Prevention of Future Deaths reports · 2025

Liliane Bowden

Regulation 28 report to prevent future deaths, reference 2025-0570, written 11 Nov 2025. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Nov 2025
Reference2025-0570
DeceasedLiliane Bowden
CoronerHenry Charles
Coroner areaHampshire, Portsmouth and Southampton
CategoryEmergency services related deaths (2019 onwards)
Organisation namedSouth Central Ambulance Service 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

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

REGULATION 28 REPORT TO PREVENT DEATHS

THIS REPORT IS BEING SENT TO:

1 SCAS Legal Services

1

CORONER

I am Henry CHARLES, HM Assistant Coroner for the coroner area of Hampshire, Portsmouth
and Southampton

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 26 September 2024 I commenced an investigation into the death of Liliane Andree
BOWDEN aged 90. The investigation concluded at the end of the inquest on 24 October
2025. The conclusion of the inquest was that:

On 26 September 2024 I commenced an investigation into the death of Liliane Andree
BOWDEN aged 90. The investigation concluded at the end of the inquest on 24 October
2025. A narrative conclusion was reached, set out in the circumstances of death, below.

4

CIRCUMSTANCES OF THE DEATH

On 23rd September 2024 Mrs Liliane Andree Bowden sadly died at Oak View Care home,
47-49 Beach Road, Hayling Island, Hampshire by reason of bronchopneumonia. She had
suffered from vascular dementia and on 10th and 11th September 2024 had suffered falls.
Although bronchopneumonia was the direct cause of death the contributions of the vascular
dementia and, latterly, the falls, were very substantial.

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:
(brief summary of matters of concern)

During the course of the inquest evidence revealed matters giving rise to concern, relating
to ambulance delay on a callout just under two weeks prior to Liliane Andree Bowden’s
death.
Ambulance Service, provided me with a detailed explanation.

It is right to immediately acknowledge that the ambulance service, South Central

In this instance the initial call was at 11.40 with a second call at 13.29, a third call at 15.53
and a fourth call (seeking an estimated time of arrival of the ambulance) at 17.29. Liliane,
90, had fallen. Category 3 was called at around,13.29, category 3 was confirmed at around
16.26. A specialist paramedic was at the deceased’s bedside at 17.35 and an ambulance
was requested at 18.00. At that time there was demand on the ambulance service (the

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

 Enhanced Patient Safety Procedure had been in place from 23.15 the previous night until
11.35 on the day of the call) and there were significant hospital handover delays at
hospital: apparently the call centre log records up to 25 ambulances held outside hospital
waiting to hand over patients that afternoon, at 18.10 there were 8 ambulances at hospital
waiting to hand over patients, one of which had been waiting for 4 hours and 40’ to hand
over their patient. It was estimated that an ambulance would not be available for seven
hours. In the event an ambulance eventually arrived at 23.30. The response timeframe
for a category 3 call is for at least 9 out of 10 calls to be within 120’.

It follows that although the Enhanced Patient Safety Procedure was activated the previous
night, following deactivation of the Enhanced Patient Safety Procedure a large contingent
of ambulances was taken out of action for substantial periods by handover issues. Quite
apart from a repetition of such circumstances potentially affecting category 1 and 2 calls,
there must be significant risk in the case of an elderly and/or vulnerable person in Category
3 having an extended wait, particularly if there has been a head injury, as is often the case.

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.

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 January 06, 2026. 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.
COPIES and PUBLICATION

8

I have sent a copy of my report to the Chief Coroner and to the following Interested
Persons

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: 11/11/2025

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

 Henry CHARLES
HM Assistant Coroner for
Hampshire, Portsmouth and Southampton

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 South Central Ambulance Service (PDF)
South Central Ambulance Service NHS Trust 
Unit 7 & 8 Talisman Business Park 
Talisman Road 
Bicester, Oxon 
OX26 6HR 

PRIVATE AND CONFIDENTIAL 
Mr Henry Charles,  
HM Assistant Coroner for Hampshire, Portsmouth and Southampton 

17th December 2025 

Dear Mr Charles, 

I am writing to you in response to the concerns that you highlighted to the Trust following the 
inquest hearing into the sad death of Liliane Andree Bowden that concluded on 24th October 
2025. Thank you for providing us with the opportunity to respond to your concerns.   

At the outset I would like to offer my personal condolences to Mrs Bowden’s family and friends.  

To confirm, your Regulation 28 report relates to concerns regarding delays that the ambulance 
service experience when ambulance crews are handing over patients at local hospital Trusts 
and the impact this has on our ability to respond to patients  waiting in the community. Your 
officer confirmed that you did not issue a report to the local hospital Trust because you wanted 
to receive a full appraisal of the difficulties SCAS and more importantly, patients face upon 
arrival at Queen Alexandra Hospital. 

It  is  regretful  that  a  Regulation  28  report  was  issued  to  this  Trust  when  the  source  of  the 
concern relates to a different organisation, and it is they who ultimately have the power to take 
action  to resolve the  concerns.  Moving forward,  we would  be  grateful  if HM  Coroner  could 
write  to  the  appropriate  organisation  in  line  with  paragraph  9  of  Chapter  16  of  the  Chief 
Coroner’s Bench Book.  

