Prevention of Future Deaths reports · 2026

Madison Smith

Regulation 28 report to prevent future deaths, reference 2026-0179, written 26 Mar 2026. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Mar 2026
Reference2026-0179
DeceasedMadison Smith
CoronerAlison Mutch
Coroner areaManchester South
CategoryChild Death (from 2015)
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:  

Secretary of State for Health and Social Care 

1  CORONER 

I am Alison Mutch, Senior Coroner, for the coroner area of 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 28th October 2024 I commenced an investigation into the death of 
Madison James Bruce SMITH. The investigation concluded at the end of 
the inquest on 23rd March 2026. The conclusion of the inquest was 
narrative: Died in circumstances where his cause of death could not 
be ascertained whilst asleep in his cot having been placed prone in 
an unsafe sleeping position. The medical cause of death was 
unascertained. 

4  CIRCUMSTANCES OF THE DEATH 

Madison James Bruce Smith was born on 1st June 2024. He was a 
healthy baby who lived with his parents. Due to concerns about his 
pattern of sleeping during the day his parents engaged a person who 
described themselves as a maternity nurse. The maternity nurse was 
listed on a maternity agency platform. Any person can describe 
themselves as a maternity nurse or a sleep nurse or a post-natal nurse. 
No qualifications are required and there is no regulation of persons 
holding themselves out as maternity nurses or the agencies that offer 
training courses or their services. In this case the maternity nurse and the 
owner of the agency had no medical qualifications other than a basic first 
aid qualification. The use of the word nurse gave the impression of a level 
of knowledge and skills that were not present. 
 The maternity nurse placed Madison in his cot in a prone position to 
sleep on the night of 17th October. The placing of a baby of his age in 
such a position is contrary to all national guidance in relation to safe 
sleeping and is known to be a significant risk factor for the sudden and 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 unexpected deaths of babies. He should not have been placed in a prone 
position. Madison stirred several times in the night. He was not checked 
other than visually via a monitor or once at a distance to ensure he was 
coping with the unfamiliar sleeping position. The maternity nurse had 
taken responsibility for checking on him. He should have been checked 
on closely particularly when he cried. At 7am on 18th October 2024 he 
was found unresponsive by his father in his cot. He was taken to 
Wythenshawe Hospital where Doctors confirmed he had died on 18th 
October. A post-mortem examination was unable to give a cause of 
death. However, it was identified that prone sleeping created an 
increased risk of his sudden unexpected death. 

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 inquest heard evidence that there is a significant demand from 
families with very young children who would like to get their children into 
a sleep routine at an early stage. To meet that demand there are now 
agencies and individuals who seek to meet that demand. However, the 
inquest was told that there is no statutory regulation of these individuals 
or of the agencies. Consequently, anyone can set up an agency that 
purports to offer training and expertise in maternity services. They need 
not have any formal training or any medical qualification. The courses 
they offer do not need to be quality assured or meet any minimum 
standards.  

2. Anyone the inquest was told, can attach the term nurse to a word such 
as night/maternity/ post-natal. The inquest was told that only the term 
registered nurse is protected and restricted in its use. An individual who 
has no medical training or formal early years training can offer their 
services to a family with young children describing themselves as for 
example a maternity nurse. This can the inquest was told give a 
misleading impression of their expertise and skill set to a family 
employing them. A statutory bar on the word nurse being used by anyone 
other than a registered nurse on the NMC register would avoid this 
situation from arising. 

3.The inquest was told that the promotion of prone sleeping by 
unqualified individuals describing themselves as maternity nurses and 
experts in sleeping poses a very significant risk to a young baby. A baby 
will sleep more deeply in a prone position which is why superficially it can 
seem to be a solution where a baby sleeps poorly. However, whenever a 
young baby is placed in such a position it will increase the risk that they 

 
 
 
 
 
 
 
 will die suddenly and unexpectedly. All health professionals need to be 
vigilant in continuing to emphasise the national guidance on safe sleeping 
and be vigilant in flagging up to a family that prone sleeping in a child that 
cannot independently turn over is not a solution to a poor sleep routine 
but rather is a factor that increases the risk of a sudden and unexpected 
death.   

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 21st May 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 namely the Family, Ruthie Maternity Services, 
 , Child Death Overview Panel who may find it useful or of 

interest. 

