Prevention of Future Deaths reports · 2025

Joseph Powell

Regulation 28 report to prevent future deaths, reference 2025-0234, written 17 May 2025. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report17 May 2025
Reference2025-0234
DeceasedJoseph Powell
CoronerSarah Murphy
Coroner areaCheshire
CategorySuicide (from 2015) · Community health care and emergency services related deaths
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 

NOTE:  This form is to be used after an inquest. 

REGULATION 28 REPORT TO PREVENT DEATHS 

THIS REPORT IS BEING SENT TO:  
The Royal College of General Practitioners (RCGP), 30 Euston Square, London, NW1 
2FB 

1  CORONER 

I am Sarah Murphy, Assistant Coroner for the coroner area of Cheshire. 

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 09 September 2024 I commenced an investigation into the death of Joseph David 
POWELL aged 28.  The investigation concluded at the end of the inquest on 13 May 2025.  
The conclusion of the inquest was: 
Suicide against a background of post-traumatic stress disorder and depression. 

The medical cause of death was: 
1A Hanging 
2 Post traumatic stress disorder and depression. 

4  CIRCUMSTANCES OF THE DEATH 

The deceased was 28 years of age with a medical history of mental illness. In March 2024 he 
was diagnosed with depression and was prescribed Sertraline for 28 days.  He did not receive 
a further prescription for this as he had not booked a follow up appointment with his GP as 
requested.  On the 22 August 2024, he re-presented to his GP surgery and was diagnosed 
with post traumatic stress disorder and an exacerbation of his depression. He denied any 
active suicidal thoughts but had experienced suicidal ideation. He was prescribed Citalopram, 
and provided with a telephone number for a local psychotherapy service and agreed to make 
a follow up appointment for a review with the GP in one to two weeks’ time.  He did not 
subsequently book a review appointment with his GP. On the 6th September 2024, he was 
found at his home address suspended 

. He was cut down and 

cardiopulmonary resuscitation was commenced whilst waiting for paramedics to arrive.  He 
did not respond to resuscitation and death was certified on the scene by paramedics at 21:24 
hours.  

5  CORONER’S CONCERNS 

During the course of the investigation my inquiries 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)  That not all GPs book follow up appointments for patients presenting with mental 
health difficulties such as depression, anxiety and post-traumatic stress disorder. 

Regulation 28 – After Inquest 
Document Template Updated 30/07/2021 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Instead, they request that the patient book their own follow up appointment with 
their GP. This can be difficult for patients who are suffering with mental health 
difficulties and can result in patients not receiving a follow up appointment with their 
GP or any further medication. 

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 July 14, 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      

I have also sent it to 
Family of Joseph Powell 
Counsel for the GP surgery.         

who may find it useful or of interest. 

I am also under a duty to send a copy of your response to the Chief Coroner and all 
interested persons who in my opinion should receive it. 

I may also send a copy of your response to any person who I believe may find it useful or of 
interest. 

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 

 Dated 17 May 2025 

Ms Sarah Murphy 
HM Assistant Coroner for Cheshire. 

Regulation 28 – After Inquest 
Document Template Updated 30/07/2021

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 Rcgp (PDF)
Ms Sarah Murphy 
Assistant Coroner – Cheshire 

Sent by email to: 

Dear Ms Murphy  

09 July 2025 

Regulation  28  Report  to  Prevent  Future  Deaths  -  touching  on  the  death  of  Joseph  David 
Powell  

I was sorry to hear of the tragic death of Mr Powell and our condolences go to his family. 

The Royal College of General Practitioners works to improve patient care by encouraging the 
highest  possible  standards  in  general  medical  practice  by  supporting  members,  setting 
standards,  providing  education  and  training  promoting  research  and  advocating  and 
representing the College. 

We  understand  that  Mr Powell  was diagnosed  with  Depression  in  March  2024  and did  not 
follow up with a GP after receiving a prescription for Sertraline until the 22 August 2024. He 
re-presented  with  additional  symptoms  of  PTSD  and  after  a  different  prescription  of 
antidepressants  he  failed  to  rebook  another  appointment  and  was  found  hanging  on  the  6 
September 2024 and subsequently died.   

Your matter of concern for which you have asked for comment is  

‘That not all GPs book follow up appointments for patients presenting with mental health difficulties 
such as depression, anxiety and post-traumatic stress disorder. Instead, they request that the patient 
book  their  own  follow  up  appointment  with  their  GP.  This  can  be  difficult  for  patients  who  are 
suffering  with  mental  health  difficulties  and  can  result  in  patients  not  receiving  a  follow  up 
appointment with their GP or any further medication.’ 

The management of Mental Health conditions is a fundamental area of General Practice and 
covered by the GP Core Curriculum in the Clinical Topic Guide for Mental Health . The College 
also  supports  member  with  continuing  professional  development  by  publishing  a  range  of 
learning materials which are collated in the mental health toolkit . There is a specific section on 
crisis, self-harm and suicide as well as an e-learning course on suicide prevention, available to 
all members. 

Royal College of General Practitioners 
30 Euston Square, London, NW1 2FB 
Tel: 020 3188 7400  |  info@rcgp.org.uk  | rcgp.org.uk 
Registered Charity Number 223106  |  Patron: His Majesty King Charles III 

 
 
 
 
 
 
 
 
 
 
  
  
  
  
  
  
  
  
 The area of follow up is an important one to be considered by the GP when understanding the 
risks to the patient and it is important to consider this in the consultation together with the 
patient and to build a safety netting approach. This is done through a personalised and shared 
care approach, including consideration of the individual’s needs, a management plan and follow 
up arrangements. As part of the management plan there would often be a safety plan for those 
identified  as  at  risk  of  suicide  which  would  include  specific  follow  up  arrangements.  These 
follow up arrangements could include rebooking of GP follow up using the surgery processes 
or through the GP booking the follow up dependant on individual circumstances.   

Depression  is  a  common  condition  and  often  also  associated  with  other  mental  health 
conditions and recognition of suicide risk is a part of the GP consultation. The management 
plan would include a specific safety plan which could include support for booking appointments 
and further planning if patients do not attend appointments.  

The RCGP actively promotes ongoing professional development for its members, and it has a 
Mental Health Special Interest Group (SIG). As a College our action shall be to highlight this 
case  to  the  Mental  Health  SIG  to  support  further  promotion  of  safety  planning  in  suicide 
prevention  for  people  with  mental  health  conditions  and  to  consider  GP  booking  of 
appointments where this is a part of the safety plan.  

Once again, we were sorry to hear about this tragic death and offer our condolences to his 
family.  

Yours sincerely 

Honorary Secretary

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