Prevention of Future Deaths reports · 2026

Julie Ley

Regulation 28 report to prevent future deaths, reference 2026-0318, written 17 Apr 2026. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report17 Apr 2026
Reference2026-0318
DeceasedJulie Ley
CoronerRobert Cohen
Coroner areaCumbria
Organisation namedLancashire & South Cumbria NHS Foundation Trust
Sourcejudiciary.uk record
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

Miss K J Gomersal LLB | Senior Coroner | Cumbria 

           HM Coroner's Courts, Allerdale House, Workington, Cumbria CA14 3YJ            

17 April 2026 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:  Lancashire and South Cumbria NHS Foundation 
Trust 

1) CORONER 

I am Mr Robert Cohen, HM Assistant Coroner for Cumbria 

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. 

http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 

http://www.legislation.gov.uk/uksi/2013/1629/part/7/made 

3) INVESTIGATION and INQUEST 

On 19 May 2025 an investigation commenced into the death of Julie Ley. The investigation 
concluded at the end of the inquest.  

The conclusion of the inquest was the following narrative: 

Julie Ley was 71 years old. She had a substantial history of mental illness. In December 2024 
Mrs Ley's condition deteriorated and she became progressively more anxious and had 
depressive symptoms. On several occasions Mrs Ley was admitted to hospital before being 
discharged to different supportive environments. However on each occasion Mrs Ley's 
symptoms made it impossible for her to care for herself and she was readmitted to hospital. 
On 16th January 2025 Mrs Ley was admitted to the Kentmere Ward at Westmorland General 
Hospital. Mrs Ley's condition worsened over time and she was detained under the Mental 
Health Act 1983 from 7th April 2025.  

The care received by Mrs Ley on the Kentmere Ward was inadequate. From mid April 2025 

 
 
  
   
 
  
  
  
  
 
 Mrs Ley became increasingly withdrawn and unkempt. Insufficient support was provided to 
her. In May 2025 Mrs Ley stopped accepting medication, food or drink. Monitoring of Mrs 
Ley's nutrition was not undertaken with appropriate diligence and she was not referred for 
treatment at a more appropriate hospital where IV therapy could be administered. The 
powers available under the Mental Health Act to give treatment without Mrs Ley's consent 
were also not used.  

Mrs Ley's physical condition deteriorated. Her risk of embolus was not properly monitored. 
On 15th May 2025 Mrs Ley died, on the Kentmere Ward, as a result of a deep vein thrombi. 
Her death was confirmed at 15:42.  

Lancashire and South Cumbria NHS Foundation Trust have accepted that there were failures 
in respect of Mrs Ley's nutrition, physical health monitoring, and use of legal frameworks and 
that Mrs Ley would not have died but for these failings.  

Mrs Ley's death was contributed to by neglect, being the failure to monitor her nutrition, the 
failure to transfer her to a hospital able to treat her worsening condition and the failure to use 
available powers to administer medication to her. 

The medical cause of Mrs Ley's death was: 

1a   Myocardial fibrosis and pulmonary thrombo-emboli due to deep vein thrombi 

1b    

1c    

 II     

4) CIRCUMSTANCES OF THE DEATH 

In addition to the matters recorded in the above narrative, I heard evidence that when CPR 
was delivered to Mrs Lay it took place on her bed, a soft surface.  

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 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.  – 

(1) The consultant who was involved in performing CPR on Mrs Ley agreed that she had 
been in bed at the time. When asked why he had not moved her to a solid surface he replied 
that he had attended many advanced life support training sessions and had never been told 
this was necessary. In their article "The impact of compliant surfaces on in-hospital chest 
compressions: Effects of common mattresses and a backboard" in the journal Resucitation 
(Vol 80, Issue 5, May 2009) the authors notes that carrying out CPR in a hospital bed may be 
50% less effective. I am concerned that despite receiving training a senior clinician was 
unaware of this and consider that it gives rise to a risk of future deaths. 
6) ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you Lancashire 
and South Cumbria NHS Foundation Trust 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 12th June 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 Interested Persons  

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. 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. 
17 April 2026 

Signature 

Robert Cohen  

HM Assistant Coroner for Cumbria

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 Lancashire and South Cumbria NHS Foundation Trust
Lancashire & South Cumbria NHS Foundation Trust 
Sceptre Point 
Sceptre Way 
Walton Summit 
Preston 
PR5 6AW 

24th April 2026 

Private & Confidential 

Mr Robert Cohen 
His Majesty’s Assistant Coroner  

Sent by e-mail:  

Dear Mr Cohen 

Thank  you  for  bringing  your  concerns  to  the  Trust’s  attention.  We  are  grateful  to  you  for 
identifying the matters set out in your report and for the opportunity to respond formally. 

On behalf of Lancashire & South Cumbria NHS Foundation Trust, I would also like to offer our 
sincere  condolences  to  the  family  of  Mrs  Ley.  We  recognise  the  profound  loss  they  have 
suffered  and  wish  to  reiterate  our  apology  for  the  deficiencies  in  care  identified  within  our 
internal investigation and during the course of the inquest. It is accepted that aspects of Mrs 
Ley’s care fell below the standard that she was entitled to expect, and we are deeply sorry for 
this. 

Your report highlights that cardiopulmonary resuscitation (CPR) was performed while Mrs Ley 
remained on a hospital bed, and refers to published literature from 2009 which indicates that 
chest  compressions  delivered  on  a  compliant  surface  may  be  less  effective  than  those 
delivered on a firm surface. You have expressed concern that this may give rise to a risk of 
future deaths. 

The Trust fully accepts the underlying principle that CPR is most effective when performed on 
a firm surface. However, the Trust considers it important to set out clearly the current national 
position, particularly as this response will be published and considered by a wider audience. 

Since the publication of the article cited in your report, national and international resuscitation 
guidance has evolved. Current Resuscitation Council UK guidance recognises that, although 
a firm surface is optimal, rescuers should not move a person from a soft surface, such as a 
bed, to the floor in order to commence CPR. The guidance emphasises that CPR should be 
started  without  delay  on  the  bed  and  that,  where  required,  chest  compressions  should  be 
delivered with increased depth to compensate for mattress compliance, alongside the use of 
appropriate mitigation such as backboards. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 This guidance reflects the need to balance optimal CPR mechanics with the practical realities 
of  in-hospital  cardiac  arrest,  including  the  risks  associated  with  manual  handling  and  the 
importance of avoiding any delay in commencing life-saving treatment. 

The Trust’s resuscitation practice is aligned with this current national guidance. In response 
to the matters raised in your report, the Trust has nevertheless taken steps to reinforce and 
assure this  position  through  resuscitation  training,  policy review, equipment  assurance  and 
clinical  governance  processes,  in  order  to  minimise  the  risk  of  misunderstanding  or 
inconsistent practice in the future. 

The  Trust  confirms  that  it  has  no  objection  to  this  response  being  published  and,  indeed, 
considers  publication to be  important  so that  there  is  clarity  regarding  current  resuscitation 
guidance and no misunderstanding about the Trust’s position in relation to CPR delivered in 
inpatient settings. 

We would, of course, be happy to meet with you or members of your office should you consider 
it helpful to discuss this response further or to provide any additional explanation. 

Thank you again for raising these matters. 

Yours sincerely, 

Chief Executive

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