  a 
debilitating constellation of physical,  psychiatric and somatic illnesses, 
with  a complex interplay between them.  She was found dead in  her 
home on  5 May 2023. Despite Post Mortem examination and 
toxicology,  no cause of death was identified. 

The medical cause of death was Unascertained . 

1 

 I returned  an  Open Conclusion. 

4  CIRCUMSTANCES OF THE DEATH 

Please see attached  Findings of Fact. 

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 fol lows. 

On the 27 April 2023  Claire's GP, 

,  wrote an email to 

querying  the  COAT  referral  and  suggesting  family  involvement  in  the 

  sharing  concerns  around  her worsening, 

formulation  of a management plan . 

Unfortunately there was no reply to this email until 5th May 2023, by which 

time  it  was  too  late.  I  do  not  criticise 

 for  this,  as  she  was  on 

holiday and thereafter catching up with what was no doubt an avalanche 

of emails. This does raise the question, however, of whether more robust 

protocols need to be in place to address the scenarios of (a) patients who 

are  not initially deemed  to  require  handover care  but deteriorate during 

a  member of staffs  leave  and  (b)  both  key  points  of contact  being  on 

leave at the  same time. 

6  ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that you  have the power to take such action. 

7  YOUR RESPONSE 

2 

 You are under a duty to  respond  to this report within 56 days of the date 
of this report,  namely by xxx.  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 following. 

,  brother of the Deceased 
, father of the  Deceased 

• 
• 
•  Care Quality Commission for England 
•  HHJ Thomas Teague QC,  the Chief Coroner of England & Wales 

I  am  also  under  a  duty  to  send  a  copy  of your  response  to  the  Chief 
Coroner and  all  interested  persons who  in  my opinion  should  receive  it. 
I  may  also  send  a  copy  of your  response  to  any  other  person  who  I 
believe may find  it useful  or of interest. 

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 
it  useful  or  of  interest.  You  may  make 
he  believes  may 
representations to  me,  the  coroner,  at the  time  of your response,  about 
the release or the publication of your response. 

find 

9  DATE 

10.11 .23 

SIGNED BY ASSISTANT C  ~ONER 

j

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 Barnet Enfield and Haringey Camden and Islington NHS Ft (PDF)
Partnership Headquarters 
4th Floor, East Wing 
St Pancras Hospital 
4 St Pancras Way 
London NW1 0PE 

 11th January 2024 

Private and Confidential 
Harry Lambert 
Assistant Coroner 
Inner North London 
Poplar Coroner’s Court 
127 Poplar High St 
London E14 0AE 

Dear Coroner Lambert 

Re Inquest touching the death of Claire Homer (date of death 05/05/2023) 

I am writing further to the inquest for Claire Homer which concluded on 11/11/2023 and at which 
you issued a Prevention of Future Deaths report.  The matters of concern raised were whether 
more robust protocols need to be in place to address the scenarios of (a) patients who are not 
initially deemed to require handover care but deteriorate during a member of staff’s leave and (b) 
both key points of contact being on leave at the same time. 

Thank you for raising these points which have been carefully considered from a service 
improvement perspective.  I can advise that the following actions have now been taken: 

1)  The importance of ensuring robust ‘Out of Office’ responses when on leave was discussed 
with staff in an Early Intervention Service-wide meeting on 24/11/2023. This meeting was 
chaired by 
service. Staff were asked to ensure their automated ‘Out of Office’ replies clearly signpost 
if the matter is urgent or requires an urgent response a) how to escalate a concern and b) 
to whom.  

, Service Manager. Minutes have since been sent to the whole 

2)  This has been followed by issuing a template that was circulated on 11/12/2023. Within 

this template, it makes clear that if the matter is urgent or requires a more rapid response, 
the sender should re-send to the relevant EIS team duty phone (Mon-Fri 9-5pm) and/or the 
team email inbox (Mon-Fri 9-5pm). As EIS is not an emergency service, the expected 
response time is within 24 hours. Contact details for the crisis line should also be provided 
for use in an emergency situation.  

         Better Mental Health. Better Lives. Better Communities.                               

 
 
 
                                                                            
 
 
 
 
 
 
 
            
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
  
 
 3)  The service manager has also requested this same practice is robustly followed for 

voicemail messages when a member of staff is absent from work. 

4)  The service manager has checked that the information is correct for both EIS teams online 
and has had this amended to include the duty mobile numbers of the two EIS teams, in 
addition to the switchboard number and team Inboxes which were already present. 

5)  With regards key contacts being on leave at the same time, the need for cover 

arrangements for doctors to be in place and communicated clearly with the team has been 
reiterated. These cover arrangements should always be clearly signposted via ‘Out of 
Office’ messages. 

6)  The service manager has reiterated to team managers the importance of balancing service 

need and cover with requests for annual leave.  

7)  The service manager has reiterated the necessity to provide the team with a clear 

handover of patients prior to taking leave. This practice is robustly in place already. 
However, when a patient deteriorates whilst they are away, the expectation is that the 
person alerting the team to this follows the signposting indicated on their ‘Out of Office’ 
reply and escalates to the team inbox and/or duty phone.  

For the record we wish for it to be noted that in this case staff email accounts have been checked 
and robust Out of Office messages were in place signposting recipients to the EIS duty team.  
Whilst the above actions are now in place within the EIS team, we will also be ensuring that this 
learning is shared and implemented across the Camden division and the wider Partnership. 

I trust that this offers you the necessary reassurance in regard to these matters but if you have 
any further queries, please do not hesitate to contact me. 

Yours sincerely 

Chief Medical Officer 

         Better Mental Health. Better Lives. Better Communities.

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