Prevention of Future Deaths reports · 2026

Yunus Hoque

Regulation 28 report to prevent future deaths, reference 2026-0113, written 26 Feb 2026. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Feb 2026
Reference2026-0113
DeceasedYunus Hoque
CoronerBenjamin Myers
Coroner areaManchester South
CategoryChild Death (from 2015) · Emergency services related deaths (2019 onwards)
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  

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  North West Ambulance Service 

1 

CORONER 

I am Benjamin Myers KC, Assistant Coroner for the coroner area of Greater Manchester 
South 

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 the 22nd January 2024, an inquest was opened concerning the death of Yunus 
Hoque, aged 13 years at the time of death.  The inquest was heard with a jury on the 9th 
February 2026 to the 12th of February 2026.  

The jury found the medical cause of death to be: 

1a) Multi-organ failure  
1b) Group A Streptococcus bronchopneumonia and Sepsis 

The jury returned a conclusion of natural causes contributed to by neglect. 

4 

CIRCUMSTANCES OF THE DEATH 

On the 14th January 2024, Yunus Hoque became ill with a viral infection.  Over the 
course of the following week he became increasingly unwell.  A Group A streptococcal 
infection overlayed the viral infection.  By the 18th January 2024, Yunus was struggling 
to lift his head from his pillow, he had a high temperature and he could not walk 
downstairs unaided.  He was sleepy and ceased to eat. He continued to deteriorate.   
His mother called 111 at 22:42 hours on the 21st January 2024.  The outcome of the 
assessment by North West Ambulance Service [‘NWAS’] in that call was that this was a 
Category 2 response.  Category 2 had an average response time of 18 minutes.  His 
mother was informed that there would be an ambulance in about an hour.  By 00:52 no 
ambulance had attended, by which time Yunus was having a seizure.  His mother called 
999 and on assessment during that call, this was now a Category 1 response.  The 
average response time for Category 1 was 7 minutes.  An ambulance was allocated at 
00:56 hours and arrived at Yunus’s home at 01:01 hours.  Yunus arrived at Tameside 
General Hospital at  01:20 hours, by which time he was in respiratory arrest.  He went 
into cardiac arrest at the hospital.  There was no response to repeated attempts at 
resuscitation.  Death was certified at 02:53 hours. 

5 

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 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.  The target response time for a Category 2 response was 18 minutes.  The caller 

was told that an ambulance would be with Yunus in about an hour. 

2.  A period of approximately 2 hours elapsed during which no ambulance arrived, and 
before the caller, Yunus’s mother, called 999.  During this period, no communication 
was received by the caller from NWAS, or on their behalf, to inform her that there 
would be this unforeseen delay. 

3.  During this 2 hour period, Yunus’s condition deteriorated further, moving from 

Category 2 to Category 1.   

4.  No further calls had been made by Yunus’s mother during this period because it was 

her understanding that an ambulance would be with Yunus within the period of time 
indicated in the first call.  Therefore she waited. 

5.  The evidence at the inquest established that the categorization in each call was at 

the appropriate level. 

6.  However, it is apparent that in circumstances where there is a significant delay over 
and above that indicated to the caller, there is no follow-up call or communication to 
indicate further delay, to confirm the status of the patient, or to suggest that 
alternative transport is required, if possible.  Notwithstanding this, in a changing 
situation, a patient may deteriorate, moving from Category 2 to Category 1 and 
therefore requiring a more urgent response: as was apparent from the evidence at 
this inquest.  But a patient, family member and / or carer who relies upon information 
already provided by the call handler, may continue to wait for an ambulance that 
they have been told will arrive in a given period of time, when in reality there is no 
likelihood of that ambulance arriving.  At the same time, NWAS will be proceeding 
on the basis that they are dealing with a Category 2 when the case has now become 
a Category 1. 

7.  The evidence established that Yunus was so ill by the time of the first call to 111 at 
22:42 on 21st January 2024, that the delay in the arrival of an ambulance did not 
contribute to his death.  

8.  Nevertheless, the absence of any system for a follow-up call by or on behalf of 

NWAS in circumstances where an unforeseen delay in ambulance attendance is 
going to be far in excess of that indicated to the caller, creates a risk that further 
deaths could occur, given that during this period a patient may deteriorate and their 
categorization can move to Category 1 from a lower category. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you [and/or 
your organization] 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 23rd April 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. 

8 

COPIES and PUBLICATION 

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

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Mother of Yunus Hoque, on behalf of the family, Tameside Metropolitan Borough 
Council, Tameside General Hospital 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 other 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. She may send a copy of this report to any person who she 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. 

