Prevention of Future Deaths reports · 2024

Juliette Sewell

Regulation 28 report to prevent future deaths, reference 2024-0459, written 19 Aug 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report19 Aug 2024
Reference2024-0459
DeceasedJuliette Sewell
CoronerAdam Hodson
Coroner areaBirmingham and Solihull
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.

1 

2 

3 

4 

5 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:   
Birmingham and Solihull Mental Health NHS Foudation Trust 
CORONER 

 I am Mr Adam Hodson, Assistant Coroner for Birmingham and Solihull 
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. 
INVESTIGATION and INQUEST 

 On 23 April 2024 I commenced an investigation into the death of Juliette Kirsty SEWELL. The 
investigation concluded at the end of the inquest. The conclusion of the inquest was; Suicide 

CIRCUMSTANCES OF THE DEATH  

  In the afternoon of 16/02/2024, Juliette was discovered unresponsive in 
 by a 
family friend, surrounded by multiple empty packets of medications, and was subsequently 
confirmed deceased at 13:43. Post-mortem investigations indicated she had died from a 
fatal overdose. Juliette had been missing since the evening of 14/02/2024 when she left 
home following difficulties in her personal life and was last seen alive by a friend at around 
22:00 on 14/02/2024. Juliette was seen crying on the porch of her friend’s home on 
Fallowfield Road before heading in the direction of 
mental health illness since 2010 and had been under the care of both her GP and her local 
mental health team. At the time of her death, Juliette had been awaiting a follow-up 
appointment with the mental health team since January 2023 which had been delayed due 
to staffing shortages, but it is unlikely that her death could have been prevented. 

. She had a history of 

 Following a post mortem, the medical cause of death was determined to be: 

 and 

 toxicity 

 1a   

 1b    

 1c    

 II    Presence of 
CORONER’S CONCERNS 

, 

, 

, 

, 

 and 

 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.  – 

1.   Following Juliette's death, a Structured Judgement Review ("SJR") was carried out which 
identified steps that have been taken. However, the SJR confirmed that a review of Rio 
records was being undertaken of those who have not been seen in over 12 months with 
actions to be identified, and that clinical stratification of current caseload is ongoing. I 

  
  
  
  
  
 
 
 understand that a review or audit of this process is being scheduled to take place at some 
point in October 2024 (date unknown). 

2.  Upon conclusion of the inquest, I am Functus Officio meaning that my powers cease and I 
will have no way of checking if the recommended actions have been completed. In the 
circumstances, where action to be taken is outstanding and when a specific review date 
has not been scheduled, I am concerned that there is a risk of future deaths occurring. 
3.  The deadline for a response under this Report should coincide with the Trust's planned 

review/audit in October, therefore I am hopeful that the Trust will be able to respond swiftly 
thereafter, and hopefully will be able to confirm that positive action that has been taken and 
whether any further work is necessary.  

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. 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, namely by 
14/10/2024. I, the Coroner, may extend the period upon request. 

6 

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 the following Interested Persons: 

, Sister 

8 

I have also sent it to the Medical Examiner, ICS, NHS England, CQC, 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. 
 19 August 2024  

9 

Signature: 

Adam Hodson 

Assistant Coroner for Birmingham and Solihull

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 Birmingham and Solihull Mental Health NHS Foundation Trust (PDF)
Legal Department 
Uffculme Centre 
52 Queensbridge Road 
Moseley 
Birmingham B13 8QY 

Tel: 

Mr Adam Hodson, 
Assistant Coroner, 
Birmingham and Solihull Areas, 
BIRMINGHAM  
B4 6BJ 

BY EMAIL ONLY TO: 

Our Ref: 

Your Ref: 

Date: 10 October 2024 

Dear Mr Hodson 

Re: Prevention of Future deaths Juliette Sewell 

Thank you for your Prevention of Future Death Report dated 19 August 2023. I would like to take this 
opportunity  to  offer  my  sincere  condolences  to  Juliette’s  family  for  their  loss  and  also  offer  my 
assurances that we have carefully reviewed her case and made improvements.  

In relation to the outstanding action you have highlighted. I can confirm that in order to provide you with 
assurances by the date of your PFD response, we have brought forward the necessary steps to ensure 
the completion of the action earlier than anticipated. I can confirm that there continues to be an ongoing 
review of our Electronic Patient Record (EPR) RiO records for service users who have not been seen 
by any clinician within the team for over 12 months as part of ongoing monitoring.   

