Noreen McGlynn

NHS
Central London
Community Healthcare
NHS  Trust

Chief Nursing & Chief People Officer
Ground Floor
15 Marylebone Road
London
NW1 5JD

CLCH  ACADEMY
Experts in Community  Healthcare

Coroner ME Hassell
Senior Coroner
Inner North London
St Pancras Coroner’s Court
Poplar Coroner’s Court
Bow  Coroner’s Court

18 th September 2025

Dear Mr Hassell,

Re:  Response  to  Prevention  of  Future  Deaths  Report -  Norah  McGLYNN aka  Noreen
Philomena McGLYNN (died 03.02.25)

Thank you for your Prevention of Future Deaths (PFD) report dated 11 July 2025, following the
conclusion of  your  investigation into the  death  of Noreen McGlynn. Please accept my  sincere
condolences to the family and all those affected by this loss.

We  have  carefully reviewed the  matters raised in  your  report. Below  is  the  detailed response
from  Central London Community Healthcare NHS  Trust (CLCH)  addressing the  concerns you
outlined.

1.  Summary of Issues Raised

Your  enquiry specifically considered whether rehydration could  have  been  offered at  home  in
the  care  of  Ms.  McGlynn, and  whether this  could  be  a  viable  option for  other  patients in  the
future.
Ms.  McGlynn’s  home  environment  was  well-supported  by  a  full-time  carer  and  close  family
members. The family considered hospital admission only when they felt that she was becoming
dehydrated. They  expressed that  if the  rapid response team  or  GPs had  been  able to provide
rehydration at home, this would have been a preferable option for Ms. McGlynn and her family.

2.  CLCH Involvement

I  note  that  a  statement  dated  7  July  2025  was  provided  in  preparation  for  the  inquest.  This
statement summarises that on 29 January 2025, the Rapid Response Team received an urgent
referral via the Single Point of Access (SPOA) to assess Ms. McGlynn for blood and urine tests.
Ms.  McGlynn  had  a  Do  Not  Attempt  Resuscitation  (DNAR)  order  in  place,  and  the  referral
stipulated that she  was  not  to be  conveyed to hospital. During the visit, the clinician found Ms.

Your  healthcare closer to  home 

 - 2 -
McGIynn  alert  but  mostly  non-verbal,  with  swallowing  difficulties,  reduced  oral  intake,  and
clinical signs  suggestive of  infection. The  rapid  response team  clinician reported her  findings
and  assessment via  discharge letter  to  the  GP  that  evening. The  SPOA  consultant had  also
sent the referral to the GP.  The agreed clinical plan which was to be as coordinated by SPOA,
family, and  healthcare providers was  to  avoid  hospital admission, undertake blood  tests,  and
have her GP review the results the following day, to consider antibiotics and other treatments.

3.  Could rehydration have been offered at home?

The  current  service specification  commissioned by  Barnet  Clinical Commissioning Group  for
Urgent  Community  Response (UCR)  services  does  include the  administration  of  IV  fluids.  It
states that  treatment at  home  may  be  appropriate for  serious illnesses when  it aligns with the
patient’s preferences. Although this  is  included in  the  service specification, decisions around
commencing IV fluid infusion need to be made with the clear understanding that the diagnostic
and  support services available in  the  community may  not  match  those  provided in  a  hospital
setting, including considerations of  the  need  for  continuous observations during  infusion. For
IV fluids to be initiated a medical doctor would need to prescribe the fluids and equipment (whilst
UCR  clinicians  may  be  non-medical  prescribers,  prescribing  IV  fluids  falls  outside  of  their
current scope of practice).

In  this  instance, the  clinical plan  did  not  include the  provision of  IV fluids. If  the  SPOA  doctor
had  decided that  IV  fluid  treatment was  needed, they  would  have  prescribed it  and  the  UCR
team  would seek to procure the treatment.

4.  Could rehydration be offered to others in the future?

Typically, patients  requiring IV  rehydration or  showing any  signs  of physical deterioration are
conveyed to A&E or secondary care for its administration.  This approach is also in accordance
with  our  deteriorating  patient  procedure  which  states  that  if  a  patient’s  condition  is  causing
concern, then action needs to be taken either through an assessment by a doctor, appropriately
qualified senior clinician, advanced practitioner or the patient should be  transferred to A&E  or
secondary care for further care.

On the occasion that a patient is severely dehydrated, the quickest and most effective treatment
would  be  to  go  to  hospital for  IV  fluid  replacement. If  the  patient wishes to  stay  at  home  and
makes that decision during GP working hours, the GP could prescribe IV fluids which could be
administered by  the  rapid  response team.  Community teams  would  also  always advise and
support patients/families on oral care which can be provided by family or carers.

As a Trust, we acknowledge the importance of the issues raised and are committed to ongoing
improvement to  prevent future  occurrences.  We  welcome the  opportunity to  collaborate  with
relevant agencies and stakeholders to enhance patient safety and standards of care.

Please do not hesitate to contact me should you require any further information or clarification.

Yours sincerely

Chief Nursing & Chief People Officer

Mountfield Surgery 

55 Mountfield Road 

Finchley 

London N3 3NR 

Date : 18th September 2025 

To: 

HM Senior Coroner 

Inner North London 

St Pancras Coroner’s Court 

Dear Ms Hassell, 

Re: Regulation 28 Report – Prevention of Future Deaths 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Deceased: Norah (Noreen Philomena) McGlynn 

Date of Death: 3 February 2025 

Thank you for your Regulation 28 Report dated 11 July 2025 regarding the sad death of 
Mrs McGlynn. We wish to express our condolences to her family for their loss. 

We have carefully considered your concerns regarding whether intravenous (IV) 
rehydration could have been offered in the home environment. After review, we must 
confirm that Mountfield Surgery is unable to provide IV rehydration at home. The 
reasons are as follows: 

Clinical Safety and Monitoring 

IV rehydration requires continuous monitoring for complications such as fluid overload, 
electrolyte imbalance, and infection. 

Such monitoring is only safely provided within a hospital or equivalent acute setting 
where medical and nursing staff are available at all times. 

Scope of Primary Care Services 

GPs and community-based clinicians do not have the resources, equipment, or staffing 
to deliver and monitor IV therapy at home. 

Current NHS community pathways do not provide for IV fluid administration in 
domiciliary settings for acutely unwell patients. 

 
 
 
 
 
 
 
 
 
 
 
 
 Alternative Community Support 

Where patients are unable to maintain oral hydration and hospital admission is not 
desired, community nursing teams may provide limited subcutaneous fluid 
administration (hypodermoclysis) in certain circumstances. 

However, this is not an equivalent substitute for IV fluids and is subject to local service 
availability and suitability for the patient. 

Conclusion and Next Steps 

We therefore respectfully submit that IV rehydration is not clinically appropriate or safe 
to administer at home. We will, however, raise this matter with our local NHS partners to 
review whether community subcutaneous rehydration pathways could be more widely 
available, in order to provide alternatives for patients who wish to avoid hospital 
admission. 

We will also be engaging with our local Primary Care Network (PCN 6) to gather their 
views on providing rehydration IV therapy at home. 

We thank you for bringing this important matter to our attention and will continue to 
ensure our patients and their families are supported with clear explanations of available 
options in similar situations. 

Yours sincerely, 

Senior Partner 

Mountfield Surgery