Barry Myers

Ms Lisa Milner  
HM Assistant Coroner  
West Sussex, Brighton and Hove 
The Coroner’s Office  
Woodvale 
Lewes Road 
Brighton  
BN2 3QB 

National Medical Director  
NHS England  
Wellington House 
133-155 Waterloo Road  
London 
SE1 8UG 

9 June 2025 

Dear Coroner, 

Re: Regulation 28 Report to Prevent Future Deaths – Barry Myers who died on 
28 January 2024.  

Thank  you  for  your  Report  to  Prevent  Future  Deaths  (hereafter  “Report”)  dated  12 
March 2025 concerning the death of Barry Myers on 28 January 2024. In advance of 
responding to the specific concerns raised in your Report, I would like to express my 
deep condolences to Barry’s family and loved ones. NHS England are keen to assure 
the  family  and  the  Coroner  that  the  concerns  raised  about  Barry’s  care  have  been 
listened to and reflected upon.   

I am grateful for the further time granted to respond to your Report, and I apologise for 
any  anguish  this  delay  may  have  caused  to  Barry’s  family  or  friends.  I  realise  that 
responses to Coroners’ Reports can form part of the important process of family and 
friends coming to terms with what has happened to their loved ones, and I appreciate 
this will have been an incredibly difficult time for them. 

Your  Report  raised  a  concern  around  there  being  insufficient  funding  in  place  for 
patients to be provided with an urgent mechanical thrombectomy between the hours 
of 16:00 and 08:00 at University Hospitals Sussex NHS Foundation Trust.  

Mechanical thrombectomy services have been commissioned since 2019, with such 
services being established within specialist neuroscience centres across the country. 
University Hospitals Sussex NHS Foundation Trust (UHSx) established their service 
in 2019 and has received block funding from NHS England each year to support the 
set up and expansion of the service. 

UHSx has not been able to expand their operating hours from the initial hours they 
started  the  service  with  (Monday-Friday,  08:00-16:00)  due  to  operational  and 
workforce challenges. Whilst there has been an increase in the number of mechanical 
thrombectomies undertaken each year at UHSx, the levels of activity are not yet at the 
value set within the block funding arrangement.   

UHSx  has  recently  approved  and  commenced  recruitment  of  key  interventional 
radiology nursing posts as part of the plans to expand the service’s operating hours. 
NHS  England  is  working  with  the  Trust  to  consider  different  workforce  models  and 

                                                                                                                       
 
 
 
 
 
 
  
 
 
 
 
 
 
  
 share the learning from other centres who have expanded their services over recent 
years. NHS England has also funded the purchase of a second bi-plane scanner to 
allow  extended  operating  hours  and  enable  more  rapid  access  to  mechanical 
thrombectomy  when  the  current  bi-plane  scanner  is  being  used  for  other  elective 
treatments. 

The  further  development  of  mechanical  thrombectomy  services  at  UHSx  is 
encompassed within a targeted piece of work with UHSx to improve the safety and 
quality of services for patients accessing some specialised commissioning services, 
which include mechanical thrombectomy services. UHSx are also continuing to work 
with  the  Sussex  Integrated  Stroke  Delivery  Network  on  projects  to  optimise  the 
pathway  for  stroke  patients,  enabling  rapid  identification  of  patients  suitable  for  a 
mechanical thrombectomy, including the use of digital diagnostic and referral systems.  

Over the past year, NHS England has been supporting UHSx with developing mutual 
aid arrangements with other centres offering mechanical thrombectomy services, for 
when  the  UHSx  service  is  not  available.  Alternative  pathways  have  recently  been 
agreed for patients in the west of Sussex (accessing care from St Richard’s Hospital 
and Winchester Hospital) to be referred directly to University Hospital Southampton 
NHS  Foundation  Trust  for  out  of  hours  mechanical  thrombectomies.  Patients  from 
other part  of  Sussex  (accessing  care  under East  Sussex  Healthcare  NHS  Trust,  or 
University  Hospitals  Sussex  NHS  Foundation  Trust  (UHS)  covering  Brighton  and 
Hove)  are  referred  to  the  University  College  London  Hospital  (UCLH)  out  of  hours. 
Both the UCLH and UHS service are currently operating 24/7.  

