Prevention of Future Deaths reports · 2025

Kenneth Clayton

Regulation 28 report to prevent future deaths, reference 2025-0094, written 19 Feb 2025. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report19 Feb 2025
Reference2025-0094
DeceasedKenneth Clayton
CoronerAlison Mutch
Coroner areaManchester South
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedTameside and Glossop Integrated Care 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:  REPORT TO PREVENT FUTURE DEATHS  

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

 Secretary of State of The Department of Health and Social Care 

1 

CORONER 

I am Alison Mutch , senior coroner, for the coroner area of Manchester South  

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 11th September 2024 I commenced an investigation into the death of Kenneth 
James CLAYTON. The investigation concluded at the end of the inquest on 27th 
January 2025. The conclusion of the inquest was NARRATIVE: Died from the 
complications of an unobserved fall that occurred in the Emergency 
Department during a prolonged wait for an inpatient bed. The medical cause 
of death was 1a) Bronchopneumonia 1b) Neck of Femur Fracture (operated 
on) 1c) Fall II) Frailty, Vascular Dementia, Acute Kidney Injury. 

4 

CIRCUMSTANCES OF THE DEATH 

Kenneth James Clayton was taken to Tameside General Hospital after two falls 
at his home address. He was assessed as requiring inpatient admission to a 
medical ward. Whilst waiting for an inpatient bed to become available he had an 
unobserved fall in the Emergency Department. He was found to have fractured 
his neck of femur and was operated on. Post operatively he deteriorated and 
developed complications from the fracture and operation. He died at Tameside 
General Hospital on 23rd August 2024.  

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.  –  

1.  The inquest heard evidence that a key factor in the fall was the prolonged time 
Mr Clayton was in the Emergency Department waiting for a bed to become 
available on a ward. The evidence was that he had been in the emergency 
department for about 8 hours when he fell. The inquest was told that the design 
of an Emergency Department is not suited to a need for prolonged observation 
of high falls risk patients. In addition generally patients are cared for on hospital 
trolleys which cannot be lowered in the way a hospital bed can be which further 
increases the risk of falls.  

2.  Prolonged waits in Emergency Department were on the evidence given to the 
inquest not unusual. As an example the court was told that on the morning the 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 inquest was heard there were patients who had been waiting 40 hours for a bed 
on a ward. 

3.  The inquest was told that the primary reason for the challenges in moving 
patients through the Emergency Department was availability of beds. The 
evidence given was that the main challenge in freeing up beds was delayed 
discharge of patients who were medically ready for discharge but who needed a 
care package or a care home place to facilitate a safe discharge. 

4.  The inquest was told that for patient safety it was important, that whilst there 

were delays in ED throughput of patients, that a robust falls risk management 
system was in place. Tameside Hospital had put additional measures in place to 
manage falls risk in ED in a more consistent way but it was unclear what steps 
were in place nationally to manage falls risk in a consistent way in Emergency 
Departments.  

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you and/or 
your organisation have 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 April 2025. 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 following interested 
Persons the son of Mr Clayton on behalf of the family, Tameside General Hospital 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. They may send a copy of this report to any person who they believe 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 

Alison Mutch 
HM Senior Coroner 

19/02/2025

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 Dhsc (PDF)
Minister of State for Health (Secondary Care)  

39 Victoria Street  
London  
SW1H 0EU  

25 April  2025 

Our ref: 

Alison Mutch   
Senior Coroner for Greater Manchester South.  
His Majesty’s Coroner’s Office,  
1 Mount Tabor Street,  
Stockport  
SK1 3AG  

By email: 

Dear Ms Mutch,   

Thank you for the Regulation 28 report of 19 February 2025 sent to the Department of Health and 
Social  Care  about  the  death  of  Kenneth  James  Clayton.  I  am  replying  as  the  Minister  with 
responsibility for urgent and emergency care.  

Firstly, I would like to say how saddened I was to read of the circumstances of Mr Clayton’s death, 
and  I  offer  my  sincere  condolences  to  his  family  and  loved  ones. The  circumstances  your  report 
describes are concerning and I am grateful to you for bringing these matters to my attention.  