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. They may send a copy of this report to any person who 
they believe 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  Alison Mutch OBE 
Senior Coroner 

26/03/2026

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 Department of Health and Social Care
Minister of State for Health (Secondary Care) 

39 Victoria Street 
London 
SW1H 0EU 

HM Coroner Alison Mutch OBE 
Coroner’s Court  
1 Mount Tabor Street 
Stockport SK1 3AG 

11 May 2026 

Dear Ms Mutch,  

Thank you for the Regulation 28 report of 26 March 2026 sent to the Secretary of State for 
Health and Social Care about the death of Master Madison James Bruce Smith.  

Firstly,  I  would  like  to  say  how  saddened  I  was  to  read  of  the  circumstances  of  Master 
Smith’s  death,  and  I  offer  my  sincere  condolences  to  his  family  and  loved  ones.  The 
circumstances  your  report  describes  are  very  concerning  and  I  am  grateful  to  you  for 
bringing these matters to my attention.  

The report raises concerns over the lack of statutory regulation of individuals or agencies 
purporting to offer training and expertise in maternity services; that anyone can attach the 
term  ‘nurse’  to  a  word  such  as  ‘night’,  ‘maternity’  or  ‘post-natal’;  and  the  risk  posed  to  a 
young baby by the promotion of prone sleeping. 

In preparing this response, Departmental officials have made enquiries with NHS England 
to ensure we adequately address your concerns. 

Regarding  statutory  regulation  and  the  protection  of  the  title  ‘nurse’,  I  understand  your 
concern that none of the roles mentioned in your report (‘maternity nurse’, ‘sleep nurse’ or 
‘post-natal nurse’) are regulated professions, and that anyone can set up an agency that 
implies  training  and  expertise  in  maternity  services  without  any  formal  training  or  any 
medical qualification. As you are aware, the Nursing and Midwifery Council (NMC) is the 
independent regulator of nurses and midwives in the UK, and nursing associates in England. 
It is a criminal offence for a person to claim, with intent to deceive (whether expressly or by 
implication), that they are on the NMC Register when they are not, to use a protected title to 
which  they  are  not  entitled,  or  to  falsely  claim  that  they  have  qualifications  in  nursing  or 
midwifery. As you point out, currently, the title ‘registered nurse’ is protected in law. This is 
obviously  not  enough  to  safeguard  the  public,  and  we  are  taking  action  to  address  the 
misuse of the trusted title ‘nurse’ by unregulated professionals. 

As part of reforms to the NMC’s legislative framework, we will create a new protection of title 
offence, making it a criminal offence for anyone who is not a registered nurse with the NMC 
to call themselves a nurse (with some limited, specified exceptions).  

 
 
 
 
 
 
 
 
 
 
 
 
  
  
  
  
 
 The  term  ‘nurse’  is  used  across  multiple  professions  –  for  example,  ‘dental  nurse’  and 
‘veterinary nurse’ – and it is not our intention to prevent the legitimate use of the title ‘nurse’ 
in  these  instances.  The  legislation  will  therefore  include  exemptions  to  allow  other 
professionals to use the  title  legitimately, and  later this year  we  will  be  seeking  views on 
which  roles  should  be  exempted.  The  Government  will  continue  to  work  with  key 
stakeholders, including the NMC, the devolved governments, the Royal College of Nursing, 
trade unions, other professional representatives and the social care sector, on developing 
the protection of title offence. 

Regarding  safe  sleeping  guidance,  I  understand  the  risk  posed  to  young  babies  by  the 
inappropriate promotion of prone sleeping by unqualified individuals. Guidance published 
by the National Institute for Health and Care Excellence states that all maternity services 
should provide advice to parents postnatally on safe sleeping, including that babies sleep 
on  a  firm,  flat  mattress,  lying  on  their  back.  NHS  England  also  provides  advice  online  at 
NHS.UK. This includes how to reduce the risk of Sudden Infant Death Syndrome (SIDS) and 
includes links to guidance from The Lullaby Trust.  

NHS England further emphasises the importance of consistent, evidence-based messaging 
from  maternity  and  neonatal  professionals.  All  parents  should  receive  information  about 
established guidance on safer sleeping at antenatal, postnatal and health visiting contacts. 

I hope this response is helpful. Thank you for bringing these concerns to my attention.   

Yours sincerely,  

MINISTER OF STATE FOR HEALTH

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