Prevention of Future Deaths reports · 2026

Graham Hollis

Regulation 28 report to prevent future deaths, reference 2026-0330, written 1 Jul 2026. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report1 Jul 2026
Reference2026-0330
DeceasedGraham Hollis
CoronerKelly Dixon
Coroner areaStaffordshire and Stoke on Trent
Organisation namedUniversity Hospitals of Derby and Burton NHS Foundation Trust
Sourcejudiciary.uk record
Responses published2

The report

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

REPORT TO PREVENT FUTURE DEATHS
REGULATION 28 OF THE CORONERS (INVESTIGATIONS) REGULATIONS
2013

Please do not include any living persons’ names in this document, in
accordance with the Chief Coroner’s PFD Publication Policy (2026).

1.

2.

3.

CORONER
I am Kelly DIXON, H M Assistant Coroner, for the coroner area of
Staffordshire and Stoke-on-Trent.

DATE OF REPORT
01 July 2026

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.

4.

THIS REPORT IS BEING SENT TO

1. University Hospitals of Derby and Burton NHS Foundation Trust
2. Staffordshire and Stoke-on-Trent Integrated Care Board

You are under a duty to respond to this report within 56 days of the date of this
report, namely by August 21, 2026. I, the coroner, may extend the period if an
appropriate application is made.

5.

YOUR RESPONSE
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.

I have a duty to send a copy of your response to the Chief Coroner.

In accordance with the Chief Coroner’s Publication Policy, you should send
me any representations regarding publication of your response. These
representations should be made at the same time as the response is provided.
I will pass any representations received to the Chief Coroner for a decision.

Please note any links to webpages included in the response will not be
checked for sensitive information prior to publication, as the information is
already online.

The names of those who do not respond to PFD reports are regularly
published on the Chief Coroner’s webpages Non-responses to Prevention of
Future Death (PFD) reports - Courts and Tribunals Judiciary.

6.

SUMMARY OF CORONER’S CONCERN

 That the Speech and Language Therapy team were unable to assess care
home residents.

7.

ACTION SHOULD BE TAKEN
In my opinion unless action is taken to address the above concerns then there
is a significant risk of future deaths and I believe each of you have the power
to take such action.

8.

INVESTIGATION AND INQUEST

On 08 September 2025 I commenced an investigation into the death of
Graham Keith HOLLIS aged 75. The investigation concluded at the end of the
inquest on 22 June 2026. The conclusion of the inquest was that:
Graham Keith Hollis, aged 75, died on 14 August 2025 at Queen’s Hospital
Burton after being admitted from his care home. He had recently been
prescribed antibiotics on 30 July 2025 following a suspected aspiration of
fluids. He was admitted to hospital after experiencing three choking episodes
on 3 and 4 August 2025. Mr Hollis died from aspiration pneumonia, with
dementia and frailty of old age contributing to his death. It is not possible to
determine what he aspirated on.

9.

CIRCUMSTANCES OF DEATH

Mr Hollis had significant pre-existing conditions, including dementia, and in the
period before his death experienced marked weight loss, reduced mobility and
increasing frailty. By late 2024 he developed coughing when drinking and was
placed on a Level 4 puréed diet with thickened fluids, which was confirmed as
appropriate by the Speech and Language Therapy (SALT) team during a
hospital admission in February 2025. During 2025 his weight loss became
more pronounced and family raised concerns that he was not tolerating the
puréed diet and was refusing food. Despite attempts to obtain a further SALT
assessment, this did not take place due to staffing shortages, with advice
provided remotely without assessment. At a best interests meeting on 21 July
2025, it was agreed that he would be fed at risk on a supervised Level 5
minced and moist diet, with a plan to revert to Level 4 if concerns arose.

Following this change, Mr Hollis initially showed improved engagement with
food but remained at risk of choking and aspiration. Between 30 July and 4
August 2025 he experienced a number of coughing and choking episodes,
including incidents where he was fed food inconsistent with the agreed diet
and where required safeguards, including seeking medical review and
reverting to Level 4, were not followed. After a further choking episode on 4
August, he was admitted to hospital and diagnosed with aspiration pneumonia.
Although he received treatment, his condition deteriorated and he died on 14
August 2025. The cause of death was aspiration pneumonia, with dementia
and frailty contributing; however, it was not possible to determine when, or on
what, he aspirated.

10. CORONER’S CONCERNS

During the course of the inquest I heard evidence 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:

The Speech and Language Therapy team advised the care home that, due to
current staffing levels, the service was unable to undertake assessments of
care homes residents, and that this issue had been escalated to the Integrated
Care Board. This was the position in July 2025, and the evidence confirmed
that it remained unchanged at the time of the inquest in June 2026.

