Prevention of Future Deaths reports · 2024

Nicola Lacey

Regulation 28 report to prevent future deaths, reference 2024-0340, written 26 Jun 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Jun 2024
Reference2024-0340
DeceasedNicola Lacey
CoronerHugh Gregory
Coroner areaHerefordshire
CategorySuicide (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.

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MANAGING CONCERNS AND ALLEGATIONS AGAINST PEOPLE WHO WORK WITH ADULTS WITH CARE AND SUPPORT 
NEEDS WITHIN HWHCT
Process for dealing with the concern about the person in a Position of Trust (POT concern)

Concern can be identified or raised in different ways

E.g. Concern raised 
through partner / 
agencies (Social 
Care, Police etc)

E.g. Member of the 
public or other 3rd 
party informs the 
partner / agency.

E.g. Concern is raised 
through information 
gathering with the 
person

E.g. Via third party 
health agencies 
(acute / GP services)

Concern or allegation is shared with the Trust.
An initial Panel meeting between the manager of the person against whom 
the allegation has been made, a member of HR, a member of IST and the 
relevant professional lead will be called within 24 hours (Monday to 
Friday*) to consider the allegation. 

*For Out of Hours (OOH) guidance, please see seperate process chart.

The information 
indicates an 
identifiable adult 
with care and 
support needs, 
or child, is 
experiencing or 
is at risk of 
abuse or 
neglect- 
   REFER TO / 
USE ADULT or 
CHILD 
SAFEGUARDING 
PROCESSES

The Panel assesses the risk, and may investigate allegations through 
internal employment processes where it is appropriate to do so

The Panel ensures that risk management actions as appropriate to the 
individual case are undertaken and an appropriate action plan is 
formulated and completed (e.g. increased supervision or monitoring, 
redeployment whilst the investigation is completed, disciplinary or dismissal).

Ongoing management of the individual against whom allegations have 
been made will be delivered via the Operational / Clinical management 
structure in consultation with Human Resources and Professional 
Leaders as appropriate.

The Panel considers making a 
notification of the disclosure to 
external agencies and / or 
regulator
 e.g.

- ICB 
- Local Authority 
- NHSP 
- CQC (when employed in a CQC 
regulated service)
- OfSTED (when employed in an 
OfSTED regulated service)
- DBS
- Professional bodies like the 
HCPC, NMC, GMC

Commissioning and regulatory 
agencies can check/oversee 
employer 
actions as part of regulatory and 
contract monitoring processes.
Also filed under 2024-0340: Enc-2_OOH-POT-Flowchart-FINAL.pdf
Ensure staff
member is
made aware,
ensure shift
is covered

Ensure that
in Hours staff
are made
aware prior to
staff member
coming on
shift

Receiving team ensures
that -

Initial safety planning
is completed for all
involved.
Medical care is offered
if needed. 
Consider risk to
others/ public.
Consider informing
family.
Consider contacting
police if a criminal act
has occurred.
Retain CCTV and other
evidence

OOH POT

Level 2 should
consider
seeking
supervision
from Level 3 if
needed

Possible POT referral
received by clinical
team

Receiving
team
discusses
with
appropriate
manager

Manager
ensures that
Level 2 on
call is
informed
of/party to
discussions

Level 2
Manager
ensures that
anonomised
allegations
are detailed
in on call log
and a
seperate
confidential
written record
is kept

On call manager hands
information over to 'in hours'
operational manager and emails
Whcnhs.integratedsafeguarding
@nhs.net with update and
hands over to operational team

Does the staff
member subject to
the allegations
need to be
removed from
shift?

The
information
indicates an
identifiable
adult with care
and support
needs, or
child, is
experiencing
or is at risk of
abuse or
neglect-
REFER TO /
USE ADULT
or CHILD
SAFEGUARDING
PROCESSES
Also filed under 2024-0340: Nicola-Lacey-Prevention-of-future-deaths-report-2024-0340_Published.pdf
H G Mark Bricknell 
Senior Coroner 
for County of Herefordshire 

26th June 2024 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:  Robert Mackie, Chief Executive, Herefordshire and Worcestershire 
Health and Care NHS Trust. 
CORONER 

1 

I am Hugh Gregory Mark Bricknell, Senior Coroner for County of Herefordshire 

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. 
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 
http://www.legislation.gov.u k/u ksi/2013/1629/pa rt/7 /made 

3 

INVESTIGATION and INQUEST 

On 13 January 2023 I commenced an investigation into the death of Nicola Jane LACEY. The investigation 
concluded at the end of the inquest on 12 June 2024. The conclusion of the inquest was 
suicide. 
CIRCUMSTANCES OF THE DEATH 

4 

Nicola Jane Lacey lived alone in a large property in rural Herefordshire.  She had recently separated from 
a partner. 
On the 30th December 2022, the deceased did not attend work and did not call anyone. This raised 
concern. As a consequence a member of staff who worked with the deceased attended her address. 
There was no answer at the address and therefore the Police were called. 
Police attended the scene and forced entry. The Police established that Nicola Jane Lacey had died. A 
note identified the deceased's intentions. 

