Coroners issue warnings to NHS trusts in relation to deaths in hospitals

Posted 26/09/2012

Coroners have the power to make recommendations to any organisation for changes in their practices if at the end of an inquest they think these might help prevent future deaths.  The latest figures have just been published and show that recommendations made between October 2011 and March 2012 have soared from 189 for the same period a year earlier to 233.  The latest figures showed the highest number of reports in any six month period since reporting began in 2008.

Over one third of all the reports made related to deaths in hospital.  There were 88 reports relating to hospitals with the next most numerous section relating to road deaths, where 30 reports were issued.  There were 27 reports relating to mental health deaths.

Coroners warned of the danger of low staffing levels drawing attention specifically to cover in the evenings, at weekends and over public holidays.  Twenty-three of the reports said that hospitals must keep better records of patients’ medical details and urged hospital staff to improve communication to avoid preventable deaths.

Trefine Maynard, a solicitor with the specialist Medical Negligence team at Ashtons Legal, said: “These recommendations come on the back of reports that have highlighted what has been called the ‘nine to five’ culture in hospitals that results in an increase of deaths in hospital outside that period of up to 10%. All too often, cases brought to us prove to involve hospital records which are incomplete, involve treatment (or failures in treatment) at weekends or over bank holiday periods.  We have all suspected for a long time that this was not coincidence and the recent media reports have confirmed the connection. 

The recommendations made by coroners have particular poignancy for me having only just attended an inquest where issues of poor staffing levels and incomplete hospital records, played a part in the events being investigated.  I, and all the lawyers working in this field, welcome the recommendations made by Coroners and hope that they will lead to real improvements.  Most of all we hope that they will lead to a sharp reduction in avoidable deaths.”