Prevention of Future Deaths reports · 2024
Regulation 28 report to prevent future deaths, reference 2024-0404, written 24 Jul 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.
| Date of report | 24 Jul 2024 |
|---|---|
| Reference | 2024-0404 |
| Deceased | Brogen-Lea Storey |
| Coroner | Nicholas Walker |
| Coroner area | Staffordshire and Stoke on Trent |
| Category | Child Death (from 2015) · Road (Highways Safety) related deaths |
| Source | judiciary.uk record · original PDF |
| Responses published | 1 |
Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.
REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1) NOTE: This form is to be used after an inquest. REGULATION 28 REPORT TO PREVENT FUTURE DEATHS THIS REPORT IS BEING SENT TO: 1. 2. 3. CORONER 1 , Road Safety Management, Staffordshire County Council I am Nicholas Walker, Assistant Coroner, for the coroner area of Staffordshire and Stoke-on-Trent. 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 2nd December 2022 I commenced an investigation into the death of Brogen-Lea Debbie Marie Storey. The investigation concluded at the end of the inquest on 11th July 2024. The conclusion of the inquest was that Brogen-Lea died after sustaining catastrophic injuries as a pedestrian in a road traffic collision 4 CIRCUMSTANCES OF THE DEATH Brogen-Lea, a schoolgirl, was walking home in the Cannock area of Staffordshire at about 6:30pm on 29th November 2022. She was late and was likely in a rush. Brogen- Lea emerged from a footpath which is bisected by a busy road subject to a 50mph limit. She continued into the carriageway and was struck by a car. The driver of the car had not seen her, likely because of a combination of her clothing and the failure of streetlamps in the area. Brogen-Lea sustained injuries from which she later died. 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 could 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 track along which Brogen-Lea walked is well-used and is bisected by a busy road with traffic travelling at speed. The road concerned is the A460 Eastern Way, Cannock and the footpath runs through the wooded area of Mill Hayes and Hawkes Green Nature Reserve. I am concerned that there is nothing to: 1. Warn drivers about the prospect of pedestrians crossing 2. Warn pedestrians about the road ahead 3. Prevent pedestrians walking into the road 4. Allow pedestrians safely to cross the road 6 ACTION SHOULD BE TAKEN In my opinion action should be taken to prevent future deaths and I believe you or your organisation has 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 16th September 2024. 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 Interested Persons and to the LOCAL SAFEGUARDING BOARD (where the deceased was under 18)]. I have also sent it to the family who may find it useful or of interest. 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 24th July 2024
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.
Accident Investigation Unit
Staffordshire County Council
Staffordshire Place 1
Tipping Street
Stafford
ST16 2DH
E-mail:
13/09/2024
Mr N Walker
Assistant Coroner
Staffordshire and Stoke-on-Trent
Coroners Service
Stoke Town Hall
Stoke on Trent
ST4 1HH
Dear Mr Walker,
Re: BL Storey (Deceased)
A460 Eastern Way, Cannock
I refer to your Regulation 28 report regarding the inquest into the death of Brogan-Lea Storey
and your comments concerning the A460 Eastern Way, Cannock and the footpath through the
wooded area of Mill Hayes and Hawkes Green Nature Reserve.
This letter is in response to the matters of concern recorded in section 5 of your report, which
states the track along which Brogen-Lea walked is well-used and is bisected by a busy road with
traffic travelling at speed, and details your concerns that there is nothing to:
1. Warn drivers about the prospect of pedestrians crossing
2. Warn pedestrians about the road ahead
3. Prevent pedestrians walking into the road
4. Allow pedestrians safely to cross the road.
To date, the following action has been taken in response to the concerns raised:
• The extent of Highway Maintainable at Public Expense has been established and contact
has been made with Cannock District Council regarding the ownership and maintenance
of the adjoining footpaths.
• A site visit with representatives from both Staffordshire County Council and Cannock
District Council took place on 20 August 2024, to review the layout of the site and consider
the pedestrian usage along the footway on the west side of the A460 and along the off-
highway footpaths through the wooded areas.
• Research and analysis of historical road traffic collisions has been undertaken within the
section of Eastern Way between the Hayes Way Island and the Hemlock Way/Hawkes
Green Lane Island of approx. 340m in length, which includes the area of footpath
intersection where this tragic incident occurred
During the last complete 5 years (2018-2022) and including any reports we have received from
Staffordshire Police since, there have been two other (slight injury) collisions on the full stretch
of road, neither of which involve a pedestrian, or display a treatable pattern.
Current consideration is being given to a number of actions that may mitigate further pedestrian
incidents from occurring at this location:
• Cutting back of shrubs and trees to improve visibility for pedestrians, highlight traffic
signage, and enable pedestrians to be clearly seen by motorists from a distance.
•
•
Installation of additional road signs and associated road markings along Eastern Way to
advise drivers of the potential presence of pedestrians.
Installation of a gate / barrier where the footway joins Eastern Way to warn pedestrians
of the main road ahead (working in collaboration with Cannock District Council).
• A possible speed limit reduction from the current 50mph limit down to 40mph.
As part of our statutory functions and commitment to our communities and road safety,
Staffordshire County Council routinely monitors personal injury collision data reported on the
public highway to identify accident clusters and trends. Any treatable pattern of accidents
identified will have proportionate remedial measures put forward for funding and will be
prioritised against other locations around Staffordshire. Consideration of the actions highlighted
above will continue over the next few months and any appropriate mitigating solutions identified
at Eastern Way will be prioritised alongside our annual programme of road safety schemes.
I hope the information provided within this letter is useful. Please let me know if you require
anything further.
Yours sincerely,
Road Safety Manager
Staffordshire County Council
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