Prevention of Future Deaths reports · 2026

Suzanne Pemberton

Regulation 28 report to prevent future deaths, reference 2026-0003, written 5 Jan 2026. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report5 Jan 2026
Reference2026-0003
DeceasedSuzanne Pemberton
CoronerSean Horstead
Coroner areaEssex
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedEssex Partnership University NHS Foundation Trust · East Suffolk and North Essex 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

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REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

The Chief Executive Officer, East Suffolk and North Essex NHS Foundation
Trust

CORONER

I am Sean Horstead, area coroner, for the coroner area of Essex

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.

INVESTIGATION and INQUEST

On  16th  September  2024  I  commenced  an  investigation  into  the  death  of
Suzanne Pemberton, aged 61 years’. The investigation concluded at the end of
the inquest on the 16th December 2025.

Suzanne  Pemberton  died  on  the  16th  September  2024  at  Colchester  General
Hospital  (CGH),  Turner  Road,  Colchester,  Essex  from  a  cause  of  death
confirmed  as: (1a)  pneumonia  and  sepsis  (joint  causes), arising  from (1b)
exacerbation  of  long-standing  bronchiectasis;  on  a  contributory  background  of
(2): severe depressive disorder, malnutrition and chronic frailty.

The  Conclusion  of  the  inquest  was  a Narrative  Conclusion  focussed  on  those
aspects of the inadequate care, management and treatment provided by Essex
Partnership  NHS  Foundation  Trust  (EPUT)  that  probably  more  than  minimally
contributed to the death.

CIRCUMSTANCES OF THE DEATH

Over the course of a two-year period preceding her death, there were a number
of  opportunities  for  (EPUT)  staff  and  clinicians  to  escalate  concerns  regarding
Suzanne’s  mental  health,  as  raised  by  those  treating  her  in  primary  and
secondary care for her complex physical medical needs arsing, principally, from
her chronic Bronchiectasis.

1

 Suzanne’s lack of concordance with her mental and physical health medication
informed  a  pattern  of  repeated  and  extended  periods  of  admission  as  an  in-
patient to treat  her lung infections which, over time  and following each hospital
discharge, 
to  chronic  and  sustained
deconditioning consequent upon depleted nutritional and physiological reserves
This,  in  turn,  directly  contributed  to  the  exacerbation  of  her  chronic  lung
condition,  leading  to  repeated  infections  and,  ultimately,  the  fatal  pneumonia
and sepsis.

that  non-concordance  - 

led  - 

in 

The  evidence  confirmed  that  by  the  time  of  her  final  admission  to  CGH  on
Thursday  12th  September  2024,  such  was  the  extent  of  the  depletion  of  her
physical  and  nutritional 
frailty  and
deconditioning,  that  Suzanne’s  death  on Monday  16th  September  was unlikely
to be avoidable.

reserves  and  consequent  extreme 

It  was  apparent, however, that from  her admission  through  until the day of her
death on 16th September Suzanne had not been fully assessed in person by the
CGH Dietetic team, notwithstanding that she had been referred to dietitians on
Friday  13th  at  09:01  hours  and  then  re-referred,  the  same  day,  at  10:09  hours
and had been deemed, when later  triaged, as a Category  2 priority to be seen
within 24 hours.

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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 will occur unless action
is taken. In the circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows.  –

Although, in the specific circumstances of this case, the delay in the provision of
an  in-person  dietetic  assessment  was  not  a  probable  causative  factor  in
Suzanne’s  death,  the  written  evidence  of  a  Senior  Gastro/Surgical  Dietician,
admitted under Rule 23, stated:

“At  present  there  is  no  funding  in  place  to  provide any  dietetic  service  for
weekends  or  bank  holidays.  Wards  are  encouraged  and  trained  to  implement
the Malnutrition Universal Screening Time ‘MUST’ care plans and utilise enteral
feeding  starter  regimes  where  appropriate  whilst  awaiting  dietetic  input.”
(Emphasis added).

The further written and oral evidence of the Dietic Professional Lead confirmed
that  CGH  only  provides any form  of  dietetic  in-put  during  weekday  working
hours  ie  between  08.00  hours  and  17.00  hours,  Monday  to  Friday  (excluding
Bank  Holidays).    The  Professional  Lead  further  reconfirmed,  in  terms,  that
outside  of  those  hours  there  is  simply no  specialist  dietetic  service  or  cover  of

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 any kind at all for patients at CGH.

