“NEAS Trust confirmed in evidence that a more detailed assessment of AG should have been…”
Dated 14 Sep 2022, from the coroner for Newcastle and North Tyneside. Sent to 1 organisation or person.
A coroner wrote this report after an inquest, to warn the organisations below about a risk of further deaths.
The 56-day response deadline
Deadline passedReplies were due by 9 Nov 2022. A reply may have been sent and not yet published.
Organisations that receive a report must reply to the coroner within 56 days, saying what they will do or why they will do nothing. We show whether a response is published on judiciary.uk.
- Report dated14 Sep 2022
- Deadline9 Nov 2022
- Published on judiciary.uk6 Oct 2022
- Today22 Oct 2026
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Responses from each recipient
| Sent to | Response |
|---|---|
| North East Ambulance Service NHS Foundation TrustNamed in the report as “North East Ambulance Service” | Deadline passedNo response published on judiciary.uk so far. The 56-day deadline was 9 Nov 2022. A reply may have been sent and not yet published. |
The coroner’s concerns
– (1) NEAS Trust confirmed in evidence that a more detailed assessment of AG should have been undertaken and Clinical input sought leading to Ambulance dispatch and potentially an 5 alternative outcome for AG. Learning from the incident was limited to 'discussion' with 2 staff involved. Serious events of this nature should be subject of Trust wide learning and training to prevent future deaths. (2) Comprehensive retraining is required for those directly involved. (3)An urgent review of Trust policy/protocol for handling/management of mental health related incidents should be undertaken and associated training in respect thereof. (4)Trust to review the events leading to AG's death and identify any additional safeguards they may put in place to prevent future deaths.
An extract. Read the full report, including the circumstances of the death, on the Courts and Tribunals Judiciary website.
- Source
- judiciary.uk, Prevention of Future Deaths reports, 2022-0292
- Added to Minute Book
- 8 Oct 2026
- Reuse
- We show short extracts and link to the original. We don’t host the full report.
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Contains public sector information licensed under the Open Government Licence v3.0. Source: Courts and Tribunals Judiciary, judiciary.uk. Open Government Licence v3.0
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