Response to concerns 

HM  Coroner  will  be  aware  that  the  issue  of  ambulance  response  times  being  affected  by 
hospital  handover  delays  is  not  a  matter  that  is  isolated  to  Hampshire.  In  response  to  the 
problem,  in  January  2023  NHS  England  asked  London  hospitals  to  support  the  timely 
handover  of  patient  care  and  the  release  of  ambulance  crews  from  London  Ambulance 
Service within a maximum of 45 minutes where it is safe and appropriate to do so.  

South  Central  Ambulance  Service  is  commissioned  by  2  Integrated  Care  Boards  (ICB); 
Buckinghamshire, Oxfordshire and Berkshire ICB and Hampshire and Isle of Wight ICB. In 
September  2024  both  ICB’s  agreed  that  they  would  also  implement  the  now  nationally 
recognised  process  of  “Release  to  Respond”  in  their  respective  geographical  areas.  This 
process was fully implemented in all hospitals in Hampshire by the end of 2024 and resulted 
in significant improvements in our response times to patients waiting in the community.  

 
 
 
 
 
 
 
 
 
 
 
 
 
 To  demonstrate  the  impact  of  the  “Release  to  Respond”  process,  in  September  2024  our 
ambulance crews spent over 4,072 hours waiting longer than the 15 minute national target to 
handover patients at Queen Alexandra Hospital alone and over 8,224 hours at all hospitals 
within the geographical area we cover. By September 2025 the figure for Queen Alexandra 
Hospital had fallen significantly to just under 319 hours and the total for all hospitals was just 
over 2,538 hours.  

To evidence the effect the reduced wait times at hospitals, among other initiatives, has had 
on  our  ability  to  attend  to  patients  in  the  community,  despite  nearly  1,000  extra  incidents 
taking  place  in  the  month  of  September  2025  compared  to  September  2024,  we  reduced 
our Category 2 response times by over 8 minutes.  

HM Coroner has asked for details of difficulties the Trust experiences when arriving at Queen 
Alexandra Hospital. Like all the acute hospital Trusts in our area, we maintain effective working 
operational  relationships  with  senior  teams  at  Queen  Alexandra  Hospital  and  good 
professional  relationships  at  all  levels  between  our  organisations,  including  the  Chief 
Executives  who  have  worked  together  with  system  partners  to  reduce  the  amount  of  time 
ambulances  are  delayed  handing  over  their  patients.  This  includes  operational  leaders 
working closely together face to face at the Emergency Department and participating in regular 
operational tactical calls during times of increased demand. The Trust is extremely grateful to 
our  Acute  Trust  Partners  for  their  continued  willingness  to  work  together  for  the  benefit  of 
our mutual patients. 

of  Ambulance  Chief  Executives 

The  SCAS  and  PHT  CEO’s  jointly  presented  the  work  our  teams  had  carried  out 
the 
excellent 
Association 
achievements in reducing handover delays.  Each year we are required to submit an annual 
plan  to  NHS  England  on  how  we  will  deliver  our  services.  For  2025/26,  our  plan 
included  average  handover  times  at  hospitals  across  our  geography.  Each  hospital  was 
asked to sign up to the improvement and for the year to date we have delivered on or below 
plan  across  our  region.  There  is  a  requirement  within  the  next  3  years  for  all  hospitals  to 
reach the 15 minute handover target and have not delay over 45 minutes. We will continue 
to  work  with  all  hospitals  to  deliver  these  targets  and  we  will  submit  our  plan  to  NSHE  in 
February for 26/27.  

showcase 

the 

to 

to 

Commissioning 

HM  Coroner  may 
targets  we  have 
to  understand 
been  commissioned  to  provide.  I  have  enclosed  a  table  providing  details  for  this  financial 
year with this letter.  

the  response 

it  useful 

find 

I hope that this letter has adequately addressed the concerns that you have raised. Should 
you wish to discuss these matters further, please contact Jennifer Saunders, Head of Legal 
Services at SCAS who will be able to facilitate this. 

Yours sincerely, 

Chief Executive 

Enc. Commissioned targets 

2

 Category 

ARP 
target 

April 25  May 25 

June 25  July 25  Aug 25  Sept 25  Oct 25 

Nov 25  Dec 25 

Jan 26 

Feb 26  March 

26 

00:07:00  00:08:33  00:08:52  00:08:45  00:09:04  00:08:57  00:08:52  00:08:59  00:08:48  00:08:51  00:08:47  00:08:51  00:08:35 

00:15:00  00:17:58  00:18:40  00:18:23  00:19:07  00:18:51  00:18:39  00:18:55  00:18:32  00:18:37  00:18:28  00:18:37  00:18:03 

00:18:00  00:26:19  00:30:32  00:28:46  00:33:32  00:31:41  00:30:21  00:32:05  00:29:37  00:30:10  00:29:16  00:30:10  00:26:44 

00:40:00  00:51:00  00:59:40  00:56:02  01:05:51  01:02:02  00:59:18  01:02:51  00:57:48  00:58:55  00:57:05  00:58:55  00:51:52 

02:00:00  04:25:39  05:37:39  05:07:26  06:28:54  05:57:18  05:34:30  06:04:06  05:22:09  05:31:22  05:16:10  05:31:22  04:32:52 

03:00:00  05:22:51  06:43:52  06:09:52  07:41:31  07:05:59  06:40:19  07:13:38  06:26:26  06:36:47  06:19:42  06:36:47  05:30:59 

Category  1 
mean 

Category  1 
90th 
percentile 

Category  2 
mean 

Category  2 
90th 
percentile 

Category  3 
90th 
percentile 

Category  4 
90th 
percentile

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