The  report  raises  concerns  regarding  Emergency  Department  waiting  times  and  patient  care  at 
Tameside and Glossop Integrated Care NHS Foundation Trust (TGFT). In preparing this response, 
my officials have made enquiries with NHS England to ensure we adequately address your concerns.   

I am assured by NHS England that TGFT is implementing an Urgent & Emergency Care Improvement 
Programme,  which focuses on  patient flow  and discharge. The programme is  entering  its  second 
year from April 2025, and significant achievements include:  

•  There  are  now  47  patients  with  a  ‘No  Criteria  to  Reside’  status.  This  is  under  the  trust’s 
trajectory number of 50, having previously been over 100. This means that patients who are 
medically  fit  for  discharge  are  being  discharged  to  the  right  place  much  quicker  therefore 
releasing hospital bed capacity.  

•  An additional ward was opened in November 2024, which includes a discharge lounge. This 
supports increase in patient flow by caring for those ready for discharge who are waiting for 
medication and transport.   

The Government is clear that patients should receive the highest standard of service and care from 
the NHS. We acknowledge that urgent and emergency care performance has failed to deliver that 
standard in recent years. We have been honest about the challenges facing the NHS and we are 
serious about tackling the issues; however, we must be clear that there are no quick fixes. I would 
like to assure you we are committed to continuing to improve services to ensure patients can access 
the right care first time, only visiting A&E when necessary, and returning waiting times to the NHS 
constitutional  standard  where  at  least  95%  of  patients  in  A&E  will  be  admitted,  transferred  or 
discharged within 4 hours.   

 
  
  
   
 
  
  
 
  
  
   
  
  
  
  
 As a first step, in the Autumn Budget, the Government announced an extra £22.6 billion in day-today 
spending  in  2025/26  for  the  NHS  compared  to  2023/24.  An  additional  £3.1bn  further  capital 
investment over 2 years will provide the highest real-terms capital budget since before 2010.   

We recognise that investment alone won’t be enough and are determined that it must go hand in 
hand with fundamental reform. On 5 December 2024, the Government published the Plan for Change 
(available here: https://www.gov.uk/government/publications/plan-for-change), that set the mandate 
for the direction of change with clear milestones in five national missions, including building an NHS 
that is fit for the future.   

On 30 January 2025, the Government published ‘Road to recovery: the government's 2025 mandate 
to NHS England’, that clearly set out delivery instructions for the NHS through the prioritisation of 
five key objectives aimed at driving reform within the NHS. Improving A&E and ambulance wait time 
was a prioritised objective in the mandate to specifically address the current challenges facing urgent 
and emergency care. On the same day NHS England published the 2025-26 planning guidance that 
contained the operational delivery detail for local NHS systems. The planning guidance included an 
implementation target for improving A&E waiting times compared to 2024/25, with a minimum of 78% 
of patients seen within 4 hours in March 2026.  

The NHS will focus on delivering the following range of practical actions to improve performance in 
2025/26:    
• 

increasing the proportion of patients seen, treated and discharged in 1 day or less using the 
principles of same day emergency care (SDEC)  

•  optimising the urgent care offer to meet the needs of their local population, including the use 

of urgent treatment centres (UTCs)  
increasing the percentage of patients discharged by or on day 7 of their admission  

• 
•  working across the NHS and local authority partners to reduce average length of discharge 

delay in line with the Better Care Fund (BCF) policy framework.  

Later in the Spring, to accompany the additional investment in the NHS, the Government will publish 
a 10-Year Health Plan which will set out the radical reforms for the NHS. The health plan will focus 
on ensuring three big reform shifts in the way our health services deliver care. First, from ‘hospital to 
community’ to  bring care  closer  to  where  people live.  Second,  from  ‘analogue  to  digital’  with  new 
technologies and digital approaches to modernise the NHS, and third from ‘sickness to prevention’ 
so people spend less time with ill-health by preventing illnesses before they happen. The reforms 
will support putting the NHS on a sustainable footing so it can tackle the problems of today and the 
future.   

In addition, we will shortly set out further actions to be taken during 2025-26 to support improvements 
to urgent and emergency care performance this year.      

I hope this response is helpful. Thank you for bringing these concerns to my attention.     

Yours sincerely,   

MINISTER OF STATE FOR HEALTH

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