9 

Date: 26th February 2026 

Benjamin Myers KC 
HM Assistant Coroner 
Greater Manchester South

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 Nwas (PDF)
Mr Benjamin Myers KC 
His Majesty’s Assistant Coroner  
Greater Manchester South Coroners Court  

By Email Only  

21 April 2026  

Dear Mr Myers 

LADYBRIDGE HALL 
399 Chorley New Road 
Bolton 
BL1 5DD 

nwas.nhs.uk 

Regulation 28 Report – Inquest Touching the Death of Yunus Hoque 

I write further to your Prevention of Future Deaths Report dated 26th February 2026, which was issued to North 
West Ambulance Service (“NWAS”) following the conclusion of the inquest touching the death of Yunus Hoque. 

I am aware that you will share my response with Yunus’s family, and I firstly wish to express my sincere condolences 
to them. NWAS’ core purpose is to save lives, prevent harm and provide services which optimise the likelihood of 
positive patient outcomes.  

Through the Regulation 28 report, you have requested that NWAS considers your matters of concern and have 
suggested that action is taken to prevent future deaths occurring in the future. By this letter I will address those 
concerns as far as I am able.  

The absence of any system for a follow-up call by or on behalf of NWAS in circumstances where an unforeseen 
delay in ambulance attendance is going to be far in excess of that indicated to the caller, creates a risk that further 
deaths could occur, given that during this period a patient may deteriorate and their categorisation can move to 
Category 1 from a lower category. 

I can confirm that since Yunus’ death in January 2024, NWAS has implemented a number of steps to ensure more 
accurate estimated time of arrival information is provided to callers. Previously, estimated times of arrival were 
provided based on information taken from across the whole geographical area of the Trust. NWAS has since moved 
to  providing  estimated  times  from  each  of  the  areas  within  the  Trust:  North  Cumbria,  South  Cumbria  and 
Lancashire,  Greater  Manchester,  and  Cheshire  and  Merseyside.  This  provides  the  caller  with  a  more  accurate 
estimated time of arrival, as the different regions of the Trust experience different demand challenges throughout 
the day.  

In  addition,  following  consistent  monitoring  to  ensure  the  most  accurate  reading  is  taken  to  provide  this 
information, it has been concluded that the ‘mean’ time provides the most accurate information which is now used 
across NWAS. 

When patients are waiting for an ambulance, I can confirm that the calls are regularly reviewed by senior clinicians 

Head uarters: 

Lad brid e Hall, 399 Chorley New Road, Bolton BL1 5DD 

Delivering the right care, 
at the right time, 
in the right place; 
every time. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 within our Contact Centres for potential deterioration. All waiting calls are also prioritised by these senior clinicians 
to ensure our ambulances are sent to our most critical patients as a priority. 

Unfortunately, this does not mean that we are able to provide an exact time of arrival for an ambulance, due to 
constraints on demand and the requirement to dispatch ambulances to the most critical patients in order of need. 
The reality is, with the finite resources available to the Trust, if NWAS were to carry out call-backs to patients to 
update them on unexpected changes to their estimated time of arrival, it would reduce our capacity to answer 999 
calls for other patients and to provide essential information to callers. 

However, prior to the closure of each call, we provide interim care advice which gives the caller advice on how to 
care for the patient until the ambulance arrives. Full worsening advice is also provided, advising the caller to contact 
999 straight away if there are any changes in the condition of the patient, if they are worried about the patient, or 
if they have any other concerns. This creates the opportunity for the patient’s condition to be re-triaged and the 
appropriate categorisation to be elicited for their symptoms and condition. 

In our experience, the most effective way to minimise waiting times and reduce anxiety for callers is to provide the 
most accurate estimated time of arrival possible at the time of the call, provide clear worsening advice, maintain 
clinical  oversight  of  all  waiting  calls  and  reprioritise  them  based  on  clinical  need,  and  maximise  ambulance 
availability by using the full range of alternative care pathways across the North West. 

Nevertheless, I can confirm that NWAS are currently exploring the use of SMS text messaging to patients who are 
waiting for an ambulance or a further clinical assessment from an NWAS clinician or external provider. This work is 
in the initial stages but will provide improved information to our callers whilst they await a response. 

In addition to the above I would like to highlight that NWAS has made significant improvement in its Category 1 and 
2 response times since Yunus’ death. This has been achieved by improving the number of responding ambulances 
available for dispatch by employing more Paramedics and Emergency Medical Technicians. We have also increased 
the  number  of  clinicians  telephoning  patients  to  complete  a  full  clinical  triage  and  referring  into  alternative 
pathways of care. This enables our responding ambulances to attend to our most critically unwell patients who 
require a Category 1 or 2 response. 

I am grateful to you for bringing this matter to my attention and I am sorry that you felt it necessary to issue a 
Prevention of Future Deaths Report to NWAS. If you require any further clarification or information, please do not 
hesitate to contact me or the Trust’s Deputy Director of Corporate Affairs, Emma Shiner.  

Yours sincerely 

Chief Executive

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