In  her  evidence  she  told  the  inquest  that  whilst  there  are,  to  her  knowledge,
“different arrangements in different Trusts” to deal with the provision of an ‘out of
hours’ service, ranging from on-site clinicians to the availability of on-call advice,
no such service of any kind is available at CGH (with proposals advanced by the
Dietetic  Team  for  a  new  business  case  for  funding  having  not  been  taken
forward).

The Professional Lead gave evidence that, in her view, this lack of service was
“far from ideal” and further accepted that this will inevitably mean that there will
be cases where, as examples, Naso-gastric feeding may not be started as soon
as it should be, or that there will occasions when the written generic ‘re-feeding’
guides  provided  by  her  Team  to  the  wards  may  not  be  appropriately  followed
(with such failures not being picked up and corrected by her Team).

She  accepted  that  in  such  circumstances  this  could  give  rise  to  the  risk  of
(avoidable future deaths.

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ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I believe you
and your organisation have the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this
report,  namely  by  Monday  2nd  March  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

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

The husband and son of the deceased;

Essex Partnership University NHS Foundation Trust;

Suzanne’s GP;

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 Suzanne’s Consultant Psychiatrist, based at Cambridgeshire University Hospital
NHS Foundation Trust.

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.  She  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

05.01.2026

HM Area Coroner for Essex Sean Horstead

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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 East Suffolk and North Essex NHS Foundation Trust (PDF)
Mr Sean Horstead 
Area Coroner for Essex 
Essex Coroners Service 
Seax House 
Essex County Council 
Victoria Road South 
Chelmsford 
CM1 1LX 

Dear Mr Horstead 

Colchester District General Hospital 
Turner Road 
Colchester 
CO4 5JL 

3 March 2026 

REGULATION 28 REPORT TO PREVENT DEATHS – INQUEST TOUCHING UPON THE DEATH OF 

SUZANNE PEMBERTON WHICH CONCLUDED ON 16 DECEMBER 2025 

I  write  in  connection  with  the  above-mentioned  Inquest and  the  Regulation  28  Report  to  Prevent 

Deaths issued by yourself on 5 January 2026 (“the Report”). 

The Report highlighted concerns relating to the specialist dietetic service or cover of any kind at all for 

patients at Colchester General Hospital outside of weekday working hours, i.e. between 08.00 hours 

and 17.00 hours, Monday to Friday (excluding Bank Holidays).   

The information presented below is intended to describe the actions which have been taken/are being 

taken by the Trust to mitigate the risk of future deaths and address the concerns you have raised. 

RESOURCE ALLOCATION 

As an Acute Medical Trust, East Suffolk and North Essex NHS Foundation Trust (“ESNEFT”) provide a 

wide range of services to patients, some of which necessitate 7-day coverage, while others do not 

mandate a permanent presence within a 7-day period. ESNEFT must manage these competing service 

needs within the constraints of finite funding availability across all its services.  

In relation to the specialist dietetic service provision, the Trust has reviewed its position and maintain 

that the provision of dietetic support in the acute setting is best administered through clinical service 

 
 during the weekday working hours, and robust care plans and enteral feeding starter regimes which 

are available for all staff to follow outside of weekday working hours.  

ACTIONS BEING TAKEN BY THE TRUST 

To ensure that patients who may need dietetic input outside of the weekday working hours receive 

the right care, the Trust has undertaken a project to ensure all relevant ward areas receive consistent 

and compliant training related to dietetic care planning. 

The Trust has, through the implementation of a new electronic patient record system, the capability 

to monitor adherence and compliance with dietetic care planning in real time. This will now make up 

part of the Trust’s audit programme. This audit has been registered formally within the 2026/27 Audit 

Programme,  which  will  enable  regular  audit  cycle  to  give  assurance  on  compliance  and  learning 

opportunities and feedback to the Division/Trust on areas of concern. 

A therapeutic review of processes is being carried out across both sites to ensure policies, procedures 

and  practices  are  in  line  with  current  guidance  and  are  implemented  in  a  consistent  approach 

throughout the Trust. 

The dietetics team are also seeking to develop an escalation process for out of hours periods, which 

will be compliance audited regularly. 

The Trust hopes that the above information demonstrates the actions being implemented by the Trust 

and adequately responds to your concerns 

I would like to personally extend our sincerest condolences to Suzanne’s family for their loss. 

If I can be of further assistance, please do not hesitate to contact me. 

Yours sincerely 

Interim Chief Executive Officer 
East Suffolk & North Essex NHS Foundation Trust

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