NHS England continues to work with UHSx to support the development of services to 
expand  their  operating  hours,  to  include  evenings  and  weekends  (operating  seven 
days a week). This is possible within the current level of funding received by the Trust, 
however  it  is  recognised  that  the  current  financial  position  of  the  Trust  means  that 
there are significant challenges to being able to identify the funds internally to expand 
the service at this time.  

the  South  East 

NHS England is working with the local Integrated Care Boards (ICBs) and mechanical 
thrombectomy  providers  across 
to  develop  a  mechanical 
thrombectomy strategy for the region, which includes ensuring that robust mutual aid 
arrangements  are  in  place  in  case  of  any  service  disruption,  and  working  with 
providers  on  developing  services  to  increase  the  numbers  of  patients  receiving 
mechanical thrombectomy treatment for strokes, to optimise the outcome for patients. 
This work has been supported by two NHS England visits to UHSx, led by myself and 
the National Clinical Director for Stroke, on 7th August 2024, and most recently on 4th 
April of this year, to ensure ongoing service development of mechanical thrombectomy 
services.   

Across  the  rest  of  the  South  East  region,  there  is  now  access  to  mechanical 
thrombectomy services 24/7, although some of this remains out of region access at 
this time as for some areas of the region access is provided in other regions via mutual 
aid.  Oxford  University  Hospitals  and  University  Hospital  Southampton  NHS 
Foundation Trusts both now deliver a 24/7 service. The UHSx service has the above 
mutual aid arrangements in place now to facilitate access for patients 24/7. Patients 
from the Surrey area can access services in London (St George’s University Hospital 

 
 
 
 
 and/or  Kings  College Hospital depending  on  the  time  of  day)  and patients from  the 
Kent & Medway area are able to access 24/7 care at the Royal London Hospital whilst 
the  local  service  is  being  developed  (anticipated  to  go  live  in  Summer  2025  on  an 
08:00-16:00 Monday -Friday basis initially).  

I  would  also  like  to  provide  further  assurances  on  the  national  NHS  England  work 
taking  place around  the  Reports  to  Prevent Future  Deaths.  All  reports  received  are 
discussed  by  the  Regulation  28  Working  Group,  comprising  Regional  Medical 
Directors,  and  other  clinical  and  quality  colleagues  from  across  the  regions.  This 
ensures that key learnings and insights around events, such as the sad death of Barry, 
are shared across the NHS at both a national and regional level and helps us to pay 
close attention to any emerging trends that may require further review and action.   

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

Yours sincerely,  

National Medical Director

Ms Lisa Milner  
HM Assistant Coroner 
West Sussex Brighton and Hove 
Parkside Chart Way 
Horsham 
RH12 1XH 

By email only 

12 May 2025 

University Hospitals Sussex NHS 
Foundation Trust 
Trust Headquarters 
Royal Sussex County Hospital 
Eastern Road 
Brighton 
BN2 5BE 
www.uhsussex.nhs.uk  

Your ref: 

Our ref: 

Dear Ms Milner 

Inquest into the death of Barry Myers 

Thank you for your letter of 13 March 2025, enclosing your formal report under Regulation 
28 to Prevent Future Deaths. 

We have made significant improvements in extending access to Mechanical Thrombectomy 
for Sussex patients 

Stroke services in Sussex are coordinated through the Integrated Stroke Services Network 
(ISDN)  which  includes  stroke  services  based  in  Brighton,  Eastbourne,  Worthing  and 
Chichester. 

The local service at the Royal Sussex County Hospital remains in place 08:00-16:00 hours 
Monday to Friday. Outside of these hours, we now have mutual aid pathways 24/7 for all of 
these sites to University College London Hospital (UCL) or University Hospital Southampton 
NHS Foundation Trust (UHS), to ensure patients have access to mechanical thrombectomy 
when clinically indicated. 

As  you  know  from  the  evidence  heard  at  the  inquest,  there  was  a  Business  Case  in 
development to extend the hours of the local service. I am delighted to confirm the Business 
Case has now been approved to extend the local service to 7 days a week, 12 hours a day, 
at the Royal Sussex County Hospital. We are actively recruiting to all staff groups required to 
provide this specialised service. We intend to extend the service to 24/7 following this. This 
work is being monitored at our monthly Thrombectomy Delivery Group meetings. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 In  addition,  we  are  in  the  process  of  installing  the  second  bi-planar  at  the  Royal  Sussex 
County  Hospital.  We  expect  this  to  be  operational  by  September  2025  and  this  will  be 
prioritised for patients undergoing mechanical thrombectomy. We are aiming to extend the 
local service by this time, dependent on staff recruitment. 

I hope you are assured that the actions we have taken have improved the service for our 
patients, and continue to do so, as they are rolled out and embedded.  

Yours sincerely, 

Chief Executive