Nicola Jane Lacey had a responsible position within Healthcare.

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 Hereforshire and Worcestershire NHS (PDF)
Chief Executives Office 
2 Kings Court 
Charles Hastings Way 
Worcester 
WR5 1JR 

Tel: 01905 681667 

Email: 

20th August 2024 

HM Senior Coroner- HG Mark Bricknell 
HM Coroner’s Office  
Town Hall 
St Owen Street 
Hereford 
HR1 2PJ 

Sent via email to: 

Dear Sirs, 

Re: Regulation 28: Report to Prevent Future Deaths in respect of Ms Nicola Lacey 

I am writing in response to your report to prevent future deaths dated 26th June 2024 addressed to 
me, I am grateful for the opportunity of responding to your concerns. 

The Trust is always keen to learn from any tragic incident and I hope that this response satisfies you 
that we have reviewed the issues raised appropriately.   

Your concern: 

Procedures should be clear and known to employers concerning appropriate disclosure of a 
colleagues ongoing mental health difficulties for the benefit of both the individual concerned 
and the safety of the wider public. 

The Trust can confirm that when working with patients with ongoing mental health difficulties we 
routinely assess the risks associated with themselves and others.  If it is identified that this risk relates 
to or is relevant to their employment, we would in the first instance discuss this with the patient and 
seek informed consent for the employer to be advised of any necessary concerns.  The importance of 
a therapeutic relationship is critical to supporting patients in their recovery.  If a patient does not agree 
to discussions taking place with their employer about their health, practitioners have very clear 
parameters when they need to consider if they should breach confidentiality.  In order to support such 
a decision, our clinical staff have access to both management and clinical supervision, safeguarding 
supervision, as well as access to other professional advice such as through our legal or information 
governance teams, or our Caldicott Guardian. 

If we have any concerns about anyone who works or volunteers with adults with care and support 
needs we would also consider this in regards to ‘A Person in a Position of Trust’ (PiPoT) framework.  

Chief Executive: 
Chair: 

 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 The Person in a Position of Trust Framework is applicable where there is an allegation or concern 
about an adult who works or volunteers in a position of trust with adults with care and support needs, 
employers, student bodies and voluntary organisations.  In Herefordshire this framework is agreed 
and overseen by the Herefordshire Safeguarding Adult Board and a copy can be found here 
Positions-of-Trust-Framework-1.pdf (herefordshiresafeguardingboards.org.uk)     

In this situation where concerns arise the clinical team notify our Safeguarding team who then co-
ordinate an appropriate discussion with professional advice and a decision is made using the Position 
of Trust Framework as to whether information is shared with an employer or not.  

Action: 

To ensure this process is clear, known to staff and followed routinely we have developed 2 Standard 
Operating Procedures (SOPs), one within working hours and one for out of hours.  These SOPs are 
now in place and will be added to our Position of Trust Policy.  Please find both SOPs attached for 
your information. 

In addition, I can confirm the author of the report who adduced oral evidence at court has been 
contacted to ensure she is happy with the above process.  As an organisation, we always prioritise 
the mental health and well-being of our staff.  We understand that mental health is just as important 
as physical health, and we are committed to creating a supportive and inclusive work environment 
that promotes mental wellness.  

We hope the above reassures you that we do offer resources and support for employees who may 
be struggling with mental health concerns.  Our goal is to ensure that all staff members feel supported  
valued and able to thrive both personally, and professionally.  We believe that by promoting mental 
health we create a positive and protective work culture for everyone.           

Conclusion: 

I would like to thank you for drawing this matter to my attention, I confirm that the point you raised has 
been carefully considered and the response set out above.  I confirm that I have no submissions to 
make about publishing this response. 

If you have any further queries do not hesitate to contact me. 

Yours faithfully 

Chief Executive 

Enc

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