In the absence of a SALT face to face assessment and with no alternative
provision available, a best interests meeting was convened involving the care
home manager, the social worker, the GP Surgery’s care coordinator, and the
deceased’s daughter. It was agreed that the deceased would be fed with
accepted risk on a Level 5 diet without specialist assessment.

11. COPIES AND PUBLICATION OF THIS REPORT

I have a duty to send a copy of my report to every Interested Person who in
my opinion should receive it.

I also may send a copy of the report to any other person who I believe may
find it useful or of interest.

I can confirm I have sent the report to:

 Family
 Mount Pleasant Residential Home
 GP Surgery
 Primary Care Network

I also have a duty to send a copy of the report to the Chief Coroner.

You may make representations to me, the coroner, about the publication of the
contents of this report in line with Chief Coroner’s PFD Publication Policy
(2026). Any representations will be sent to the Chief Coroner alongside the
report. Please refer to box 4 above for additional information relating to the
publication of reports and responses.

12. SIGNATURE

Kelly DIXON
H M Assistant Coroner for
Staffordshire and Stoke-on-Trent

Responses

2 responses 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 Staffordshire and Stoke on Trent Integrated Care Board
HM Assistant Coroner Kelly Dixon 
Staffordshire and Stoke-on-Trent 
Coroner's Service 

Wellington Civic Offices, 
Larkin Way, Tan Bank,  
TF1 1LX

Monday 17th August 2026 

Dear Assistant Coroner Dixon, 

Regulation 28 Report to Prevent Future Deaths 

Deceased: Graham Keith Hollis 
Date of Report: 1 July 2026 

Thank you for your Prevention of Future Deaths Report issued under Regulation 28 
of the Coroners (Investigations) Regulations 2013 following the inquest into the 
death of Mr Graham Keith Hollis. 

The Staffordshire and Stoke-on-Trent Integrated Care Board (ICB) recognises the 
concerns raised regarding the availability of Speech and Language Therapy (SALT) 
assessments for care home residents in East Staffordshire and welcomes the 
opportunity to outline the actions taken and planned in response. 

Response to the Matter of Concern 

The concern identified by the Court relates to evidence that the Speech and 
Language Therapy service was unable to undertake face-to-face assessments of 
care home residents because of workforce shortages, and that this position 
remained unchanged at the time of the inquest. 

The ICB commissions Speech and Language Therapy services from University 
Hospitals of Derby and Burton NHS Foundation Trust (UHDB) for Care Homes in 
East Staffordshire and requires providers to maintain safe and effective services for 
the populations they serve. During the period in question, UHDB experienced 
significant workforce challenges within the Speech and Language Therapy service 
which affected its ability to provide assessments to some care home residents. 

Actions Taken 

The ICB became aware of the workforce capacity issues through established 
contract management and oversight arrangements with UHDB. The matter has been 
reviewed through regular contract meetings and provider assurance processes, with 
the Trust required to report on service performance, risks and mitigation plans. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Whilst recruitment and retention challenges have affected the provider's ability to 
fully staff the service, interim arrangements have been implemented to ensure 
clinical support remains available pending restoration of full service capacity. These 
arrangements include: 

•  Provision of specialist advice and guidance by the Speech and Language 
Therapy service to care homes through remote support mechanisms, 
including email advice. 

•  Ongoing escalation routes for complex cases where specialist input is 

required. 

•  Continued monitoring of service capacity, waiting times and clinical risk 

through routine commissioner-provider oversight arrangements. 

•  Review of the effectiveness of interim pathways to ensure that care homes 
continue to have access to specialist advice while workforce shortages are  
addressed. 

Future Actions 

The ICB recognises the importance of timely access to specialist swallowing 
assessments for care home residents and has therefore: 

•  Continued to hold UHDB to account through contractual performance 

management processes regarding workforce recovery and service capacity. 

•  Commenced planning for recommissioning of the service within the 

community, with consideration being given to service resilience, workforce 
sustainability, responsiveness for care home residents and arrangements for 
managing periods of reduced staffing capacity. 

•  Ensured that lessons arising from this Prevention of Future Deaths report will 
inform future commissioning intentions and service requirements for SALT 
services. 

Conclusion 

The ICB acknowledges the Coroner's concerns and recognises the importance of 
ensuring access to appropriate specialist SALT assessment for care home residents. 
While the staffing challenges experienced by the provider have not yet been fully 
resolved, the ICB has maintained oversight through its contractual mechanisms, 
supported interim advice arrangements to mitigate risk, and is progressing 
recommissioning activity designed to strengthen the resilience and sustainability of 
the service in the future. 