As of September 2024, there are 553 service users who have not had contact with Lyndon CMHT in 
over a year, which is 21.14% of the total caseload. Of the 553 service users, 36.99% (204) have been 
offered at least one appointment in the last year by the team but did not attend (DNA). The caseload 
stratification work described at the inquest continues to  develop, to date, 1028 desktop reviews have 
been completed. Of this number, 436 have since had contact with the CMHT and a further 110 have an 
appointment booked on the system.  Lyndon CMHT books appointments up to five weeks ahead, so the 
remaining 482 service users will be booked in when new appointment slots become available.  The 482 
patients are existing patients of the CMHT, they have had appointments with the CMHT and have Care 
Support Plans in place. Further appointments are being made with them to review the next stage in their 
ongoing treatment and care and consider whether their needs can be met by the  Neighbourhood Mental 
Health Team.   

Patients are informed at their appointment by the relevant clinician that they will be offered a further 
appointment, in the meantime if the need arises, they are advised to contact the CMHT duty worker or 

 Chair: 

  │  Chief Executive: 

│  Website: www.bsmhft.nhs.uk 

Customer Relations: Mon–Fri, 8am–6pm  │  Tel: 

  │  Email: 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 out  of hours numbers.  This  contingency plan  is  also  included  in  the  care  support plans that  patients 
receive following their appointment. Where patients require more urgent appointments, this is discussed 
with the relevant doctor to make arrangements for the patient to be seen by a duty worker or by a doctor 
in an urgent outpatient slot. 

The team also review service user needs by way of MDTs for those patients who have been waiting for 
an extended period time. STR workers will also go out and visit service users if we have not been able 
to reach them on the phone. There are process to ensure clinical contact with patients to check on their 
mental health and wellbeing, and if necessary any urgent need for an appointment would be expedited 
with an appointment being booked in the next available slot or an urgent appointment to be arranged.  

Alongside this work, the team are also implementing a new system to improve the booking of out-patient 
appointments  and  development  of  a  report  that  will  easily  identify  those  who  are  approaching  the 
scheduled date of their next appointment with the team.  This work is underway and significant changes 
have already been made to the processes for booking of appointments, which has seen a reduction in 
our DNA rates.  The development of the report relies upon changes being made to RiO. These changes 
are due to be added to the ‘test’ system by 27th September 2024 and will go ‘live’ from 31st October 
2024.  Once data has been input into RiO the report can be finalised and launched.  

All other systems are in place to support the report from the ‘go live’ date, and this will strengthen the 
clinical oversight we have of the caseload. Whilst waiting for the above work to be implemented, there 
is scrutiny of the waiting lists by the Associate Director, Head of Nursing, Clinical Director, and Clinical 
Services Manager fortnightly. The Clinical Services Manager also scrutinises the waiting lists and those 
who have not been seen for over 12 months at a monthly meeting with the Hub Manager and Business 
Support Services Manager.  

The following processes are continuing: 
•  The list of those who are open but not seen for over 12 months is available via Insight reports.  This 
is scrutinised on a regular basis by the Business Support Services Manager and their team, who 
then highlight these cases to a senior clinician (i.e. Psychiatrist, Hub Manager, Clinical Lead) within 
the team so that they can determine the management plan and when the service user needs to be 
seen. 

•  Continue with current meetings to scrutinise waiting lists and overall caseload. 
•  Hub Manager to provide Clinical Services Manager with a weekly position update of progress being 
made for those who have not been seen for over 12 months, and to escalate any barriers that may 
be hindering this. 

•  Caseload  stratification  work  to  continue,  with  monthly  updates  to  be  sent  to  Clinical  Services 
Manager detailing how many have been completed and the outcome of these (e.g. seen by team, 
discharged to GP, transferred, etc). 

We hope that we have been able to offer reassurances that as a Trust we are committed to improving 
services for our patients and ensuring that improvements are made as soon as possible.  

If we can provide any further information, please do not hesitate to contact us.  

Yours sincerely  

Chief Executive 
BSMHFT 

2

Related reports

Other reports by Adam Hodson

See all →

More reports categorised “Suicide (from 2015)”

See all →

Track Suicide (from 2015)

See every Prevention of Future Deaths report matching Suicide (from 2015), and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.