Prevention of Future Deaths reports · 2024

Stephen Lindsay

Regulation 28 report to prevent future deaths, reference 2024-0420, written 1 Aug 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report1 Aug 2024
Reference2024-0420
DeceasedStephen Lindsay
CoronerRobert Cohen
Coroner areaCumbria
CategoryMental Health related deaths
Organisation namedCumbria, Northumberland, Tyne and Wear 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.

Kally Cheema LLB | Senior Coroner | Cumbria 

           Fairfield, Station Road, Cockermouth, Cumbria CA13 9PT            

Case Ref: 11367656 

1 August 2024 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:  North East and North Cumbria Integrated Care 
Board 
CORONER 

I am Robert Cohen, HM Assistant Coroner for Cumbria  
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. 

1 

2 

http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 

http://www.legislation.gov.uk/uksi/2013/1629/part/7/made 
INVESTIGATION and INQUEST 

On 6 March 2024 I commenced an investigation into the death of Stephen LINDSAY. The 
investigation concluded at the end of the inquest . The conclusion of the inquest was 

Death by suicide. 

3 

1a Hanging   

1b    

1c    

 II     
CIRCUMSTANCES OF THE DEATH 

Mr Lindsay was 71 years old. He lived in Cockermouth, Cumbria. In October 2023 Mr 
Lindsay was diagnosed with metastatic Oesophageal Cancer. He experienced a number 
of complications associated with his diagnosis and was in pain.  

4 

In November 2023 Mr Lindsay reported to his GP that he felt overwhelmed. In January 
2024 Mr Lindsay had a procedure at the Royal Victoria Infirmary, Newcastle. The RVI 

 
  
   
  
  
  
  
 Mental Health Team (operated under the aegis of Cumbria, Northumbria, Tyne and Wear 
NHS Foundation Trust ('CNTW')) subsequently wrote to Mr Lindsay's GP noting concerns 
about his mental health and suicidal ideation and noting that the efficacy of 
antidepressant medication should be "monitored by services supporting Steven locally".  

Mr Lindsay's GP referred him to the local Community Treatment Team run by CNTW. On 
21st February 2021 that team responded: "This is a very sad situation and must be very 
difficult for Stephen. I am sorry that CTT are not a service that can offer the interventions 
that are needed at this stage. I am surprised that palliative care/McMillan team don't have 
staff that can help Stephen understand the diagnosis and prognosis. I am sorry that I can't 
be anymore help".  

Mr Lindsay died on 28th February 2024. I concluded that his death was suicide.  
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.  – 

5 

(1) I am concerned that providing treatment for Mr Lindsay's mental health was passed 
between several teams, with none of them being willing to accept that it fell within the 
ambit of services they had been commissioned to provide. I am concerned that there is a 
risk that in future cases mental health support will not be provided to those suffering from 
terminal illness and that this may lead to other patients experiencing crisis and attempting 
to end their lives. I consider that the lack of clarity as to the responsibility for providing 
such care may cause further deaths.  

(2) 

(3) 

ACTION SHOULD BE TAKEN 

6 

In my opinion action should be taken to prevent future deaths and I believe you North 
East and North Cumbria Integrated Care Board have the power to take such action. 
YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 26th September 2024. I, the coroner, may extend the period. 

7 

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. 
COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to CNTW. 

I am also under a duty to send the Chief Coroner a copy of your response. 

8 

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. 

  
  
 1 August 2024 

9 

Signature 

Robert Cohen HM Assistant Coroner for

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 Nenc ICB (PDF)
Mr Robert Cohen 
HM Assistant Coroner for Cumbria  
Fairfield, 
Station Road, 
Cockermouth, 
Cumbria, 
CA13 9PT 

Dear Mr Cohen, 

NENC ICB 
Pemberton House 
Colima Avenue 
Sunderland 
SR5 3XB 

19.09.24  

Re Regulation 28 Report to Prevent Future Deaths - Mr Lindsay  

Thank you for your Report to Prevent Future Deaths (hereafter “Report”) dated 1st August 2024  
concerning the death of Mr Lindsay on 28th February 2024. In advance of responding to the action 
raised in your Report, I would like to express my deep condolences to Mr Lindsay's family.  
The response from the North East and North Cumbria Integrated Care Board (NENC ICB) to the 
concern in your Report is as follows. 

Concern: I am concerned that providing treatment for Mr Lindsay's mental health was 
passed between several teams, with none of them being willing to accept that it fell within 
the ambit of services they had been commissioned to provide. I am concerned that there is 
a risk that in future cases mental health support will not be provided to those suffering 
from terminal illness and that this may lead to other patients experiencing crisis and 
attempting to end their lives. I consider that the lack of clarity as to the responsibility for 
providing such care may cause further deaths. 

The ICB have undertaken a review of Mr Lindsay's patient journey from the months prior to his 
diagnosis with metastatic Oesophageal Cancer up until his date of death. 

Working with the organisations involved each team has completed a review of their care and 
treatment and reflected on the patient's pathway. As a result, a few immediate actions were 
identified and are currently being implemented. These are as follows:   

•  Cumbria, Northumberland, Tyne and Wear NHS FT (CNTWFT) are raising awareness with 
their teams of the Marie Curie helpline for people living with terminal illness as well as 
educating teams on the Macmillan service offer.  

•  North Cumbria Integrated Care NHS Trust (NCIC) have provided further training to the 

palliative care team to help better support conversations with patients, who may have risk 
issues, how to assess them and to secure the right level of care. The Trust are also reviewing 
their draft Mental Health Strategy, this is to ensure it reflects and highlights that those patients  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 presenting with a long-term condition are likely to have a higher risk of death by suicide. The 
strategy will also clearly outline the role and responsibilities of the CNTWFT mental health 
teams and the necessity to share assessments and safety plans with relevant parties. 

To further address your concern, the ICB will also be holding a reflective learning event with those 
involved in Mr Lindsay's care and treatment. This will enable the teams to reflect, identify and 
explore further opportunities to improve patients experience of care and to ensure that there are 
no unforeseen barriers in ensuring that any patient suffering a terminal illness receives seamless, 
responsive and supportive care.  We would be happy to share the outcome of this event with Mr 
Lindsay's family and yourself.  

Thank you for bringing this important patient safety concern to my attention and please do not 
hesitate to contact me should you need any further information.  

Yours sincerely, 

Chief Nurse AHP People Officer  
North East and North Cumbria Integrated Care Board

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