We trust this response provides assurance regarding the actions taken and planned 
by the Integrated Care Board 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Yours sincerely, 

Chief Nursing Officer 
NHS Staffordshire and Stoke on Trent ICB 
NHS Shropshire, Telford and Wrekin ICB 

3
Response from University Hospitals of Derby and Burton NHS Foundation Trust
Ms Kelly Dixon  
HM Assistant Coroner for 
Staffordshire & Stoke on Trent  

21 August 2026 

Dear Madam  

Re:  GRAHAM HOLLIS - Regulation 28 Report Response  

I am writing in response to the Regulation 28 Report dated 1 July 2026 following the 
inquest into the death of Mr Graham Hollis.    

Conscious that Mr Hollis' family will receive a copy of this response, I firstly want to 
begin by offering my deepest condolences to his family.   

I note that you have identified concern that due to current staffing levels the Speech 
and  Language  Therapy  (SALT)  team  are  unable  to  undertake  assessment  of  care 
home  residents.  This  was  the  position  in  July  2025,  and  it  remained  unchanged  at 
the time of the inquest held in June 2026.    

Such  concerns  are  taken  very  seriously,  and  we  are  continually  taking  steps  to 
actively address this.    

I  confirm  that  University  Hospitals  of  Derby  and  Burton  NHS  Foundation  Trust 
(UHDB)  are  commissioned  by  the  South  Staffordshire  and  Stoke  on  Trent  ICB 
(SSOT  ICB)  to  provide  community  SALT  services  to  domiciliary  settings  and 
residential care homes in East Staffordshire.  

The UHDB SALT team has been unable to provide face-to-face assessments since 
January 2025 due to capacity constraints. As a mitigation, the team has continued to 
provide advice remotely where requested, including via telephone and email.   

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 that  offered 

I  understand  that  the  inquest  heard  evidence  that  in  Mr  Hollis'  case  the  clinical 
advice provided by the SALT team by email on 17 July 2025 would not have differed 
the 
to 
recommendations  within  that email  were based on the  clinical  information  available 
at  the  time,  including  the  patient's  history  and  established  risk  factors.  I  appreciate 
however  that  these  were  based  on  the  established  information  from  his  care  team 
rather than  upon a physical examination.  

face  consultation  had 

taken  place,  as 

if  a 

face 

to 

The  Trust  is  continues  to  actively  try  to  recruit  into  the  team  to  close  this  resource 
gap.   

These attempts have included ongoing and active attempts to recruit at Band 7 level, 
which were unfortunately unsuccessful, with applicants withdrawing prior to interview 
on  two  separate  occasions.  There  is,  unfortunately  a  shortage  of  appropriately 
qualified SALT practitioners and efforts to secure locum staff as an interim measure 
have  also  been  unsuccessful.  We  have  also  been  unable  to  fill  this  gap  from  the 
NHS  bank  supply.     This  reflects  the  wider national  context  where  shortages  within 
the SALT workforce are well recognised 

We  have  however  been  able  to  make  some  very  recent  progress.  Upon  recent 
interview  we  have  secured  a  Band  7  Locum  Speech  and  Language  Therapist  to 
deliver the community based activity. Whilst we had attempted to fill with a full time 
position, the individual concerned is only available 2 days per week.     

A  recruitment  process  is  also  currently  under  way  for  a  Band  6  Speech  and 
Language Therapist with focus on the inpatient service required at Queen's Hospital 
Burton, including the Samuel Johnson and Sir Robert Peel community hospital sites. 
The decision to recruit at Band 6 level reflects a revised strategy aimed at improving 
recruitment success.  Interviews were held on 10 August 2026 for a substantive 0.74 
whole  time  equivalent  Band  6  professional.  Two  appointable  candidates  were 
interviewed. 

The team are now exploring if a temporary Band 6 practitioner post can be appointed 
for  the  wider  SALT  team  based  at  Queens  Hospital  Burton,  utilising  the  potentially 
remaining 0.6  whole  time equivalent  Locum funding, to further  enhance  capacity  to 
deliver  the  community  based  activity.    This  is  of  course  subject  to  candidates 
accepting  offers  of  recruitment,  but  does  offer  us  more  positive  progress  than  on 
previous recruitment drives.  

It  is  the  Trust's  position  that  ultimately  that  community  SALT  services  need  to  be 
delivered by community NHS providers rather than an from an acute provider. This 
remains under active discussion with  our Integrated Care Board colleagues.    The 
long-term aim is to draw Trust commissioning of the service to a close, but this will 

 
 
 
 
 
 
 
 
 
 
 
 
 
 need  to  be  done  in  a  safe  way  with  a  new  provider.  To  achieve  this  the  Trust  is 
exploring alternative service delivery options and is supported by the ICB.  

We  hope  that  this  response  provides  assurance  that  we  are  doing  all  we  can  to 
improve community SALT services taking account of the constraints involved.      

Yours sincerely 

Deputy Chief Executive and Chief Nurse

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